Defensive remodeling: How bacterial surface properties and biofilm formation promote resistance to antimicrobial peptides

• An updated review on multidrug resistance bacteria against antimicrobial peptides.
• Resistance to AMPs is due to changes in bacterial surface and secretion of protective material.
• Bacterial resistance to AMPs often involves biophysical and biochemical changes to the bacterial cell wall.
• The review focuses on the biophysical, surface and surrounding changes that bacteria undergo in acquiring resistance to AMPs.

Multidrug resistance bacteria are a major concern worldwide. These pathogens cannot be treated with conventional antibiotics and thus alternative therapeutic agents are needed. Antimicrobial peptides (AMPs) are considered to be good candidates for this purpose. Most AMPs are short and positively charged amphipathic peptides, which are found in all known forms of life. AMPs are known to kill bacteria by binding to the negatively charged bacterial surface, and in most cases cause membrane disruption. Resistance toward AMPs can be developed, by modification of bacterial surface molecules, secretion of protective material and up-regulation or elimination of specific proteins. Because of the general mechanisms of attachment and action of AMPs, bacterial resistance to AMPs often involves biophysical and biochemical changes such as surface rigidity, cell wall thickness, surface charge, as well as membrane and cell wall modification. Here we focus on the biophysical, surface and surrounding changes that bacteria undergo in acquiring resistance to AMPs. In addition we discuss the question of whether bacterial resistance to administered AMPs might compromise our innate immunity to endogenous AMPs. This article is part of a Special Issue entitled: Bacterial Resistance to Antimicrobial Peptides.