FFiigghhttiinngg AAnnttiimmiiccrroobbiiaall RReessiissttaannccee Edited by Ana Budimir Published by: IAPC Publishing, Zagreb, Croatia, 2018 Editor: Ana Budimir Fighting Antimicrobial Resistance Proofreading and graphic layout: Ana Blažeković © 2018 by the authors; licensee IAPC, Zagreb, Croatia. This book is an open-access book distributed under the terms and conditions of the Creative Commons Attribution license. The efforts have been made to publish reliable and accurate data as much as possible, but the authors and the editor cannot assume responsibility for the validity of materials or the consequences of their use. ISBN 978-953-56942-6-7 IAPC Publishing is a part of International Association of Physical Chemists ii CONTENTS EDITORIAL FOREWORD ................................................................................................................................ xix LIST OF CONTRIBUTORS ............................................................................................................................... xxi ABOUT THE EDITOR ...................................................................................................................................... xxv Chapter 1 FIGHTING ANTIMICROBIAL RESISTANCE IN ESKAPE PATHOGENS ............................................ 1 Rocío Trastoy, Lucia Blasco, German Bou, and Maria Tomás* 1.1. INTRODUCTION ............................................................................................................................................. 3 1.2. PREVENTION .................................................................................................................................................. 4 1.3. ESKAPE PATHOGENS .................................................................................................................................. 4 1.4. NEW ANTIINFECTIVE TREATMENTS .................................................................................................. 5 a) New drugs ............................................................................................................................................................ 6 b) Phage therapy (including derivatives) ................................................................................................... 7 c) Antivirulence therapy ..................................................................................................................................... 8 d) Antibodies ........................................................................................................................................................ 12 e) Probiotics .......................................................................................................................................................... 12 f) Immune stimulation ...................................................................................................................................... 12 1.5. CONCLUSION ................................................................................................................................................ 13 ACKNOWLEDGEMENTS ................................................................................................................................... 13 COMPETING INTERESTS ................................................................................................................................. 13 REFERENCES ........................................................................................................................................................ 14 iii Chapter 2 THE IMPRESSIVE ADAPTABILITY OF Acinetobacter baumannii: A PARADIGM OF ANTIMICROBIAL RESISTANCE ................................................................................ 19 Alejandro Beceiro 2.1. INTRODUCTION ....................................................................................................................................... 21 2.2. MECHANISMS OF A. baumannii ANTIMICROBIAL RESISTANCE .......................................... 22 -lactams ....................................................................................................................... 23 -lactamases ................................................................................................. 23 2.2.1. Resistance to β -lactamases ................................................................................................. 24 2.2.1.1. Class A β -lactamases .................................................................................................. 24 2.2.1.2. Class B β -lactamases ................................................................................................. 25 2.2.1.3. Class C β 2.2.1.6. Outer membrane proteins ...................................................................................... 26 2.2.1.4. Class D β 2.2.1.7. Multidrug efflux pumps ........................................................................................... 27 2.2.1.8. Penicillin-binding proteins ..................................................................................... 27 -lactamase inhibitors ................................................................. 28 2.2.2. Resistance to aminoglycosides ......................................................................................................... 28 2.2.3. Resistance2.2.1.9. to Resistancetigecycline to................................ β ..................................................................................... 29 2.2.4. Resistance to polymyxins ................................................................................................................... 29 2.3. VIRULENT AND MULTIDRUG-RESISTANT DISSEMINATED CLONES OF A. baumannii .................................................................................................................................................... 30 2.4. ANTIMICROBIAL RESISTANCE AND VIRULENCE MECHANISM CO- SELECTION ................................................................................................................................................. 32 ACKNOWLEGMENTS ......................................................................................................................................... 34 REFERENCES ........................................................................................................................................................ 34 iv Chapter 3 ANTIMICROBIAL RESISTANCE IN STAPHYLOCOCCI ......................................................................... 41 Monika Pipová 3.1. INTRODUCTION .......................................................................................................................................... 43 3.2. CHARACTERISTICS OF THE GENUS STAPHYLOCOCCUS ........................................................... 45 3.3. CLINICAL SIGNIFICANCE OF STAPHYLOCOCCI ............................................................................ 47 3.4. MECHANISMS OF ANTIMICROBIAL RESISTANCE IN STAPHYLOCOCCI ........................... 50 3.4.1. Resistance to beta-lactams ................................................................................................................. 51 3.4.2. Resistance to tetracyclines ................................................................................................................. 53 3.4.3. Resistance to macrolides ..................................................................................................................... 54 3.4.4. Resistance to aminoglycosides ......................................................................................................... 55 3.4.5. Resistance to chloramphenicol ........................................................................................................ 56 3.4.6. Resistance to glycopeptides ............................................................................................................... 57 3.4.7. Resistance to oxazolidinones ............................................................................................................ 58 3.4.8. Resistance to lipopeptides .................................................................................................................. 58 3.5. METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) ......................................... 59 3.6. FIGHTING STRATEGIES ........................................................................................................................... 64 3.7. CONCLUSION ................................................................................................................................................ 67 REFERENCES ........................................................................................................................................................ 68 v Chapter 4 VANCOMYCIN-RESISTANT ENTEROCOCCUS COLONISATION: IS ISOLATION THE ONLY PRECAUTION? ................................................................................................ 77 Filiz Orak* 4.1. INTRODUCTION ....................................................................................................................................... 79 4.2. GENUS DEFINITION .................................................................................................................................. 79 4.3. ENTEROCOCCUS IN THE ENVIRONMENT ...................................................................................... 79 4.4. DRUG RESISTANCE...................................................................................................................................