Problematic Groups of Multidrug-Resistant Bacteria and Their Resistance Mechanisms

  • Verena Kohler
  • Ankita Vaishampayan
  • Elisabeth GrohmannEmail author


The occurrence of multidrug-resistant pathogenic bacteria is steadily increasing, not only in medical centers but also in food, animals and the environment, which is of primordial concern for health authorities worldwide. The World Health Organization (WHO) published a global pathogen priority list to encourage international interdisciplinary research initiatives on the occurrence, dissemination, and epidemiology of the most dangerous multiresistant pathogens with the aim to develop effective prevention strategies against the spread of these bugs and new therapeutic approaches to treat infections in agreement with the One Health concept. According to the WHO global pathogen priority list, the most critical resistant pathogens include carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa and carbapenem-resistant as well as third-generation cephalosporin-resistant Enterobacteriaceae. This critical group is followed by pathogens of high priority including vancomycin-resistant Enterococcus faecium, methicillin- and vancomycin-resistant Staphylococcus aureus, and clarithromycin-resistant Helicobacter pylori. Here, we summarize recent data on the occurrence and spread of these and other harmful resistant pathogens, on their resistance mechanisms as well as on the modes of resistance spread, as far as is known. We finish the chapter with an outlook on promising innovative strategies to treat infectious diseases caused by multiresistant pathogens – in combination with antibiotic therapy – as well as on approaches to combat the antibiotic resistance spread.


Antibiotic resistance Bacterial pathogen Biofilm Horizontal gene transfer Multidrug resistance WHO pathogen priority list 



accessory gene regulator


ß-lactamase-negative ampicillin resistant


Centers for Disease Control and Prevention


chronic obstructive pulmonary disease


carbapenem-resistant Acinetobacter baumannii


carbapenem-resistant Enterobacteriaceae


carbapenem-resistant Pseudomonas aeruginosa


extended spectrum ß-lactamase


European Union


Food and Drug Administration




horizontal gene transfer


intensive care unit


active on imipenem


insertion sequence


Klebsiella pneumoniae carbapenemase




multidrug resistant


methicillin-resistant Staphylococcus aureus


methicillin-sensitive S. aureus


New Delhi MBL


outer membrane protein




penicillin-binding protein


plasmid-mediated quinolone resistance


penicillin-non-susceptible Streptococcus pneumoniae


resistance-nodulation-cell division


staphylococcal chromosome cassette mec


Verona integron-encoded MBL


vancomycin-resistant Enterococci


vancomycin-resistant E. faecium


vancomycin-resistant S. aureus


World Health Organization


extremely multidrug resistant


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Verena Kohler
    • 1
  • Ankita Vaishampayan
    • 2
  • Elisabeth Grohmann
    • 2
    Email author
  1. 1.Department of Molecular Biosciences, The Wenner-Gren InstituteStockholm UniversityStockholmSweden
  2. 2.Life Sciences and TechnologyBeuth University of Applied Sciences BerlinBerlinGermany

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