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Word Count: 30,130
The phenomenon of bacterial resistance toward conventional antibiotics is one of the major concerns for the infectious diseases control practitioners 1 Many susceptible clinical isolates turn to resistance as results of acquiring alteration mutations and transformation resistance genes However there is other several factors as well are playing rule in antibiotics resistance issue including - bacterial occurs among health care facilities which somehow allows transfer resistance within bacterial community inadequate medical procedures share the hazards percentage of rising resistant pathogens as a result of infections - lack in the knowledge of using basic hygienic methods such as hand hygiene - absence of antimicrobial drugs prescription guidelines - unavailability of a fast and effective diagnostic analysis for identifying the pathogenic isolates in order to choose its appropriate antibiotics 1 Conventional gentamicin treatment widely used is to overcome bacterial resistance among nosocomial for decades while gentamicin is a family member of aminoglycoside antibiotics which known for their potential bactericidal activities against both of gram negative and positive bacteria Aminoglycoside antibiotics including gentamicin works on disrupting protein synthesis by binding bacterial ribosomal at 16S rRNA of the 30S subunits but not 50s and70s 2 3 Indeed Aminoglycoside antibiotics also able to inhibit ribosome recycling process by binding bacterial RNA helix H69 of ribosomal subunit and restore the association of the bacterial ribosome recycling factor RRF with the ribosomal subunits that are already disrupted 4 Despite their potintial bactericidal activity gentamicin didnt fully invested as strong medications because of two reasons first is due to its toxicity and second is because of the acquired bacterial resistant against it However gentamicin been with caution to treats resistance clinical bacterial strians due to its broad-spectrum bactericidal activity for both of Gram-positive and negative pathogens 5-7 Therefore gentamicin was preferable to overcome sustained bacterial resistance of Staphylococcus aureus methicillin-resistant staphylococcus aureus MRSA Burkholderiacepacia complex Klebsiella pneumonia Acinetobacter baumannii and Pseudomonas aeruginosa Though bacterial world enriched with a lot of mechanism
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