Medicine · Literature

Research papers on Antibiotic resistance

Recent and highly-cited academic work on antibiotic resistance, gathered from Semantic Scholar, CrossRef and OpenAlex.

1. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis

   Christopher J L Murray, Kevin S Ikuta, Fablina Sharara, et al. · 2022 · The Lancet · 15,743 citations

   BACKGROUND: Antimicrobial resistance (AMR) poses a major threat to human health around the world. Previous publications have estimated the effect of AMR on incidence, deaths, hospital length of stay, and health-care costs for specific pathogen-drug combinations in select locations. To our knowledge, this study presents the most comprehensive estimates of AMR burden to date. METHODS: We estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with bacterial AMR for 23 pathogens and 88 pathogen-drug combinations in 204 countries and territories in 2019. We obtained data from systematic literature reviews, hospital systems, surveillance systems, and other sourc

2. Identification of acquired antimicrobial resistance genes

   Ea Zankari, Henrik Hasman, Salvatore Cosentino, et al. · 2012 · Journal of Antimicrobial Chemotherapy · 5,184 citations

   OBJECTIVES: Identification of antimicrobial resistance genes is important for understanding the underlying mechanisms and the epidemiology of antimicrobial resistance. As the costs of whole-genome sequencing (WGS) continue to decline, it becomes increasingly available in routine diagnostic laboratories and is anticipated to substitute traditional methods for resistance gene identification. Thus, the current challenge is to extract the relevant information from the large amount of generated data. METHODS: We developed a web-based method, ResFinder that uses BLAST for identification of acquired antimicrobial resistance genes in whole-genome data. As input, the method can use both pre-assembled

3. Antiseptics and Disinfectants: Activity, Action, and Resistance

   Gerald McDonnell, A.D. Russell · 1999 · Clinical Microbiology Reviews · 4,755 citations

   Antiseptics and disinfectants are extensively used in hospitals and other health care settings for a variety of topical and hard-surface applications. A wide variety of active chemical agents (biocides) are found in these products, many of which have been used for hundreds of years, including alcohols, phenols, iodine, and chlorine. Most of these active agents demonstrate broad-spectrum antimicrobial activity; however, little is known about the mode of action of these agents in comparison to antibiotics. This review considers what is known about the mode of action and spectrum of activity of antiseptics and disinfectants. The widespread use of these products has prompted some speculation on

4. Mechanisms of Antimicrobial Peptide Action and Resistance

   Michael R. Yeaman, Nannette Y. Yount · 2003 · Pharmacological Reviews · 2,969 citations

5. The Crisis in Antibiotic Resistance

   Harold C. Neu · 1992 · Science · 2,851 citations

   The synthesis of large numbers of antibiotics over the past three decades has caused complacency about the threat of bacterial resistance. Bacteria have become resistant to antimicrobial agents as a result of chromosomal changes or the exchange of the exchange of genetic material via plasmids and transposons. Streptococcus pneumoniae, Streptococcus pyogenes, and staphylococci, organisms that cause respiratory and cutaneous infections, and members of the Enterobacteriaceae and Pseudomonas families, organisms that cause diarrhea, urinary infection, and sepsis, are now resistant to virtually all of the older antibiotics. The extensive use of antibiotics in the community and hospitals has fueled

6. Antibiotics in Laboratory Medicine.

   Víctor Lorian · 1980 · Annals of Internal Medicine · 2,789 citations

   The Breakpoint 1 Matthew A. Wikler, Paul G. Ambrose Antimicrobial Susceptibility on Solid Media 8 John D. Turnidge, Jan M. Bell Susceptibility Testing of Antimicrobials in Liquid Media 61 Daniel Amsterdam Antimicrobial Susceptibility Testing of Anaerobic Bacteria 144 David W. Hecht Antimycobacterial Agents: In Vitro Susceptibility Testing and Mechanisms of Action and Resistance 155 Clark B. Inderlied and Kevin A. Nash Antifungal Drugs: Mechanisms of Action, Drug Resistance, Susceptibility Testing, and Assays of Activity in Biological Fluids 226 Michael A. Pfaller, Daniel J. Diekema, and Michael G. Rinaldi Antimicrobial Susceptibility Testing for Some Atypical Microorganisms (Chlamydia, Mycop

