{"$update": {"344": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "345": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36002": {"category_aro_name": "ATP-binding cassette (ABC) antibiotic efflux pump", "category_aro_cvterm_id": "36002", "category_aro_accession": "0010001", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. ATP-binding cassette (ABC) transporters are present in all cells of all organisms and use the energy of ATP binding/hydrolysis to transport substrates across cell membranes."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36975": {"category_aro_name": "bacitracin F", "category_aro_cvterm_id": "36975", "category_aro_accession": "3000631", "category_aro_class_name": "Antibiotic", "category_aro_description": "Bacitracin F is a component of bacitracin, an antibiotic mixture that interferes with bacterial cell wall synthesis. It is formed when the thiazoline ring of bacitracin A is oxidatively deaminated."}, "36973": {"category_aro_name": "bacitracin A", "category_aro_cvterm_id": "36973", "category_aro_accession": "3000629", "category_aro_class_name": "Antibiotic", "category_aro_description": "Bacitracin A is the primary component of bacitracin. It contains many uncommon amino acids and interferes with bacterial cell wall synthesis."}, "36974": {"category_aro_name": "bacitracin B", "category_aro_cvterm_id": "36974", "category_aro_accession": "3000630", "category_aro_class_name": "Antibiotic", "category_aro_description": "Bacitracin B is a component of bacitracin, an antibiotic mixture that interferes with bacterial cell wall synthesis. It differs from Bacitracin A with a valine instead of an isoleucine in its peptide."}}}}}, "346": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "347": {"$update": {"ARO_description": "SFH-1 confers resistance to carbapenems in Serratia fonticola.", "ARO_category": {"41374": {"category_aro_name": "SFH beta-lactamase", "category_aro_cvterm_id": "41374", "category_aro_accession": "3004210", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "This type of Subclass B2 beta-lactamases was first identified from a Serratia fonticola environmental isolate."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}}}}, "340": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "341": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36029": {"category_aro_name": "IMP beta-lactamase", "category_aro_cvterm_id": "36029", "category_aro_accession": "3000020", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Plasmid mediated IMP-type carbapenemases, of which at least 26 varieties are currently known, became established in Japan in the 1990s in enteric gram-negative organisms, Pseudomonas and Acinetobacter species. Integron-associated, sometimes within plasmids. Hydrolyses all beta-lactams except monobactams, and evades all beta-lactam inhibitors."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "342": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}, "36590": {"$insert": {"category_aro_class_name": "Efflux Regulator"}}}, "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}}}}}, "343": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "348": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "38788": {"category_aro_name": "OXY beta-lactamase", "category_aro_cvterm_id": "38788", "category_aro_accession": "3002388", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXY beta-lactamases are chromosomal class A beta-lactamases that are found in Klebsiella oxytoca. At constitutive low levels, OXY beta-lactamases confer resistance to aminopenicillins and carboxypenicillins. At high induced levels,  OXY beta-lactamases confer resistance to penicillins, cephalosporins and aztreonam."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "349": {"$update": {"ARO_category": {"36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}, "39340": {"category_aro_name": "van ligase", "category_aro_cvterm_id": "39340", "category_aro_accession": "3002906", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "van ligases synthesize alternative substrates for peptidoglycan synthesis that reduce vancomycin binding affinity."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}}}}, "1653": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35953": {"category_aro_name": "sisomicin", "category_aro_cvterm_id": "35953", "category_aro_accession": "0000035", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sisomicin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Sisomicin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36484": {"category_aro_name": "AAC(6')", "category_aro_cvterm_id": "36484", "category_aro_accession": "3000345", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Acetylation of the aminoglycoside antibiotic on the amino group at position 6'."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "35966": {"category_aro_name": "kanamycin A", "category_aro_cvterm_id": "35966", "category_aro_accession": "0000049", "category_aro_class_name": "Antibiotic", "category_aro_description": "Kanamycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Kanamycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35926": {"category_aro_name": "dibekacin", "category_aro_cvterm_id": "35926", "category_aro_accession": "0000007", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dibekacin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Dibekacin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36998": {"category_aro_name": "arbekacin", "category_aro_cvterm_id": "36998", "category_aro_accession": "3000654", "category_aro_class_name": "Antibiotic", "category_aro_description": "A synthetic derivative (1-N-(4-amino-2-hydroxybutyryl) of dibekacin used in Japan. It is active against methicillin-resistant Staph. aureus and shows synergy with ampicillin when treating gentamicin and vancomycin resistant enterocci."}, "36999": {"category_aro_name": "gentamicin B", "category_aro_cvterm_id": "36999", "category_aro_accession": "3000655", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gentamicin B is a semisynthetic aminoglycoside antibacterial."}, "35956": {"category_aro_name": "netilmicin", "category_aro_cvterm_id": "35956", "category_aro_accession": "0000038", "category_aro_class_name": "Antibiotic", "category_aro_description": "Netilmicin is a member of the aminoglycoside family of antibiotics. These antibiotics have the ability to kill a wide variety of bacteria by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth. Netilmicin is not absorbed from the gut and is therefore only given by injection or infusion. It is only used in the treatment of serious infections particularly those resistant to gentamicin."}, "35932": {"category_aro_name": "amikacin", "category_aro_cvterm_id": "35932", "category_aro_accession": "0000013", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amikacin is an aminoglycoside antibiotic that works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36996": {"category_aro_name": "isepamicin", "category_aro_cvterm_id": "36996", "category_aro_accession": "3000652", "category_aro_class_name": "Antibiotic", "category_aro_description": "A semi-synthetic derivative of gentamicin B (hydroxyamino propionyl genamicin B). It is modified to combat microbial inactivation and has a slightly larger spectrum of activity compared to other aminoglycosides, including Ser marcescens, Enterobacteria, and K pneumoniae."}, "35924": {"category_aro_name": "neomycin", "category_aro_cvterm_id": "35924", "category_aro_accession": "0000005", "category_aro_class_name": "Antibiotic", "category_aro_description": "Neomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Neomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35969": {"category_aro_name": "tobramycin", "category_aro_cvterm_id": "35969", "category_aro_accession": "0000052", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tobramycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Tobramycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "2317": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}, "36590": {"$insert": {"category_aro_class_name": "Efflux Regulator"}}}, "$delete": ["39418", "40439", "40190"], "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36002": {"category_aro_name": "ATP-binding cassette (ABC) antibiotic efflux pump", "category_aro_cvterm_id": "36002", "category_aro_accession": "0010001", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. ATP-binding cassette (ABC) transporters are present in all cells of all organisms and use the energy of ATP binding/hydrolysis to transport substrates across cell membranes."}, "41433": {"category_aro_name": "pmr phosphoethanolamine transferase", "category_aro_cvterm_id": "41433", "category_aro_accession": "3004269", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "This family of phosphoethanolamine transferase catalyze the addition of 4-amino-4-deoxy-L-arabinose (L-Ara4N) and phosphoethanolamine to lipid A, which impedes the binding of colistin to the cell membrane."