It results from altered cellular physiology and structure caused by changes in a microorganism's genetic makeup. It is unpredictable character and results from mutations or other mechanisms of genetic exchange (Reddy, 2009b).
Through the study of bacterial structure, antibiotics can be designed specifically to overcome the natural barrier of intrinsic resistance in order to successfully target specific organisms. However, much of the antimicrobial resistance associated with nosocomial infections falls into the category of acquired resistance (Spratt and Wade, 2005).
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