7. Antibiotic resistance: a rundown of a global crisis

   Bilal Aslam, Wei Wang, Muhammad Arshad, et al. · 2018 · Infection and Drug Resistance · 2,562 citations

   The advent of multidrug resistance among pathogenic bacteria is imperiling the worth of antibiotics, which have previously transformed medical sciences. The crisis of antimicrobial resistance has been ascribed to the misuse of these agents and due to unavailability of newer drugs attributable to exigent regulatory requirements and reduced financial inducements. Comprehensive efforts are needed to minimize the pace of resistance by studying emergent microorganisms, resistance mechanisms, and antimicrobial agents. Multidisciplinary approaches are required across health care settings as well as environment and agriculture sectors. Progressive alternate approaches including probiotics, antibodie

8. An overview of the antimicrobial resistance mechanisms of bacteria

   Wanda Reygaert · 2018 · AIMS Microbiology · 1,859 citations

   Resistance to antimicrobial agents has become a major source of morbidity and mortality worldwide. When antibiotics were first introduced in the 1900's, it was thought that we had won the war against microorganisms. It was soon discovered however, that the microorganisms were capable of developing resistance to any of the drugs that were used. Apparently most pathogenic microorganisms have the capability of developing resistance to at least some antimicrobial agents. The main mechanisms of resistance are: limiting uptake of a drug, modification of a drug target, inactivation of a drug, and active efflux of a drug. These mechanisms may be native to the microorganisms, or acquired from other m

9. Molecular mechanisms of biofilm-based antibiotic resistance and tolerance in pathogenic bacteria.

   Clayton W. Hall, T. Mah · 2017 · FEMS microbiology reviews · 1,443 citations

10. Molecular mechanisms of antibiotic resistance revisited

    Elizabeth M. Darby, Eleftheria Trampari, Pauline Siasat, et al. · 2022 · Nature Reviews Microbiology · 1,324 citations

11. Antibiotic resistance in microbes: History, mechanisms, therapeutic strategies and future prospects.

    Tanvir Mahtab Uddin, A. Chakraborty, A. Khusro, et al. · 2021 · Journal of infection and public health · 1,051 citations

    Antibiotics have been used to cure bacterial infections for more than 70 years, and these low-molecular-weight bioactive agents have also been used for a variety of other medicinal applications. In the battle against microbes, antibiotics have certainly been a blessing to human civilization by saving millions of lives. Globally, infections caused by multidrug-resistant (MDR) bacteria are on the rise. Antibiotics are being used to combat diversified bacterial infections. Synthetic biology techniques, in combination with molecular, functional genomic, and metagenomic studies of bacteria, plants, and even marine invertebrates are aimed at unlocking the world's natural products faster than previ

12. Antibiotic development challenges: the various mechanisms of action of antimicrobial peptides and of bacterial resistance

    Fernanda Guilhelmelli, Nathália Vilela, Patrícia Albuquerque, et al. · 2013 · Frontiers in Microbiology · 542 citations

    Antimicrobial peptides (AMPs) are natural antibiotics produced by various organisms such as mammals, arthropods, plants, and bacteria. In addition to antimicrobial activity, AMPs can induce chemokine production, accelerate angiogenesis, and wound healing and modulate apoptosis in multicellular organisms. Originally, their antimicrobial mechanism of action was thought to consist solely of an increase in pathogen cell membrane permeability, but it has already been shown that several AMPs do not modulate membrane permeability in the minimal lethal concentration. Instead, they exert their effects by inhibiting processes such as protein and cell wall synthesis, as well as enzyme activity, among o

13. Mechanisms of antimicrobial resistance in biofilms

    Hoyu Liu, Emma L. Prentice, Mark A. Webber · 2024 · npj Antimicrobials and Resistance · 409 citations

    Most bacteria in nature exist in aggregated communities known as biofilms, and cells within a biofilm demonstrate major physiological changes compared to their planktonic counterparts. Biofilms are associated with many different types of infections which can have severe impacts on patients. Infections involving a biofilm component are often chronic and highly recalcitrant to antibiotic therapy as a result of intrinsic physical factors including extracellular matrix production, low growth rates, altered antibiotic target production and efficient exchange of resistance genes. This review describes the biofilm lifecycle, phenotypic characteristics of a biofilm, and contribution of matrix and pe

14. Occurrence of antibiotics and bacterial resistance genes in wastewater: resistance mechanisms and antimicrobial resistance control approaches