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "40429": {"category_aro_name": "resistance by absence", "category_aro_cvterm_id": "40429", "category_aro_accession": "3003764", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mechanism of antibiotic resistance conferred by deletion of gene (usually a porin)"}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}}}}}, "2310": {"$update": {"model_type": "protein variant model", "model_description": "The protein variant model is an AMR detection model. Protein variant models are similar to protein homolog models - they detect the presence of a protein sequence based on its similarity to a curated reference sequence, but secondarily search submitted query sequences for curated sets of mutations shown clinically to confer resistance relative to wild-type. This model includes a protein reference sequence, a curated BLASTP cut-off, and mapped resistance variants. Mapped resistance variants may include any or all of: single resistance variants, insertions, deletions, co-dependent resistance variants, nonsense SNPs, and/or frameshift mutations. Protein variant model matches to reference sequences are categorized on two criteria: \"strict\" and \"loose\". A strict match has a BLASTP bitscore above the curated BLASTP cutoff value and contains at least one detected mutation from amongst the mapped resistance variants; a loose match has a BLASTP bitscore below the curated BLASTP cutoff value but still contains at least one detected mutation from amongst the mapped resistance variants. Regardless of BLASTP bitscore, if a sequence does not contain one of the mapped resistance variants, it is not considered a match and not detected by the protein variant model.", "ARO_category": {"37633": {"category_aro_name": "kirromycin", "category_aro_cvterm_id": "37633", "category_aro_accession": "3001234", "category_aro_class_name": "Antibiotic", "category_aro_description": "Kirromycin, also known as mocimycin, is the representative molecule of its own class of elfamycins which is composed of more than 10 analogs. Kirromycin binds to the domain 1,2 interface of elongation factor Tu. This interaction maintains the EF-Tu*GTP conformation even after GTP is hydrolyzed to GDP. EF-Tu*GDP normally releases aa-tRNA and then exits the ribosome; however, kirromycin*EF-Tu*GDP*aa-tRNA forms a strong complex and remains bound to the ribosome, prohibits translocation of the peptide chain and translation is halted."}, "36725": {"category_aro_name": "pulvomycin", "category_aro_cvterm_id": "36725", "category_aro_accession": "3000586", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pulvomycin is a polyketide antibiotic that binds elongation factor Tu (EF-Tu) to inhibit protein biosynthesis by preventing the formation of the ternary complex (EF-Tu*GTP*aa-tRNA). Phenotypically, it was shown that pulvomycin sensitivity is dominant over resistance."}, "37711": {"category_aro_name": "elfamycin resistant EF-Tu", "category_aro_cvterm_id": "37711", "category_aro_accession": "3001312", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Sequence variants of elongation factor Tu that confer resistance to elfamycin antibiotics."}, "37636": {"category_aro_name": "GE2270A", "category_aro_cvterm_id": "37636", "category_aro_accession": "3001237", "category_aro_class_name": "Antibiotic", "category_aro_description": "GE2270A is the model molecule of cyclic thiazolyl peptide elfamycins. GE2270A is produced by Planobispora rosea. Biosynthesis of the molecule has been shown to originate as a ribosomally synthesized peptide that undergoes significant post-translational modification. Clinical use of cyclic thiazolyl peptides is hindered by their low water solubility and bioavailability."}, "40497": {"category_aro_name": "kirromycin self resistant EF-Tu", "category_aro_cvterm_id": "40497", "category_aro_accession": "3003810", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Natural producers of kirromycin and kirromycin-like antibiotics (i.e., kirrothrycin) possess self-resistance, which is classified here"}, "39998": {"category_aro_name": "LFF571", "category_aro_cvterm_id": "39998", "category_aro_accession": "3003414", "category_aro_class_name": "Antibiotic", "category_aro_description": "LFF571 is a novel semi-synthetic thiopeptide antibiotic derived from GE2270. It has been shown to possess potent in vitro and in vivo activity against Gram-positive bacteria. It is hypothesized that it a translation inhibitor leading to cell death."}, "37618": {"category_aro_name": "elfamycin antibiotic", "category_aro_cvterm_id": "37618", "category_aro_accession": "3001219", "category_aro_class_name": "Drug Class", "category_aro_description": "Elfamycins are molecules that inhibit bacterial elongation factor Tu (EF-Tu), a key protein which brings aminoacyl-tRNA (aa-tRNA) to the ribosome during protein synthesis. Elfamycins defined by their target (EF-Tu), rather than a conserved chemical backbone. Elfamycins follow two mechanisms to disrupt protein synthesis: 1. kirromycins and enacyloxin fix EF-Tu in the GTP bound conformation and lock EF-Tu onto the ribosome, and 2. pulvomycin and GE2270 cover the binding site of aa-tRNA disallowing EF-Tu from being charged with aa-tRNA. All elfamycins cause increased the affinity of EF-Tu for GTP."}, "37641": {"category_aro_name": "enacyloxin IIa", "category_aro_cvterm_id": "37641", "category_aro_accession": "3001242", "category_aro_class_name": "Antibiotic", "category_aro_description": "Enacyloxin IIa is structurally distinct but acts in a similar mechanism to kirromycin-like elfamycins. It prohibits the transfer of the amino acid at the A site to the elongating peptide chain. It is most likely that the mechanism of action is that EF-Tu*GDP is locked in the EF-Tu*GTP form, and EF-Tu*GDP*aa-tRNA is immobilized on the ribosome. It is an open question whether enacyloxin IIa actually belongs to the kirromycin-like group of elfamycins due to their high similarity."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}}, "model_param": {"$insert": {"snp": {"param_type": "single resistance variant", "param_value": {"8300": "A379T"}, "clinical": {"8300": "A379T"}, "param_type_id": "36301", "param_description": "A nucleotide or amino acid substitution that confers elevated resistance to antibiotic(s) relative to wild type. The most common type encoded in the CARD is an amino acid substitution gleaned from the literature with format [wild-type][position][mutation], e.g. R184Q. When present in the associated gene or protein, a single resistance variant confers resistance to an antibiotic drug or drug class. Single resistance variants are used by the protein variant and rRNA mutation models to detect antibiotic resistance from submitted sequences."}}}, "model_type_id": "40293"}}, "298": {"$update": {"ARO_category": {"36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36216": {"category_aro_name": "vanY", "category_aro_cvterm_id": "36216", "category_aro_accession": "3000077", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "VanY is a D,D-carboxypeptidase that cleaves removes the terminal D-Ala from peptidoglycan for the addition of D-Lactate. The D-Ala-D-Lac peptidoglycan subunits have reduced binding affinity with vancomycin compared to D-Ala-D-Ala."}}}}, "299": {"$update": {"ARO_category": {"41363": {"category_aro_name": "CepS beta-lactamase", "category_aro_cvterm_id": "41363", "category_aro_accession": "3004199", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CepS beta-lactamases are Class C beta-lactamases capable of hydrolyzing cephalosporin."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "296": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "36030": {"category_aro_name": "VIM beta-lactamase", "category_aro_cvterm_id": "36030", "category_aro_accession": "3000021", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "The Verone integron-encoded metallo-beta-lactamase (VIM) family was reported from Italy in 1999. There are, to date, 23 reported variants.  VIM enzymes mostly occur in P. aeruginosa, also P. putida and, very rarely, Enterobacteriaceae. Integron-associated, sometimes within plasmids. Hydrolyses all beta-lactams except monobactams, and evades all beta-lactam inhibitors.  There is a strong incidence of these in East Asia."}}}}, "297": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "294": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "39434": {"category_aro_name": "CfxA beta-lactamase", "category_aro_cvterm_id": "39434", "category_aro_accession": "3003000", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "cfxA beta-lactamases are class A beta-lactamases"}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "295": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "292": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "293": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "290": {"$update": {"ARO_category": {"37018": {"category_aro_name": "dalfopristin", "category_aro_cvterm_id": "37018", "category_aro_accession": "3000674", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dalfopristin is a water-soluble semi-synthetic derivative of pristinamycin IIA. It is produced by Streptomyces pristinaespiralis and is used in combination with quinupristin in a 7:3 ratio. Both work together to inhibit protein synthesis, and is active against Gram-positive bacteria."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36592": {"category_aro_name": "streptogramin vat acetyltransferase", "category_aro_cvterm_id": "36592", "category_aro_accession": "3000453", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "vat (Virginiamycin acetyltransferases) enzymes catalyze the transfer of an acetyl group from acetyl-CoA to the secondary alcohol of streptogramin A compounds, thus inactivating virginiamycin-like antibiotics and conferring resistance to these compounds."