Understanding bacterial resistance to antimicrobial peptides: From the surface to deep inside

• Resistant bacterial infections are a major global health problem.
• We examine high-throughput methods to discriminate bacterial resistance.
• We discussed main membrane alterations that cause antimicrobial peptide resistance.
• Polysaccharide layer and LPS are the main targets of cell wall modifications.
• Cellular metabolism also can be altered in antimicrobial peptide resistant strains.

Resistant bacterial infections are a major health problem in many parts of the world. The major commercial antibiotic classes often fail to combat common bacteria. Although antimicrobial peptides are able to control bacterial infections by interfering with microbial metabolism and physiological processes in several ways, a large number of cases of resistance to antibiotic peptide classes have also been reported. To gain a better understanding of the resistance process various technologies have been applied. Here we discuss multiple strategies by which bacteria could develop enhanced antimicrobial peptide resistance, focusing on sub-cellular regions from the surface to deep inside, evaluating bacterial membranes, cell walls and cytoplasmic metabolism. Moreover, some high-throughput methods for antimicrobial resistance detection and discrimination are also examined. This article is part of a Special Issue entitled: Bacterial Resistance to Antimicrobial Peptides.