    Christopher Mutuku, Zoltán Gazdag, Szilvia Melegh · 2022 · World Journal of Microbiology and Biotechnology · 259 citations

    Antimicrobial pharmaceuticals are classified as emergent micropollutants of concern, implying that even at low concentrations, long-term exposure to the environment can have significant eco-toxicological effects. There is a lack of a standardized regulatory framework governing the permissible antibiotic content for monitoring environmental water quality standards. Therefore, indiscriminate discharge of antimicrobials at potentially active concentrations into urban wastewater treatment facilities is rampant. Antimicrobials may exert selective pressure on bacteria, leading to resistance development and eventual health consequences. The emergence of clinically important multiple antibiotic-resi

15. Antibiotic failure: Beyond antimicrobial resistance.

    César de la Fuente-Núñez, Angela Cesaro, Robert E W Hancock · 2023 · Drug resistance updates : reviews and commentaries in antimicrobial and anticancer chemotherapy · 213 citations

    Despite significant progress in antibiotic discovery, millions of lives are lost annually to infections. Surprisingly, the failure of antimicrobial treatments to effectively eliminate pathogens frequently cannot be attributed to genetically-encoded antibiotic resistance. This review aims to shed light on the fundamental mechanisms contributing to clinical scenarios where antimicrobial therapies are ineffective (i.e., antibiotic failure), emphasizing critical factors impacting this under-recognized issue. Explored aspects include biofilm formation and sepsis, as well as the underlying microbiome. Therapeutic strategies beyond antibiotics, are examined to address the dimensions and resolution

16. Evaluation of Antibiotic Resistance Mechanisms in Gram-Negative Bacteria

    A. Gauba, Khondaker Miraz Rahman · 2023 · Antibiotics · 200 citations

    Multidrug-resistant Gram-negative bacterial infections are exponentially increasing, posing one of the most urgent global healthcare and economic threats. Due to the lack of new therapies, the World Health Organization classified these bacterial species as priority pathogens in 2017, known as ESKAPE pathogens. This classification emphasizes the need for urgent research and development of novel targeted therapies. The majority of these priority pathogens are Gram-negative species, which possess a structurally dynamic cell envelope enabling them to resist multiple antibiotics, thereby leading to increased mortality rates. Despite 6 years having passed since the WHO classification, the progress

17. Combating Antibiotic Resistance: Mechanisms, Multidrug-Resistant Pathogens, and Novel Therapeutic Approaches: An Updated Review

    Mostafa E. Elshobary, Nadia K. Badawy, Yara Ashraf, et al. · 2025 · Pharmaceuticals · 174 citations

    The escalating global health crisis of antibiotic resistance, driven by the rapid emergence of multidrug-resistant (MDR) bacterial pathogens, necessitates urgent and innovative countermeasures. This review comprehensively examines the diverse mechanisms employed by bacteria to evade antibiotic action, including alterations in cell membrane permeability, efflux pump overexpression, biofilm formation, target site modifications, and the enzymatic degradation of antibiotics. Specific focus is given to membrane transport systems such as ATP-binding cassette (ABC) transporters, resistance–nodulation–division (RND) efflux pumps, major facilitator superfamily (MFS) transporters, multidrug and toxic

18. Mechanisms of antibiotic resistance in Pseudomonas aeruginosa biofilms

    María Fernández-Billón, Aina E. Llambías-Cabot, E. Jordana-Lluch, et al. · 2023 · Biofilm · 106 citations

    Pseudomonas aeruginosa is a major cause of life-threatening acute infections and life-long lasting chronic infections. The characteristic biofilm mode of life in P. aeruginosa chronic infections severely limits the efficacy of antimicrobial therapies, as it leads to intrinsic tolerance, involving physical and physiological factors in addition to biofilm-specific genes that can confer a transient protection against antibiotics promoting the development of resistance. Indeed, a striking feature of this pathogen is the extraordinary capacity to develop resistance to nearly all available antibiotics through the selection of chromosomal mutations, evidenced by its outstanding and versatile mutati

19. The Global Challenge of Antimicrobial Resistance: Mechanisms, Case Studies, and Mitigation Approaches

    Abubakar Nazir, Awais Nazir, Varisha Zuhair, et al. · 2025 · Health Science Reports · 97 citations

    Antimicrobial resistance (AMR) is projected to cause 10 million deaths annually by 2050 if left unaddressed, posing a severe threat to global health and modern medicine. This review analyzes the molecular and ecological mechanisms underlying antibiotic resistance and evaluates global efforts aimed at containment to identify actionable strategies to mitigate AMR's escalating impact.