}, "37013": {"category_aro_name": "pristinamycin IIA", "category_aro_cvterm_id": "37013", "category_aro_accession": "3000669", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin IIA is a streptogramin A antibiotic."}, "37016": {"category_aro_name": "madumycin II", "category_aro_cvterm_id": "37016", "category_aro_accession": "3000672", "category_aro_class_name": "Antibiotic", "category_aro_description": "Madumycin II is a streptogramin A antibiotic."}, "37017": {"category_aro_name": "griseoviridin", "category_aro_cvterm_id": "37017", "category_aro_accession": "3000673", "category_aro_class_name": "Antibiotic", "category_aro_description": "Griseoviridin is a streptogramin A antibiotic."}, "35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}}}}, "291": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35940": {"category_aro_name": "ribostamycin", "category_aro_cvterm_id": "35940", "category_aro_accession": "0000021", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ribostamycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Ribostamycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "37001": {"category_aro_name": "paromomycin", "category_aro_cvterm_id": "37001", "category_aro_accession": "3000657", "category_aro_class_name": "Antibiotic", "category_aro_description": "An aminoglycoside antibiotic used for the treatment of parasitic infections. It is similar to neomycin sharing a similar spectrum of activity, but its hydroxyl group at the 6'-position instead of an amino group makes it resistant to AAC(6') modifying enzymes."}, "35966": {"category_aro_name": "kanamycin A", "category_aro_cvterm_id": "35966", "category_aro_accession": "0000049", "category_aro_class_name": "Antibiotic", "category_aro_description": "Kanamycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Kanamycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36265": {"category_aro_name": "APH(3')", "category_aro_cvterm_id": "36265", "category_aro_accession": "3000126", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Phosphorylation of 2-deoxystreptamine aminoglycosides on the hydroxyl group at position 3'"}, "35924": {"category_aro_name": "neomycin", "category_aro_cvterm_id": "35924", "category_aro_accession": "0000005", "category_aro_class_name": "Antibiotic", "category_aro_description": "Neomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Neomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "36997": {"category_aro_name": "G418", "category_aro_cvterm_id": "36997", "category_aro_accession": "3000653", "category_aro_class_name": "Antibiotic", "category_aro_description": "A gentamicin class aminoglycoside antibiotic often used in mammalian cell culture work as a selectable marker for the neo cassette (APH3')."}, "37045": {"category_aro_name": "lividomycin B", "category_aro_cvterm_id": "37045", "category_aro_accession": "3000701", "category_aro_class_name": "Antibiotic", "category_aro_description": "Lividomycin B is a derivative of lividomycin A with a removed mannose group (demannosyllividomycin A). Livodomycins interfere with bacterial protein synthesis."}, "37044": {"category_aro_name": "lividomycin A", "category_aro_cvterm_id": "37044", "category_aro_accession": "3000700", "category_aro_class_name": "Antibiotic", "category_aro_description": "Lividomycin A is a pentasaccharide antibiotic which interferes with bacterial protein synthesis."}}}}, "270": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36236": {"category_aro_name": "LEN beta-lactamase", "category_aro_cvterm_id": "36236", "category_aro_accession": "3000097", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "LEN beta-lactamases are chromosomal class A beta-lactamases that confer resistance to ampicillin, amoxicillin, carbenicillin, and ticarcillin but not to extended-spectrum beta-lactams."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}}}}, "271": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "272": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "273": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36182": {"category_aro_name": "VEB beta-lactamase", "category_aro_cvterm_id": "36182", "category_aro_accession": "3000043", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "VEB beta-lactamases or Vietnamese extended-spectrum beta-lactamases are class A beta-lactamases that confer high-level resistance to oxyimino cephalosporins and to aztreonam"}}}}, "274": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "275": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "38817": {"category_aro_name": "OKP beta-lactamase", "category_aro_cvterm_id": "38817", "category_aro_accession": "3002417", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OKP beta-lactamases are chromosomal class A beta-lactamase that confer resistance to penicillins and early cephalosporins in Klebsiella pneumoniae. OKP beta-lactamases can be subdivided into two groups: OKP-A and OKP-B which diverge by about 4.2%"}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "276": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}, "36590": {"$insert": {"category_aro_class_name": "Efflux Regulator"}}}, "$delete": ["35950"], "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35949": {"category_aro_name": "tigecycline", "category_aro_cvterm_id": "35949", "category_aro_accession": "0000030", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tigecycline is an glycylcycline antibiotic. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35960": {"category_aro_name": "glycylcycline", "category_aro_cvterm_id": "35960", "category_aro_accession": "0000042", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycylcyclines are a new class of antibiotics derived from tetracycline. These tetracycline analogues are specifically designed to overcome two common mechanisms of tetracycline resistance. Presently, there is only one glycylcycline antibiotic for clinical use: tigecycline. It works by inhibiting action of the prokaryotic 30S ribosome, preventing the binding of aminoacyl-tRNA."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}}}}}, "277": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "278": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36720": {"category_aro_name": "CphA beta-lactamase", "category_aro_cvterm_id": "36720", "category_aro_accession": "3000581", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CphA is an Ambler Class B MBL; subclass B2 originally isolated from Aeromonas hydrophilia.  This enzyme has specific activity against carbapenems and is active as a mono-zinc protein."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}}}}, "279": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "1132": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "2262": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}}}}}, "2260": {"$update": {"ARO_category": {"37018": {"category_aro_name": "dalfopristin", "category_aro_cvterm_id": "37018", "category_aro_accession": "3000674", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dalfopristin is a water-soluble semi-synthetic derivative of pristinamycin IIA. It is produced by Streptomyces pristinaespiralis and is used in combination with quinupristin in a 7:3 ratio. Both work together to inhibit protein synthesis, and is active against Gram-positive bacteria."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36592": {"category_aro_name": "streptogramin vat acetyltransferase", "category_aro_cvterm_id": "36592", "category_aro_accession": "3000453", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "vat (Virginiamycin acetyltransferases) enzymes catalyze the transfer of an acetyl group from acetyl-CoA to the secondary alcohol of streptogramin A compounds, thus inactivating virginiamycin-like antibiotics and conferring resistance to these compounds."}, "37013": {"category_aro_name": "pristinamycin IIA", "category_aro_cvterm_id": "37013", "category_aro_accession": "3000669", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin IIA is a streptogramin A antibiotic."}, "37016": {"category_aro_name": "madumycin II", "category_aro_cvterm_id": "37016", "category_aro_accession": "3000672", "category_aro_class_name": "Antibiotic", "category_aro_description": "Madumycin II is a streptogramin A antibiotic."}, "37017": {"category_aro_name": "griseoviridin", "category_aro_cvterm_id": "37017", "category_aro_accession": "3000673", "category_aro_class_name": "Antibiotic", "category_aro_description": "Griseoviridin is a streptogramin A antibiotic."}, "35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}}}}, "2261": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36360": {"category_aro_name": "lincosamide nucleotidyltransferase (LNU)", "category_aro_cvterm_id": "36360", "category_aro_accession": "3000221", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Resistance to the lincosamide antibiotic by ATP-dependent modification of the 3' and/or 4'-hydroxyl groups of the methylthiolincosamide sugar."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}}}}, "2267": {"$update": {"ARO_category": {"35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "41240": {"category_aro_name": "nitrofuran antibiotic", "category_aro_cvterm_id": "41240", "category_aro_accession": "3004116", "category_aro_class_name": "Drug Class", "category_aro_description": "Nitrofurans are chemotherapeutic agents with antibacterial and antiprotozoal activity."