Mechanisms of Antimicrobial Resistance: Highlights on Current Advance Methods for Detection of Drug Resistance and Current Pipeline Antitubercular Agents

Abstract

Background: Sir Alexander Fleming accidentally discovered antibiotics in 1928. Antibiotics have played a significant role in treating infectious diseases. The extensive use of antibiotics has enabled the microorganisms to develop resistance against the antibiotics given, which has become a global concern. This review aims to examine some of the mechanisms behind resistance and advanced methods for detecting drug-resistant and antibacterial drugs in the clinical pipeline.

Methods: An extensive search was carried out in different databases, viz. Scopus, Embase, Cochrane, and PubMed. The keywords used in the search were antimicrobial resistance, antibiotic resistance, antimicrobial tolerance, antibiotic tolerance, and methods to reduce antimicrobial resistance. All the studies published in the English language and studies focusing on antibiotic resistance were included in the analysis.

Results: The most common mechanisms involved in antimicrobial resistance are reflux pumping, antibiotic inactivation, acquired resistance, intrinsic resistance, mutation, bio-film resistance, etc. Antibacterial medicinal products for multidrug resistance (MDR) infections are active against pathogens, which are registered in the World Health Organization (WHO) priority pathogen list (PPL).

Conclusion: Furthermore, their innovativeness was assessed by their lack of cross-resistance. Finally, novel antibacterial drugs without pre-existing inter-resistance, especially those with highresistance gram-negative bacteria and tuberculosis (TB), are understated and urgently required.

Keywords: Antimicrobial resistance; MALDI-TOF; TB drugs pipeline; antibacterial agents; antitubercular agents; mNGS.