In recent years, we have seen antimicrobial resistance rapidly emerge at a global scale and spread from one country to the other faster than previously thought. Superbugs and multidrug-resistant bacteria are endemic in many parts of the world. There is no question that the widespread use, overuse, and misuse of antimicrobials during the last 80 years have been associated with the explosion of antimicrobial resistance. On the other hand, the molecular pathways behind the emergence of antimicrobial resistance in bacteria were present since ancient times. Some of these mechanisms are the ancestors of current resistance determinants. Evidently, there are plenty of putative resistance genes in the environment, however, we cannot yet predict which ones would be able to be expressed as phenotypes in pathogenic bacteria and cause clinical disease. In addition, in the presence of inhibitory and sub-inhibitory concentrations of antibiotics in natural habitats, one could assume that novel resistance mechanisms will arise against antimicrobial compounds. This review presents an overview of antimicrobial resistance mechanisms, and describes how these have evolved and how they continue to emerge. As antimicrobial strategies able to bypass the development of resistance are urgently needed, a better understanding of the critical factors that contribute to the persistence and spread of antimicrobial resistance may yield innovative perspectives on the design of such new therapeutic targets.

中文翻译：

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细菌中的抗菌素耐药性：机制，进化和持久性。

近年来，我们已经看到抗药性耐药性在全球范围内迅速兴起，并且从一个国家传播到另一个国家的速度比以前想象的要快。超级细菌和耐多药细菌是世界许多地方的地方病。毫无疑问，在过去的80年中，抗菌剂的广泛使用，过度使用和误用与抗菌素耐药性的爆发有关。另一方面，自古以来就存在细菌中产生抗菌素耐药性的分子途径。这些机制中的一些是电流电阻决定因素的祖先。显然，环境中存在许多假定的抗性基因，但是，我们仍无法预测哪些基因能够在致病细菌中表现为表型并引起临床疾病。此外，在自然栖息地中存在抑制性和亚抑制性浓度的抗生素时，人们可以假设将出现针对抗菌化合物的新型耐药机制。这篇综述对抗菌素耐药性机制进行了概述，并描述了它们如何演变以及如何继续出现。由于迫切需要能够绕开耐药性发展的抗菌策略，因此，对有助于抗菌性耐药性的持久性和扩散的关键因素的更好理解可能会为这种新型治疗靶标的设计提供创新的见解。这篇综述对抗菌素耐药性机制进行了概述，并描述了它们如何演变以及如何继续出现。由于迫切需要能够绕开耐药性发展的抗菌策略，因此，对有助于抗菌性耐药性的持久性和传播的关键因素的更好理解可能会为这种新型治疗靶标的设计提供创新的见解。这篇综述对抗菌素耐药性机制进行了概述，并描述了它们如何演变以及如何继续出现。由于迫切需要能够绕开耐药性发展的抗菌策略，因此，对有助于抗菌性耐药性的持久性和传播的关键因素的更好理解可能会为这种新型治疗靶标的设计提供创新的见解。