}, "35992": {"category_aro_name": "nitrofurantoin", "category_aro_cvterm_id": "35992", "category_aro_accession": "0000075", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nitrofurantoin is an antibiotic used to treat urinary tract infections. It inhibits enzyme synthesis by inhibiting essential enzymes involved in the citric acid cycle, as well as those involved in DNA, RNA, and protein synthesis. It is marketed under the following brand names: Furadantin, Macrobid, Macrodantin, Nitro Macro and Urantoin."}, "40411": {"category_aro_name": "antibiotic resistant nfsA", "category_aro_cvterm_id": "40411", "category_aro_accession": "3003754", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "The nfsA-encoded nitroreductase is the major oxygen-insensitive nitroreductase present in E. coli. NfsA uses only NADPH and has broad electron acceptor specificity. Mutations in nfsA cause resistance to nitrofurazone and furazolidone. Resistance to nitrofurantoin via mutation of nfsA reduces the fitness of clinical isolates of E. coli."}}}}, "2264": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36002": {"category_aro_name": "ATP-binding cassette (ABC) antibiotic efflux pump", "category_aro_cvterm_id": "36002", "category_aro_accession": "0010001", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. ATP-binding cassette (ABC) transporters are present in all cells of all organisms and use the energy of ATP binding/hydrolysis to transport substrates across cell membranes."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "37247": {"category_aro_name": "oleandomycin", "category_aro_cvterm_id": "37247", "category_aro_accession": "3000867", "category_aro_class_name": "Antibiotic", "category_aro_description": "Oleandomycin is a 14-membered macrolide produced by Streptomyces antibioticus. It is ssimilar to erythromycin, and contains a desosamine amino sugar and an oleandrose sugar. It targets the 50S ribosomal subunit to prevent protein synthesis."}}}}}, "2265": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"37716": {"category_aro_name": "pleuromutilin", "category_aro_cvterm_id": "37716", "category_aro_accession": "3001317", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pleuromutilin is a natural product antibiotic produced by Clitopilus passeckerianus. Related antibiotics of clinical significance, such as tiamulin and retapamulin, are semi-synthetic derivatives of this compound."}, "36002": {"category_aro_name": "ATP-binding cassette (ABC) antibiotic efflux pump", "category_aro_cvterm_id": "36002", "category_aro_accession": "0010001", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. ATP-binding cassette (ABC) transporters are present in all cells of all organisms and use the energy of ATP binding/hydrolysis to transport substrates across cell membranes."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "37014": {"category_aro_name": "pleuromutilin antibiotic", "category_aro_cvterm_id": "37014", "category_aro_accession": "3000670", "category_aro_class_name": "Drug Class", "category_aro_description": "Pleuromutilins are natural fungal products that target bacterial protein translation by binding the the 23S rRNA, blocking the ribosome P site at the 50S subunit. They are mostly used for agriculture and veterinary purposes."}, "35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}}}}}, "2445": {"$update": {"ARO_category": {"35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}, "36699": {"category_aro_name": "Erm 23S ribosomal RNA methyltransferase", "category_aro_cvterm_id": "36699", "category_aro_accession": "3000560", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Erm proteins are part of the RNA methyltransferase family and methylate A2058 (E. coli nomenclature) of the 23S ribosomal RNA conferring degrees of resistance to Macrolides, Lincosamides and Streptogramin b. This is called the MLSb phenotype."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}}}}, "108": {"$update": {"ARO_category": {"36237": {"category_aro_name": "PDC beta-lactamase", "category_aro_cvterm_id": "36237", "category_aro_accession": "3000098", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "PDC beta-lactamases are class C beta-lactamases that are found in Pseudomonas aeruginosa."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "109": {"$update": {"ARO_category": {"35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "37022": {"category_aro_name": "vernamycin B-gamma", "category_aro_cvterm_id": "37022", "category_aro_accession": "3000678", "category_aro_class_name": "Antibiotic", "category_aro_description": "Vernamycin B-gamma is a class B streptogramin derived from virginiamycin S1."}, "37247": {"category_aro_name": "oleandomycin", "category_aro_cvterm_id": "37247", "category_aro_accession": "3000867", "category_aro_class_name": "Antibiotic", "category_aro_description": "Oleandomycin is a 14-membered macrolide produced by Streptomyces antibioticus. It is ssimilar to erythromycin, and contains a desosamine amino sugar and an oleandrose sugar. It targets the 50S ribosomal subunit to prevent protein synthesis."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35974": {"category_aro_name": "telithromycin", "category_aro_cvterm_id": "35974", "category_aro_accession": "0000057", "category_aro_class_name": "Antibiotic", "category_aro_description": "Telithromycin is a semi-synthetic derivative of erythromycin. It is a 14-membered macrolide and is the first ketolide antibiotic to be used in clinics. Telithromycin binds the 50S subunit of the bacterial ribosome to inhibit protein synthesis."}, "36284": {"category_aro_name": "tylosin", "category_aro_cvterm_id": "36284", "category_aro_accession": "3000145", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tylosin is a 16-membered macrolide, naturally produced by Streptomyces fradiae. It interacts with the bacterial ribosome 50S subunit to inhibit protein synthesis."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}, "36315": {"category_aro_name": "dirithromycin", "category_aro_cvterm_id": "36315", "category_aro_accession": "3000176", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dirithromycin is an oxazine derivative of erythromycin, sharing the 14-carbon macrolide ring. The antibiotic binds to the 50S subunit of the ribosome to inhibit bacterial protein synthesis."}, "35982": {"category_aro_name": "clarithromycin", "category_aro_cvterm_id": "35982", "category_aro_accession": "0000065", "category_aro_class_name": "Antibiotic", "category_aro_description": "Clarithromycin is a methyl derivative of erythromycin, sharing the 14-carbon macrolide ring. The antibiotic binds to the 50S subunit of the ribosome and is used to treat pharyngitis, tonsillitis, acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, pneumonia (especially atypical pneumonias associated with Chlamydia pneumoniae or TWAR), and skin structure infections."}, "35983": {"category_aro_name": "clindamycin", "category_aro_cvterm_id": "35983", "category_aro_accession": "0000066", "category_aro_class_name": "Antibiotic", "category_aro_description": "Clindamycin is a lincosamide antibiotic that blocks A-site aminoacyl-tRNA binding. It is usually used to treat infections with anaerobic bacteria but can also be used to treat some protozoal diseases, such as malaria."}, "37018": {"category_aro_name": "dalfopristin", "category_aro_cvterm_id": "37018", "category_aro_accession": "3000674", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dalfopristin is a water-soluble semi-synthetic derivative of pristinamycin IIA. It is produced by Streptomyces pristinaespiralis and is used in combination with quinupristin in a 7:3 ratio. Both work together to inhibit protein synthesis, and is active against Gram-positive bacteria."}, "37019": {"category_aro_name": "pristinamycin IB", "category_aro_cvterm_id": "37019", "category_aro_accession": "3000675", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin IB is a class B streptogramin similar to pristinamycin IA, the former containing a N-methyl-4-(methylamino)phenylalanine instead of a N-methyl-4-(dimethylamino)phenylalanine in its class A streptogramin counterpart (one less methyl group)."}, "36723": {"category_aro_name": "quinupristin", "category_aro_cvterm_id": "36723", "category_aro_accession": "3000584", "category_aro_class_name": "Antibiotic", "category_aro_description": "Quinupristin is a type B streptogramin and a semisynthetic derivative of pristinamycin 1A. It is a component of the drug Synercid and interacts with the 50S subunit of the bacterial ribosome to inhibit protein synthesis."}, "36722": {"category_aro_name": "pristinamycin IA", "category_aro_cvterm_id": "36722", "category_aro_accession": "3000583", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin 1A is a type B streptogramin antibiotic produced by Streptomyces pristinaespiralis. It binds to the P site of the 50S subunit of the bacterial ribosome, preventing the extension of protein chains."}, "36699": {"category_aro_name": "Erm 23S ribosomal RNA methyltransferase", "category_aro_cvterm_id": "36699", "category_aro_accession": "3000560", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Erm proteins are part of the RNA methyltransferase family and methylate A2058 (E. coli nomenclature) of the 23S ribosomal RNA conferring degrees of resistance to Macrolides, Lincosamides and Streptogramin b. This is called the MLSb phenotype."