File(s) not publicly available

Mechanisms of bacterial resistance to antibiotics in infections of COPD patients

journal contribution
posted on 06.12.2017, 00:00 by Jennelle Kyd, John Mcgrath, Ajay Krishnamurthy
A key characteristic of airway inflammation in chronic obstructive pulmonary disease (COPD) is the persistent presence of bacteria in the lower airways. The most commonly isolated bacteria in the lower respiratory tract of COPD patients are nontypeable Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae, with growing evidence of the significance of Pseudomonas aeruginosa infections in severe COPD disease. This review focuses on the antibiotic resistant mechanisms associated with the gram-negative bacteria H. influenzae and M. catarrhalis and comparison with P. aeruginosa infection because of the recent evidence of its significance in patients with severe COPD disease. These mechanisms of resistance to β-lactams in H. influenzae and M. catarrhalis are mostly associated with serine β-lactamases of class A type, whereas P. aeruginosa strains exhibit a much broader repertoire with class A-D type mechanisms. Other mechanisms of antibiotic resistance include membrane permeability, efflux pump systems and mutations in antimicrobial targets. Antimicrobial resistance within biofilm matrices appears to be different to the mechanisms observed when the bacteria are in the planktonic state. P. aeruginosa exhibits a more numerous and diverse range of antimicrobial resistance mechanisms in comparison to M. catarrhalis and H. influenzae. The recognition that P. aeruginosa is associated with exacerbations in patients with more severe COPD and that turnover in infecting strains is detected (unlike in cystic fibrosis patients), then further investigation is required to better understand the contribution of antimicrobial resistance and other virulence mechanisms to poor clinical outcomes to improve therapeutic approaches. © 2011 Bentham Science Publishers Ltd.

Funding

Category 1 - Australian Competitive Grants (this includes ARC, NHMRC)

History

Volume

12

Issue

4

Start Page

521

End Page

530

Number of Pages

10

ISSN

1389-4501

Location

Netherlands

Publisher

Bentham Science Publishers Ltd

Language

en-aus

Peer Reviewed

Yes

Open Access

No

External Author Affiliations

Institute for Health and Social Science Research (IHSSR);

Era Eligible

Yes

Journal

Current drug targets.