5. What is the importance of intrinsic resistance?

Give  Pseudomonas aeruginosa

examples.  Serratia marcescens
Intrinsic antibiotic resistance is mainly mediated by Citrobacter koseri is intrinsically resistant to Piperacillin
impermeability of cellular envelopes, the activity of whereas Proteus spp is intrinsically resistant to
multidrug efflux pumps or lack of drug targets. Enzymes (such Tetracycline/Tigecycline, Nitrofurantoin and Polymyxin B
as transferases) which are involved in basic bacterial Colistin
metabolic processes also confer intrinsic resistance in some Acinetobacter baumanni complex is notorious pathogen
bacterial species such as Pseudomonas aeruginosa, which is resistant to most of the available antibiotics. It is
and Staphylococcus aureus. intrinsically resistant to
According to the published findings such natural insensitivity  Ampicillin, Amoxicillin
can be due to:  Ampicillin-sulbactam
 lack of affinity of the drug for the bacterial target  Aztreonam
 inaccessibility of the drug into the bacterial cell  Ertapenem
 extrusion of the drug by chromosomally encoded  Trimethoprim
active exporters  Chloramphenicol
 innate production of enzymes that inactivate the Similarly Pseudomonas aeruginosa is intrinsically resistant to
drug  Ampicillin, Amoxicillin
 Ampicillin-sulbactam
It is important in the management of infections involving  Amoxicillin-Clavulanate
multidrug-resistant pathogens since the therapeutic options  Cefotaxime
are limited. Knowledge in intrinsic resistance can be used in  Ceftriaxone
genomic approaches to identify genetic loci necessary for  Ertapenem
antimicrobial resistance of the opportunistic pathogen like  Tetracyclines/Tigecyclines
Pseudomonas aeruginosa.
 Trimethoprim
Examples are:
 Trimethoprim-sulfamethoxazole
Bacterial pathogen that are intrinsically resistance to
 Chloramphenicol
Ampicillin
Both Acinetobacter and Pseudomonas are also intrinsically
 Acinetobacter baumanni complex
resistant to penicillin (ie, benzylpenicillin), cephalosporin I
 Citrobacter freundii
(cephalothin,cefazolin), cephalosporin II (cefuroxime),
 Citrobacter koseri cephamycins (cefoxitin, cefotetan), clindamycin, daptomycin,
 Enterobacter aerogenes fusidic acid, glycopeptides(vancomycin, teicoplanin),
 Enterobacter cloacae complex linezolid, macrolides (erythromycin, azithromycin,
 Klebsiella pneumoniae clarithromycin), quinupristin-dalfopristin, and rifampin.
 Morganella morganii Bacteroides spp. which is one of the most frequently isolated
 Proteus vulgaris anaerobic Gram negative bacilli is intrinsically resistant to
 Pseudomonas aeruginosa  Aminoglycosides
 Serratia marcescens  Penicillin and
 Yersinia enterocolitica  Ampcillin
Bacterial pathogens that are Intrinsically Resistant to Intrinsic Antibiotic Resistance in Gram Positive Bacteria
Amoxicillin-Clavulanate combination Among gram positive bacteria, S. saprophyticus is intrinscially
 Citrobacter freundii resistance to Novobiocin which is the basis for Novobiocin
 Enterobacter aerogenes sensitivity test done in urine isolate (if CONS is isolated).
 Enterobacter cloacae complex
 Morganella morganii Enterococcus faecalis/faecium are intrinsically resistant to
 Pseudomonas aeruginosa  Cephalosporin*
 Serratia marcescens  Aminoglycosides*
 Yersinia enterocolitica  Clindamycin*
Bacterial pathogens that are Intrinsically Resistant to  Trimethoprim
Ampicillin-sulbactam combination  Trimethoprim-sulfamethoxazole*
 Acinetobacter baumanni complex  Fusidic acid
 Citrobacter freundii *may appear active in vitro but are not effective clinically and
 Citrobacter koseri should not be reported as susceptible.
 Enterobacter aerogenes
 Enterobacter cloacae complex
 Proteus vulgaris
Both Enterococci and Staphylococci are also intrinsically
resistant to aztreonam, polymyxin B/colistin, and nalidixic
acid.
Anaerobic Gram positive bacilli,  Clostridium spp. is resistant
to Aminoglycosides.
References:
Murray, J., Kwon, T., Marcotte, E., and Whiteley, M. (2015).
Intrinsic Antimicrobial Resistance Determinants in the
Superbug Pseudomonas Aeruginosa. mBio 6(6):e01603-15.
Retrieved from: doi:10.1128/mBio.01603-15.
Acharya, T. (2017). Lists of Bacterial Pathogens Associated
with Intrinsic Antibiotic Resistance. Retrieved from:
https://microbeonline.com/lists-bacterial-pathogens-
intrinsic-antibiotic-resistance/