}, "37013": {"category_aro_name": "pristinamycin IIA", "category_aro_cvterm_id": "37013", "category_aro_accession": "3000669", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin IIA is a streptogramin A antibiotic."}, "37016": {"category_aro_name": "madumycin II", "category_aro_cvterm_id": "37016", "category_aro_accession": "3000672", "category_aro_class_name": "Antibiotic", "category_aro_description": "Madumycin II is a streptogramin A antibiotic."}, "37017": {"category_aro_name": "griseoviridin", "category_aro_cvterm_id": "37017", "category_aro_accession": "3000673", "category_aro_class_name": "Antibiotic", "category_aro_description": "Griseoviridin is a streptogramin A antibiotic."}, "35964": {"category_aro_name": "lincomycin", "category_aro_cvterm_id": "35964", "category_aro_accession": "0000046", "category_aro_class_name": "Antibiotic", "category_aro_description": "Lincomycin is a lincosamide antibiotic that comes from the actinomyces Streptomyces lincolnensis. It binds to the 23s portion of the 50S subunit of bacterial ribosomes and inhibit early elongation of peptide chain by inhibiting transpeptidase reaction."}, "35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}, "35946": {"category_aro_name": "roxithromycin", "category_aro_cvterm_id": "35946", "category_aro_accession": "0000027", "category_aro_class_name": "Antibiotic", "category_aro_description": "Roxithromycin is a semi-synthetic, 14-carbon ring macrolide antibiotic derived from erythromycin. It is used to treat respiratory tract, urinary and soft tissue infections. Roxithromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}, "36295": {"category_aro_name": "spiramycin", "category_aro_cvterm_id": "36295", "category_aro_accession": "3000156", "category_aro_class_name": "Antibiotic", "category_aro_description": "Spiramycin is a 16-membered macrolide and is natural product produced by Streptomyces ambofaciens. It binds to the 50S subunit of bacterial ribosomes and inhibits peptidyl transfer activity to disrupt protein synthesis."}, "36297": {"category_aro_name": "azithromycin", "category_aro_cvterm_id": "36297", "category_aro_accession": "3000158", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azithromycin is a 15-membered macrolide and falls under the subclass of azalide. Like other macrolides, azithromycin binds bacterial ribosomes to inhibit protein synthesis. The nitrogen substitution at the C-9a position prevents its degradation."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}}}}, "102": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "39785": {"category_aro_name": "TLA beta-lactamase", "category_aro_cvterm_id": "39785", "category_aro_accession": "3003201", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "The TLA beta-lactamases are resistant to expanded-spectrum cephalosporins, aztreonam, ciprofloxacin, and ofloxacin but was susceptible to amikacin, cefotetan, and imipenem."}}}}, "103": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35977": {"category_aro_name": "ceftazidime", "category_aro_cvterm_id": "35977", "category_aro_accession": "0000060", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftazidime is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria. Unlike most third-generation agents, it is active against Pseudomonas aeruginosa, however it has weaker activity against Gram-positive microorganisms and is not used for such infections."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "37084": {"category_aro_name": "cefalotin", "category_aro_cvterm_id": "37084", "category_aro_accession": "3000704", "category_aro_class_name": "Antibiotic", "category_aro_description": "Cefalotin is a semisynthetic cephalosporin antibiotic activate against staphylococci. It is resistant to staphylococci beta-lactamases but hydrolyzed by enterobacterial beta-lactamases."}, "35979": {"category_aro_name": "ceftriaxone", "category_aro_cvterm_id": "35979", "category_aro_accession": "0000062", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftriaxone is a third-generation cephalosporin antibiotic. The presence of an aminothiazolyl sidechain increases ceftriazone's resistance to beta-lactamases. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "100": {"$update": {"ARO_category": {"36659": {"category_aro_name": "isoniazid", "category_aro_cvterm_id": "36659", "category_aro_accession": "3000520", "category_aro_class_name": "Drug Class", "category_aro_description": "Isoniazid is an organic compound that is the first-line anti tuberculosis medication in prevention and treatment. As a prodrug, it is activated by mycobacterial catalase-peroxidases such as M. tuberculosis KatG. Isoniazid inhibits mycolic acid synthesis, which prevents cell wall synthesis in mycobacteria."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "40067": {"category_aro_name": "ethionamide", "category_aro_cvterm_id": "40067", "category_aro_accession": "3003474", "category_aro_class_name": "Drug Class", "category_aro_description": "ethionamide is a second-line antitubercular agent that inhibits mycolic acid synthesis"}, "40050": {"category_aro_name": "ethionamide resistant ethA", "category_aro_cvterm_id": "40050", "category_aro_accession": "3003457", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Mutations that occurs on the ethA genes resulting in the inability to catalyzes the oxidation of ethionamide (ETH) to the corresponding sulfoxide (the active drug)"}}}}, "101": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "106": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36595": {"category_aro_name": "thiamphenicol", "category_aro_cvterm_id": "36595", "category_aro_accession": "3000456", "category_aro_class_name": "Antibiotic", "category_aro_description": "Derivative of Chloramphenicol. The nitro group (-NO2) is substituted by a sulfomethyl group (-SO2CH3)."}, "36261": {"category_aro_name": "chloramphenicol acetyltransferase (CAT)", "category_aro_cvterm_id": "36261", "category_aro_accession": "3000122", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Inactivates chloramphenicol by addition of an acyl group. cat is used to describe many variants of the chloramphenicol acetyltransferase gene in a range of organisms including Acinetobacter calcoaceticus, Agrobacterium tumefaciens, Bacillus clausii, Bacillus subtilis, Campylobacter coli, Enterococcus faecalis, Enterococcus faecium, Lactococcus lactis, Listeria monocytogenes, Listonella anguillarum Morganella morganii, Photobacterium damselae subsp. piscicida, Proteus mirabilis, Salmonella typhi, Serratia marcescens, Shigella flexneri, Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus intermedius, Streptococcus agalactiae, Streptococcus suis and Streptomyces acrimycini"}, "36521": {"category_aro_name": "azidamfenicol", "category_aro_cvterm_id": "36521", "category_aro_accession": "3000382", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azidamfenicol is a water soluble derivative of chloramphenicol, sharing the same mode of action of inhibiting peptide synthesis by interacting with the 23S RNA of the 50S ribosomal subunit."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}, "107": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "104": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "105": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36230": {"category_aro_name": "CARB beta-lactamase", "category_aro_cvterm_id": "36230", "category_aro_accession": "3000091", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CARB beta-lactamases are class A lactamases that can hydrolyze carbenicillin. Many of the PSE beta-lactamases have been renamed as CARB-lactamases with the notable exception of PSE-2 which is now OXA-10."}}}}, "2046": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}}}}}, "2047": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "2044": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "2045": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "38788": {"category_aro_name": "OXY beta-lactamase", "category_aro_cvterm_id": "38788", "category_aro_accession": "3002388", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXY beta-lactamases are chromosomal class A beta-lactamases that are found in Klebsiella oxytoca. At constitutive low levels, OXY beta-lactamases confer resistance to aminopenicillins and carboxypenicillins. At high induced levels,  OXY beta-lactamases confer resistance to penicillins, cephalosporins and aztreonam."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "2042": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36199": {"category_aro_name": "IND beta-lactamase", "category_aro_cvterm_id": "36199", "category_aro_accession": "3000060", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "IND beta-lactamases are class B carbapenem-hydrolyzing beta-lactamases"}}}}, "2043": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35957": {"category_aro_name": "spectinomycin", "category_aro_cvterm_id": "35957", "category_aro_accession": "0000039", "category_aro_class_name": "Antibiotic", "category_aro_description": "Spectinomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Spectinomycin works by binding to the bacterial 30S ribosomal subunit inhibiting translation."