title: Combinatorial genetic evolution of multiresistance.
abstract: The explosion in genetic information, whilst extending our knowledge, might not necessary increase our conceptual understanding on the complexities of bacterial genetics, or why some antibiotic resistant genotypes such as blaCTX-M-15 and blaVIM-2 appear to dominate. However, the information we have thus far suggests that clinical isolates have 'hijacked' plasmids, primarily built of backbone-DNA originating from environmental bacteria. Additionally, the combinatorial presence of other elements such as transposons, integrons, insertion sequence (IS) elements and the 'new' ISCR (IS common region) elements have also contributed to the increase in antibiotic resistance - an antibiotic resistant cluster composing four or five genes has become commonplace. In some instances, the presence of antibiotics themselves, such as fluoroquinolones, can mediate a bacterial SOS cell response, subsequently amplifying and/or augmenting the transfer of large genetic entities therefore, potentially promoting long-term detrimental effects.
authors.affiliation: Department of Molecular and Cellular Medicine, School of Medical Sciences, University of Bristol, Bristol BS8 1TD, UK. t.r.walsh@bristol.ac.uk
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Walsh
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000187:drug effects / Q000235:genetics* / Q000472:pathogenicity; D001424:Bacterial Infections / Q000382:microbiology; D004251:DNA Transposable Elements; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004783:Environmental Microbiology; D019143:Evolution, Molecular; D005798:Genes, Bacterial; D006801:Humans; D007438:Introns; D005810:Multigene Family; D010957:Plasmids / Q000235:genetics; D014774:Virulence
chemical_list: D000900:Anti-Bacterial Agents; D004251:DNA Transposable Elements; D004269:DNA, Bacterial