This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Microbiology
All of the following statements about Penicillin Resistance is true, EXCEPT: 
Select and explain. 
A. b- Lactamase production is the most common mechanism of resistance, B. Alteration in target PBPs is an impoant resistance mechanism in Gram negative bacteria, C. Alteration in permeability / penetration of antibiotic causes resistance only in Gram negative bacteria, D. b-Lactamase production causes resistance in both Gram positive and Gram negative bacteria
B: Alteration in target PBPs is an impoant resistance mechanism in Gram negative bacteria
Answer: B: Alteration in target PBPs is an impoant resistance mechanism in Gram negative bacteria 
Explanation: Alteration in target Penicillin Binding Proteins (PBPs) is an impoant resistance mechanism in gram positive bacteria and not gram negative. It is very unusual to encounter Gram Negative bacteria that have acquired Resistance to b -Lactam Antibiotics due to an alteration in target (Penicillin Binding Proteins). Ref: Antimicrobial Resistance : A Crisis in Health Care By Jungkind, Page 17; Jawetz, Melnick and Adelberg's Medical microbiology, 23rd Edition, Page 175.