MOC - Antimicrobial Resistance (AMR)
Mechanisms, mobile genetics, diagnostics, and surveillance of drug-resistant microbes.
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Overview
AMR is evolutionary biology under pharmacologic pressure. Resistance spreads by Mutation and Selection and especially Horizontal Gene Transfer on Plasmids — measured clinically by Antimicrobial Susceptibility Testing and increasingly by genomics.
Key Subtopics
- Intrinsic vs acquired resistance
- Target modification, inactivation enzymes, efflux, porin loss, bypass
- Mobile elements: plasmids, transposons, integrons
- Biofilm tolerance vs genetic resistance — Biofilm
- Stewardship and infection control
- One Health surveillance databases
Core Concepts
- Mutation and Selection
- Horizontal Gene Transfer · Conjugation · Transformation · Transduction
- Plasmid
- Bacterial Cell Wall · Bacterial Plasma Membrane
Diagnostic and Lab Methods
- Antimicrobial Susceptibility Testing
- PCR (resistance gene markers)
- Whole-Genome Sequencing
- Hub: MOC - Diagnostic & Lab Methods
Core Notes
- Antimicrobial Resistance — definition, terminology, drivers
- Mechanisms of Antibiotic Resistance — the five biochemical strategies
- Efflux Pumps — the expression-level mechanism databases miss
- MRSA — mecA/SCCmec and PBP2a
- VRE — vanA/vanB and cell-wall remodeling
- ESBL — CTX-M/TEM/SHV extended-spectrum β-lactamases
- AmpC — class C cephalosporinases (inducible vs plasmid)
- Carbapenemases — KPC, MBLs (NDM/VIM/IMP), OXA-48-like
- Colistin Resistance — lipid A remodeling and mobile mcr
- ESKAPE Pathogens — the priority organism set
- Persisters and Antibiotic Tolerance — MIC-blind survival
- Antimicrobial Stewardship · Infection Prevention and Control · Vaccination — the three prevention levers
- One Health — reservoirs beyond the hospital
Computational Layer
- Hubs: MOC - Bioinformatics in Microbiology · MOC - AI in Microbiology
- Detection: AMR Gene Databases · WGS Bioinformatics Pipeline · Variant Calling in Bacteria (point mutations)
- Mobility context: Plasmid and Mobile Element Analysis · Pangenome Analysis
- Prediction: Genotype to Phenotype Prediction · Machine Learning for AMR Prediction · Protein Language Models (novel variants)
- Surveillance: MLST and cgMLST · Phylodynamics · AI for Outbreak Detection
- Therapy support: AI in Antimicrobial Stewardship · AI for Antibiotic Discovery
- Judging claims: Model Evaluation in Clinical Microbiology (very major errors)
- Why expression matters: Microbial Transcriptomics → Figure - Omics Layers in Microbiology
- Paper: Paper - AMR Database M.Centner 2026
Important Papers
Important Organisms (MDR exemplars)
- Staphylococcus aureus → MRSA
- Escherichia coli / Klebsiella pneumoniae → ESBL · Carbapenemases
- Pseudomonas aeruginosa · Acinetobacter baumannii (MDR non-fermenters)
- Enterococcus faecium → VRE
- Neisseria gonorrhoeae (urgent therapeutic threat)
Research Questions
- How should plasmid epidemiology be reported alongside clonal outbreaks?
- When is genotypic prediction sufficient without MIC?
Related MOCs
- MOC - Antimicrobials · MOC - Bacteriology · MOC - Clinical Microbiology
- MOC - Fundamentals of Microbiology · MOC - Diagnostic & Lab Methods
Build Status
| Cluster | Status |
|---|---|
| Mechanism concept links | done |
| Dedicated mechanism notes (MRSA · ESBL · Carbapenemases · VRE · AmpC · Colistin Resistance) | ✅ 2026-08-02 |
| Paper integration | started |