}, "41439": {"category_aro_name": "ANT(3'')", "category_aro_cvterm_id": "41439", "category_aro_accession": "3004275", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Nucleotidylylation of streptomycin at the hydroxyl group at position 3''"}, "35958": {"category_aro_name": "streptomycin", "category_aro_cvterm_id": "35958", "category_aro_accession": "0000040", "category_aro_class_name": "Antibiotic", "category_aro_description": "Streptomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Streptomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "2040": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "2041": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "2048": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "2049": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "1213": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}, "36590": {"$insert": {"category_aro_class_name": "Efflux Regulator"}}}, "$insert": {"36421": {"category_aro_name": "sulfonamide antibiotic", "category_aro_cvterm_id": "36421", "category_aro_accession": "3000282", "category_aro_class_name": "Drug Class", "category_aro_description": "Sulfonamides are broad spectrum, synthetic antibiotics that contain the sulfonamide group. Sulfonamides inhibit dihydropteroate synthase, which catalyzes the conversion of p-aminobenzoic acid to dihydropteroic acid as part of the tetrahydrofolic acid biosynthetic pathway. Tetrahydrofolic acid is essential for folate synthesis, a precursor of many nucleotides and amino acids. Many sulfamides are taken with trimethoprim, an inhibitor of dihydrofolate reductase, also disturbing the trihydrofolic acid synthesis pathway."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "40362": {"category_aro_name": "panipenem", "category_aro_cvterm_id": "40362", "category_aro_accession": "3003708", "category_aro_class_name": "Antibiotic", "category_aro_description": "Panipenem is a carbapenem antibacterial agent with a broad spectrum of in vitro activity covering a wide range of Gram-negative and Gram-positive aerobic and anaerobic bacterial.  It is used in combination with betamipron to inhibit panipenem uptake into the renal tubule and prevent nephrotoxicity."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35996": {"category_aro_name": "clavulanate", "category_aro_cvterm_id": "35996", "category_aro_accession": "0000079", "category_aro_class_name": "Adjuvant", "category_aro_description": "Clavulanic acid is a beta-lactamase inhibitor (marketed by GlaxoSmithKline, formerly Beecham) combined with penicillin group antibiotics to overcome certain types of antibiotic resistance. It is used to overcome resistance in bacteria that secrete beta-lactamase, which otherwise inactivates most penicillins."}, "35990": {"category_aro_name": "meropenem", "category_aro_cvterm_id": "35990", "category_aro_accession": "0000073", "category_aro_class_name": "Antibiotic", "category_aro_description": "Meropenem is an ultra-broad spectrum injectable antibiotic used to treat a wide variety of infections, including meningitis and pneumonia. It is a beta-lactam and belongs to the subgroup of carbapenem, similar to imipenem and ertapenem."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "36689": {"category_aro_name": "aztreonam", "category_aro_cvterm_id": "36689", "category_aro_accession": "3000550", "category_aro_class_name": "Antibiotic", "category_aro_description": "Aztreonam was the first monobactam discovered, and is greatly effective against Gram-negative bacteria while inactive against Gram-positive bacteria. Artreonam is a poor substrate for beta-lactamases, and may even act as an inhibitor. In Gram-negative bacteria, Aztreonam interferes with filamentation, inhibiting cell division and leading to cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "36242": {"category_aro_name": "aminocoumarin antibiotic", "category_aro_cvterm_id": "36242", "category_aro_accession": "3000103", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminocoumarin antibiotics bind DNA gyrase subunit B to inhibit ATP-dependent DNA supercoiling."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35977": {"category_aro_name": "ceftazidime", "category_aro_cvterm_id": "35977", "category_aro_accession": "0000060", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftazidime is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria. Unlike most third-generation agents, it is active against Pseudomonas aeruginosa, however it has weaker activity against Gram-positive microorganisms and is not used for such infections."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35979": {"category_aro_name": "ceftriaxone", "category_aro_cvterm_id": "35979", "category_aro_accession": "0000062", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftriaxone is a third-generation cephalosporin antibiotic. The presence of an aminothiazolyl sidechain increases ceftriazone's resistance to beta-lactamases. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "40523": {"category_aro_name": "ticarcillin", "category_aro_cvterm_id": "40523", "category_aro_accession": "3003832", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ticarcillin is a carboxypenicillin used for the treatment of Gram-negative bacteria, particularly P. aeruginosa. Ticarcillin's antibiotic properties arise from its ability to prevent cross-linking of peptidoglycan during cell wall synthesis, when the bacteria try to divide, causing cell death."}, "36981": {"category_aro_name": "ampicillin", "category_aro_cvterm_id": "36981", "category_aro_accession": "3000637", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ampicillin is a penicillin derivative that is highly acid stable, with its activity similar to benzylpenicillin."}, "35981": {"category_aro_name": "amoxicillin", "category_aro_cvterm_id": "35981", "category_aro_accession": "0000064", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amoxicillin is a moderate-spectrum, bacteriolytic, beta-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. A derivative of penicillin, it has a wider range of treatment but remains relatively ineffective against Gram-negative bacteria. It is commonly taken with clavulanic acid, a beta-lactamase inhibitor. Like other beta-lactams, amoxicillin interferes with the synthesis of peptidoglycan."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36468": {"category_aro_name": "sulfamethoxazole", "category_aro_cvterm_id": "36468", "category_aro_accession": "3000329", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfamethoxazole is a sulfonamide antibiotic usually taken with trimethoprim, a diaminopyrimidine antibiotic. Sulfamethoxazole inhibits dihydropteroate synthase, essential to tetrahydrofolic acid biosynthesis. This pathway generates compounds used in the synthesis of many amino acids and nucleotides."}, "36250": {"category_aro_name": "novobiocin", "category_aro_cvterm_id": "36250", "category_aro_accession": "3000111", "category_aro_class_name": "Antibiotic", "category_aro_description": "Novobiocin is an aminocoumarin antibiotic produced by Streptomyces spheroides and Streptomyces niveus, and binds DNA gyrase subunit B inhibiting ATP-dependent DNA supercoiling."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "40957": {"category_aro_name": "trimethoprim-sulfamethoxazole", "category_aro_cvterm_id": "40957", "category_aro_accession": "3004024", "category_aro_class_name": "Antibiotic", "category_aro_description": "An antibiotic cocktail containing the diaminopyrimidine antibiotic Trimethoprim and the sulfonamide antibiotic sulfamethoxazole (1 TMP:5 SMX)."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36297": {"category_aro_name": "azithromycin", "category_aro_cvterm_id": "36297", "category_aro_accession": "3000158", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azithromycin is a 15-membered macrolide and falls under the subclass of azalide. Like other macrolides, azithromycin binds bacterial ribosomes to inhibit protein synthesis. The nitrogen substitution at the C-9a position prevents its degradation."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "2038": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36198": {"category_aro_name": "KPC beta-lactamase", "category_aro_cvterm_id": "36198", "category_aro_accession": "3000059", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Klebsiella pneumoniae carbapenem resistant (KPC) beta-lactamases are notorious for their ability to efficiently hydrolyze carbapenems, unlike other Ambler Class A beta-lactamases.  There are currently 9 variants reported worldwide.  These enzymes were first isolated from Klebsiella pneumoniae strains in 2001 in the United States.  Hospital outbreaks have since been reported in Greece and Israel and KPC carrying strains are now endemic to New York facilities.  KPC-1 and KPC-2 have been shown to be identical and are now referred to as KPC-2."}}}}, "1210": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36002": {"category_aro_name": "ATP-binding cassette (ABC) antibiotic efflux pump", "category_aro_cvterm_id": "36002", "category_aro_accession": "0010001", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. ATP-binding cassette (ABC) transporters are present in all cells of all organisms and use the energy of ATP binding/hydrolysis to transport substrates across cell membranes."