Understanding and overcoming antibiotic resistance
Antibiotic drugs have revolutionized medicine and made our modern way of life possible. In addition to their essential role in the clinic, antibiotics are used in a huge array of non-medical applications, from promoting growth in livestock, to preserving building materials from contamination, to treating blight in orchards. However, overuse threatens their efficacy due to the promotion and spread of antibiotic resistant bacteria. Antibiotics target and inhibit essential cellular processes, retarding growth and causing cell death. However, if bacteria are exposed to drugs below the dose required to kill all bacteria in a population (the minimum bactericidal concentration or MBC), they can mutate and resist antibiotic treatment via natural selection for resistance-conferring mutations. These genetic mutations can arise from the adoption of a plasmid encoding a resistance gene or by mutation to the bacterial chromosome itself. The concern around the increasing prevalence of drug resistant bacteria is compounded by the fact that the discovery of new antibiotics is a fleeting rare event. Most classes of antibiotics on the market were discovered in the mid-to-late 20 century. Thus, there is a limited arsenal of drugs to fight resistant bacteria, and bacteria can be resistant to multiple drugs at a time. Given the importance of antibiotics to modern medicine, and the growing apprehension surrounding the threat of resistance, scientists are studying every aspect of antibiotic resistance. This Open Highlight features some of the cutting-edge research from the Open Access corpus on three major areas of focus: the cellular mechanisms of resistance, the evolution and spread of resistance, and techniques for combating resistance.