Antimicrobial resistance to at least one antimicrobial agent in two or more antimicrobial classes is referred to as multiple drug resistance (MDR), sometimes known as multi-resistance. Antimicrobial classes group antimicrobial substances according to their action mechanism and the target species they are effective against. Multi-drug resistant bacteria are the MDR forms that pose the greatest concern to the healthcare system, additional groups comprise MDR viruses, fungi, and parasites resistant to multiple antivirals, antifungal, and antiparasitic drugs respectively. A variety of "complicated to treat infections" such as catheter-associated urinary tract infections, ventilator-associated pneumonia, surgical site, and numerous other refractory infections have been caused by pathogens with intensifying multidrug resistance characteristics. These infections were initially most common in hospital environments but are also now found in communities. Due to natural and unnatural pressures, antibiotic resistance often originates via spontaneous genetic alterations or is gained by horizontal gene transfer of pathogenicity islands harbouring resistance genes - a genetic mechanism by which antimicrobial resistance can propagate through the transfer of antibiotic-resistant genes (ARGs) across microorganisms. Nevertheless, antibiotic resistance is the product of microbes' genetic adaptation to the environment, improper and irrational utilisation of antimicrobial drugs not only in the health care system but also in the veterinary and agricultural domains plays a critical part in hastening this trend. In healthcare, improper antimicrobial selection, poor adherence to treatment standards, and insufficient antimicrobial dose with acts of self-medication are the leading reasons for pathogen progression to resist antimicrobials. It would not be an exaggeration to state that we have reached the end of the antibiotic era. A step ahead from this age can elevate a basic bacterium to the level of sars-cov-2, whose antivirus we crave.
Key words: Multiple drug resistance; Antibiotics; Horizontal gene transfer, ESKAPE pathogens, Superbugs.
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