20. Overcoming the rising incidence and evolving mechanisms of antibiotic resistance by novel drug delivery approaches - an overview.

    Christopher K. C. LAI, Rita W. Y. NG, Sharon S. Y. LEUNG, et al. · 2021 · Advanced drug delivery reviews · 93 citations

    Antimicrobial resistance is a normal evolutionary process for microorganisms. Antibiotics exerted accelerated selective pressure that hasten bacterial resistance through mutation, and acquisition external genes. These genes often carry multiple antibiotic resistant determinants allowing the recipient microbe an instant "super-bug" status. The extent of Antimicrobial Resistance (AMR) has reached a level of global crisis, existing antimicrobials are no long effective in treating infections caused by AMR pathogens. The great majority of clinically available antimicrobial agents are administered through oral and intra-venous routes. Overcoming antibacterial resistance by novel drug delivery appr

21. Biochemistry of Bacterial Biofilm: Insights into Antibiotic Resistance Mechanisms and Therapeutic Intervention

    Kashish Azeem, Sadaf Fatima, Asghar Ali, et al. · 2025 · Life · 81 citations

    Biofilms, composed of structured communities of bacteria embedded in a self-produced extracellular matrix, pose a significant challenge due to their heightened resistance to antibiotics and immune responses. This review highlights the mechanisms underpinning antibiotic resistance within bacterial biofilms, elucidating the adaptive strategies employed by microorganisms to withstand conventional antimicrobial agents. This encompasses the role of the extracellular matrix, altered gene expression, and the formation of persister cells, contributing to the recalcitrance of biofilms to eradication. A comprehensive understanding of these resistance mechanisms provides a for exploring innovative ther

22. Advanced Nanoparticles in Combating Antibiotic Resistance: Current Innovations and Future Directions

    Dana Mohammed AlQurashi, Tayf Fahad AlQurashi, Raneia Idrees Alam, et al. · 2025 · Journal of Nanotheranostics · 80 citations

    Antibiotic resistance poses a significant global health challenge, undermining the effectiveness of conventional treatments and increasing mortality rates worldwide. Factors such as the overuse and misuse of antibiotics in healthcare and agriculture, along with poor infection control practices, have accelerated the emergence of resistant bacterial strains. The stagnation in the development of new antibiotics, compounded by economic and biological challenges, has necessitated alternative approaches to combat resistant infections. Nanotechnology provides a promising solution using nanoparticles (NPs), which combat bacteria through mechanisms like membrane disruption and reactive oxygen species

23. Phytochemicals as Invaluable Sources of Potent Antimicrobial Agents to Combat Antibiotic Resistance

    Ragi Jadimurthy, S. Jagadish, S. C. Nayak, et al. · 2023 · Life · 72 citations

    Simple Summary Many microorganisms develop resistance to drugs through different mechanisms, and this process is called antimicrobial resistance. It is highly essential to discover new antimicrobials to kill pathogenic microbes that have developed antimicrobial resistance. Natural sources, including plants, have been serving as a great source of medicinally important compounds for the past several decades. In this article, we have discussed the antimicrobial properties of plant-derived compounds against drug-resistant human pathogens, including bacteria, fungi, and viruses. Abstract Plants have been used for therapeutic purposes against various human ailments for several centuries. Plant-der

24. Metal-Based Approaches for the Fight against Antimicrobial Resistance: Mechanisms, Opportunities, and Challenges

    Chenyuan Wang, Xueying Wei, Liang Zhong, et al. · 2025 · Journal of the American Chemical Society · 71 citations

    The rapid emergency and spread of antimicrobial-resistant (AMR) bacteria and the lack of new antibiotics being developed pose serious threats to the global healthcare system. Therefore, the development of more effective therapies to overcome AMR is highly desirable. Metal ions have a long history of serving as antimicrobial agents, and metal-based compounds are now attracting more interest from scientific communities in the fight against AMR owing to their unique mechanism. Moreover, they may also serve as antibiotic adjuvants to enhance the efficacy of clinically used antibiotics. In this perspective, we highlight important showcase studies in the last 10 years on the development of metal-b