}, "36242": {"category_aro_name": "aminocoumarin antibiotic", "category_aro_cvterm_id": "36242", "category_aro_accession": "3000103", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminocoumarin antibiotics bind DNA gyrase subunit B to inhibit ATP-dependent DNA supercoiling."}, "36250": {"category_aro_name": "novobiocin", "category_aro_cvterm_id": "36250", "category_aro_accession": "3000111", "category_aro_class_name": "Antibiotic", "category_aro_description": "Novobiocin is an aminocoumarin antibiotic produced by Streptomyces spheroides and Streptomyces niveus, and binds DNA gyrase subunit B inhibiting ATP-dependent DNA supercoiling."}}}}}, "2688": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}, "36590": {"$insert": {"category_aro_class_name": "Efflux Regulator"}}}, "$insert": {"36421": {"category_aro_name": "sulfonamide antibiotic", "category_aro_cvterm_id": "36421", "category_aro_accession": "3000282", "category_aro_class_name": "Drug Class", "category_aro_description": "Sulfonamides are broad spectrum, synthetic antibiotics that contain the sulfonamide group. Sulfonamides inhibit dihydropteroate synthase, which catalyzes the conversion of p-aminobenzoic acid to dihydropteroic acid as part of the tetrahydrofolic acid biosynthetic pathway. Tetrahydrofolic acid is essential for folate synthesis, a precursor of many nucleotides and amino acids. Many sulfamides are taken with trimethoprim, an inhibitor of dihydrofolate reductase, also disturbing the trihydrofolic acid synthesis pathway."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "40362": {"category_aro_name": "panipenem", "category_aro_cvterm_id": "40362", "category_aro_accession": "3003708", "category_aro_class_name": "Antibiotic", "category_aro_description": "Panipenem is a carbapenem antibacterial agent with a broad spectrum of in vitro activity covering a wide range of Gram-negative and Gram-positive aerobic and anaerobic bacterial.  It is used in combination with betamipron to inhibit panipenem uptake into the renal tubule and prevent nephrotoxicity."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35996": {"category_aro_name": "clavulanate", "category_aro_cvterm_id": "35996", "category_aro_accession": "0000079", "category_aro_class_name": "Adjuvant", "category_aro_description": "Clavulanic acid is a beta-lactamase inhibitor (marketed by GlaxoSmithKline, formerly Beecham) combined with penicillin group antibiotics to overcome certain types of antibiotic resistance. It is used to overcome resistance in bacteria that secrete beta-lactamase, which otherwise inactivates most penicillins."}, "35990": {"category_aro_name": "meropenem", "category_aro_cvterm_id": "35990", "category_aro_accession": "0000073", "category_aro_class_name": "Antibiotic", "category_aro_description": "Meropenem is an ultra-broad spectrum injectable antibiotic used to treat a wide variety of infections, including meningitis and pneumonia. It is a beta-lactam and belongs to the subgroup of carbapenem, similar to imipenem and ertapenem."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "36689": {"category_aro_name": "aztreonam", "category_aro_cvterm_id": "36689", "category_aro_accession": "3000550", "category_aro_class_name": "Antibiotic", "category_aro_description": "Aztreonam was the first monobactam discovered, and is greatly effective against Gram-negative bacteria while inactive against Gram-positive bacteria. Artreonam is a poor substrate for beta-lactamases, and may even act as an inhibitor. In Gram-negative bacteria, Aztreonam interferes with filamentation, inhibiting cell division and leading to cell death."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36242": {"category_aro_name": "aminocoumarin antibiotic", "category_aro_cvterm_id": "36242", "category_aro_accession": "3000103", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminocoumarin antibiotics bind DNA gyrase subunit B to inhibit ATP-dependent DNA supercoiling."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35977": {"category_aro_name": "ceftazidime", "category_aro_cvterm_id": "35977", "category_aro_accession": "0000060", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftazidime is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria. Unlike most third-generation agents, it is active against Pseudomonas aeruginosa, however it has weaker activity against Gram-positive microorganisms and is not used for such infections."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35979": {"category_aro_name": "ceftriaxone", "category_aro_cvterm_id": "35979", "category_aro_accession": "0000062", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftriaxone is a third-generation cephalosporin antibiotic. The presence of an aminothiazolyl sidechain increases ceftriazone's resistance to beta-lactamases. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "36981": {"category_aro_name": "ampicillin", "category_aro_cvterm_id": "36981", "category_aro_accession": "3000637", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ampicillin is a penicillin derivative that is highly acid stable, with its activity similar to benzylpenicillin."}, "35981": {"category_aro_name": "amoxicillin", "category_aro_cvterm_id": "35981", "category_aro_accession": "0000064", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amoxicillin is a moderate-spectrum, bacteriolytic, beta-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. A derivative of penicillin, it has a wider range of treatment but remains relatively ineffective against Gram-negative bacteria. It is commonly taken with clavulanic acid, a beta-lactamase inhibitor. Like other beta-lactams, amoxicillin interferes with the synthesis of peptidoglycan."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36468": {"category_aro_name": "sulfamethoxazole", "category_aro_cvterm_id": "36468", "category_aro_accession": "3000329", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfamethoxazole is a sulfonamide antibiotic usually taken with trimethoprim, a diaminopyrimidine antibiotic. Sulfamethoxazole inhibits dihydropteroate synthase, essential to tetrahydrofolic acid biosynthesis. This pathway generates compounds used in the synthesis of many amino acids and nucleotides."}, "36250": {"category_aro_name": "novobiocin", "category_aro_cvterm_id": "36250", "category_aro_accession": "3000111", "category_aro_class_name": "Antibiotic", "category_aro_description": "Novobiocin is an aminocoumarin antibiotic produced by Streptomyces spheroides and Streptomyces niveus, and binds DNA gyrase subunit B inhibiting ATP-dependent DNA supercoiling."}, "40957": {"category_aro_name": "trimethoprim-sulfamethoxazole", "category_aro_cvterm_id": "40957", "category_aro_accession": "3004024", "category_aro_class_name": "Antibiotic", "category_aro_description": "An antibiotic cocktail containing the diaminopyrimidine antibiotic Trimethoprim and the sulfonamide antibiotic sulfamethoxazole (1 TMP:5 SMX)."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36297": {"category_aro_name": "azithromycin", "category_aro_cvterm_id": "36297", "category_aro_accession": "3000158", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azithromycin is a 15-membered macrolide and falls under the subclass of azalide. Like other macrolides, azithromycin binds bacterial ribosomes to inhibit protein synthesis. The nitrogen substitution at the C-9a position prevents its degradation."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "2689": {"$update": {"ARO_category": {"35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "37022": {"category_aro_name": "vernamycin B-gamma", "category_aro_cvterm_id": "37022", "category_aro_accession": "3000678", "category_aro_class_name": "Antibiotic", "category_aro_description": "Vernamycin B-gamma is a class B streptogramin derived from virginiamycin S1."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "36600": {"category_aro_name": "florfenicol", "category_aro_cvterm_id": "36600", "category_aro_accession": "3000461", "category_aro_class_name": "Antibiotic", "category_aro_description": "Florfenicol is a fluorine derivative of chloramphenicol, where the nitro group (-NO2) is substituted by a sulfomethyl group (-SO2CH3) and the hydroxyl group (-OH), by a fluorine group (-F). The action mechanism is the same as chloramphenicol's, where the antibiotic binds to the 23S RNA of the 50S subunit of bacterial ribosomes to inhibit protein synthesis."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}, "36595": {"category_aro_name": "thiamphenicol", "category_aro_cvterm_id": "36595", "category_aro_accession": "3000456", "category_aro_class_name": "Antibiotic", "category_aro_description": "Derivative of Chloramphenicol. The nitro group (-NO2) is substituted by a sulfomethyl group (-SO2CH3)."}, "41123": {"category_aro_name": "23S rRNA with mutation conferring resistance to linezolid antibiotics", "category_aro_cvterm_id": "41123", "category_aro_accession": "3004057", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Point mutations in the 23S rRNA subunit may confer resistance to linezolid and other oxazolidinone antibiotics."}, "35989": {"category_aro_name": "linezolid", "category_aro_cvterm_id": "35989", "category_aro_accession": "0000072", "category_aro_class_name": "Antibiotic", "category_aro_description": "Linezolid is a synthetic antibiotic used for the treatment of serious infections caused by Gram-positive bacteria that are resistant to several other antibiotics. It inhibits protein synthesis by binding to domain V of the 23S rRNA of the 50S subunit of bacterial ribosomes."}, "36218": {"category_aro_name": "oxazolidinone antibiotic", "category_aro_cvterm_id": "36218", "category_aro_accession": "3000079", "category_aro_class_name": "Drug Class", "category_aro_description": "Oxazolidinones are a class of synthetic antibiotics discovered the the 1980's.  They inhibit protein synthesis by binding to domain V of the 23S rRNA of the 50S subunit of bacterial ribosomes.  Linezolid is the only member of this class currently in clinical use."}, "35983": {"category_aro_name": "clindamycin", "category_aro_cvterm_id": "35983", "category_aro_accession": "0000066", "category_aro_class_name": "Antibiotic", "category_aro_description": "Clindamycin is a lincosamide antibiotic that blocks A-site aminoacyl-tRNA binding. It is usually used to treat infections with anaerobic bacteria but can also be used to treat some protozoal diseases, such as malaria."}, "37018": {"category_aro_name": "dalfopristin", "category_aro_cvterm_id": "37018", "category_aro_accession": "3000674", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dalfopristin is a water-soluble semi-synthetic derivative of pristinamycin IIA. It is produced by Streptomyces pristinaespiralis and is used in combination with quinupristin in a 7:3 ratio. Both work together to inhibit protein synthesis, and is active against Gram-positive bacteria."}, "37019": {"category_aro_name": "pristinamycin IB", "category_aro_cvterm_id": "37019", "category_aro_accession": "3000675", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin IB is a class B streptogramin similar to pristinamycin IA, the former containing a N-methyl-4-(methylamino)phenylalanine instead of a N-methyl-4-(dimethylamino)phenylalanine in its class A streptogramin counterpart (one less methyl group)."}, "36723": {"category_aro_name": "quinupristin", "category_aro_cvterm_id": "36723", "category_aro_accession": "3000584", "category_aro_class_name": "Antibiotic", "category_aro_description": "Quinupristin is a type B streptogramin and a semisynthetic derivative of pristinamycin 1A. It is a component of the drug Synercid and interacts with the 50S subunit of the bacterial ribosome to inhibit protein synthesis."}, "36722": {"category_aro_name": "pristinamycin IA", "category_aro_cvterm_id": "36722", "category_aro_accession": "3000583", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin 1A is a type B streptogramin antibiotic produced by Streptomyces pristinaespiralis. It binds to the P site of the 50S subunit of the bacterial ribosome, preventing the extension of protein chains."}, "37036": {"category_aro_name": "bleomycin B2", "category_aro_cvterm_id": "37036", "category_aro_accession": "3000692", "category_aro_class_name": "Antibiotic", "category_aro_description": "Bleomycin B2 is a glycopeptide antibiotic produced by Streptomyces verticillus taken as a mixture of bleomycins. It induces stand breaks in bacterial nucleic acids."}, "37034": {"category_aro_name": "bleomycinic acid", "category_aro_cvterm_id": "37034", "category_aro_accession": "3000690", "category_aro_class_name": "Antibiotic", "category_aro_description": "Bleomycinic acid is a glycopeptide antibiotic produced by Streptomyces verticillus taken as a mixture of bleomycins. It induces stand breaks in bacterial nucleic acids."}, "37035": {"category_aro_name": "bleomycin A2", "category_aro_cvterm_id": "37035", "category_aro_accession": "3000691", "category_aro_class_name": "Antibiotic", "category_aro_description": "Bleomycin A2 is a glycopeptide antibiotic produced by Streptomyces verticillus taken as a mixture of bleomycins. It induces stand breaks in bacterial nucleic acids."}, "37013": {"category_aro_name": "pristinamycin IIA", "category_aro_cvterm_id": "37013", "category_aro_accession": "3000669", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin IIA is a streptogramin A antibiotic."}, "37014": {"category_aro_name": "pleuromutilin antibiotic", "category_aro_cvterm_id": "37014", "category_aro_accession": "3000670", "category_aro_class_name": "Drug Class", "category_aro_description": "Pleuromutilins are natural fungal products that target bacterial protein translation by binding the the 23S rRNA, blocking the ribosome P site at the 50S subunit. They are mostly used for agriculture and veterinary purposes."}, "37016": {"category_aro_name": "madumycin II", "category_aro_cvterm_id": "37016", "category_aro_accession": "3000672", "category_aro_class_name": "Antibiotic", "category_aro_description": "Madumycin II is a streptogramin A antibiotic."}, "37017": {"category_aro_name": "griseoviridin", "category_aro_cvterm_id": "37017", "category_aro_accession": "3000673", "category_aro_class_name": "Antibiotic", "category_aro_description": "Griseoviridin is a streptogramin A antibiotic."}, "35964": {"category_aro_name": "lincomycin", "category_aro_cvterm_id": "35964", "category_aro_accession": "0000046", "category_aro_class_name": "Antibiotic", "category_aro_description": "Lincomycin is a lincosamide antibiotic that comes from the actinomyces Streptomyces lincolnensis. It binds to the 23s portion of the 50S subunit of bacterial ribosomes and inhibit early elongation of peptide chain by inhibiting transpeptidase reaction."}, "35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}, "36521": {"category_aro_name": "azidamfenicol", "category_aro_cvterm_id": "36521", "category_aro_accession": "3000382", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azidamfenicol is a water soluble derivative of chloramphenicol, sharing the same mode of action of inhibiting peptide synthesis by interacting with the 23S RNA of the 50S ribosomal subunit."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}, "2685": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}, "36590": {"$insert": {"category_aro_class_name": "Efflux Regulator"}}}, "$insert": {"36421": {"category_aro_name": "sulfonamide antibiotic", "category_aro_cvterm_id": "36421", "category_aro_accession": "3000282", "category_aro_class_name": "Drug Class", "category_aro_description": "Sulfonamides are broad spectrum, synthetic antibiotics that contain the sulfonamide group. Sulfonamides inhibit dihydropteroate synthase, which catalyzes the conversion of p-aminobenzoic acid to dihydropteroic acid as part of the tetrahydrofolic acid biosynthetic pathway. Tetrahydrofolic acid is essential for folate synthesis, a precursor of many nucleotides and amino acids. Many sulfamides are taken with trimethoprim, an inhibitor of dihydrofolate reductase, also disturbing the trihydrofolic acid synthesis pathway."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "40362": {"category_aro_name": "panipenem", "category_aro_cvterm_id": "40362", "category_aro_accession": "3003708", "category_aro_class_name": "Antibiotic", "category_aro_description": "Panipenem is a carbapenem antibacterial agent with a broad spectrum of in vitro activity covering a wide range of Gram-negative and Gram-positive aerobic and anaerobic bacterial.  It is used in combination with betamipron to inhibit panipenem uptake into the renal tubule and prevent nephrotoxicity."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35996": {"category_aro_name": "clavulanate", "category_aro_cvterm_id": "35996", "category_aro_accession": "0000079", "category_aro_class_name": "Adjuvant", "category_aro_description": "Clavulanic acid is a beta-lactamase inhibitor (marketed by GlaxoSmithKline, formerly Beecham) combined with penicillin group antibiotics to overcome certain types of antibiotic resistance. It is used to overcome resistance in bacteria that secrete beta-lactamase, which otherwise inactivates most penicillins."}, "35990": {"category_aro_name": "meropenem", "category_aro_cvterm_id": "35990", "category_aro_accession": "0000073", "category_aro_class_name": "Antibiotic", "category_aro_description": "Meropenem is an ultra-broad spectrum injectable antibiotic used to treat a wide variety of infections, including meningitis and pneumonia. It is a beta-lactam and belongs to the subgroup of carbapenem, similar to imipenem and ertapenem."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "36689": {"category_aro_name": "aztreonam", "category_aro_cvterm_id": "36689", "category_aro_accession": "3000550", "category_aro_class_name": "Antibiotic", "category_aro_description": "Aztreonam was the first monobactam discovered, and is greatly effective against Gram-negative bacteria while inactive against Gram-positive bacteria. Artreonam is a poor substrate for beta-lactamases, and may even act as an inhibitor. In Gram-negative bacteria, Aztreonam interferes with filamentation, inhibiting cell division and leading to cell death."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36242": {"category_aro_name": "aminocoumarin antibiotic", "category_aro_cvterm_id": "36242", "category_aro_accession": "3000103", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminocoumarin antibiotics bind DNA gyrase subunit B to inhibit ATP-dependent DNA supercoiling."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35977": {"category_aro_name": "ceftazidime", "category_aro_cvterm_id": "35977", "category_aro_accession": "0000060", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftazidime is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria. Unlike most third-generation agents, it is active against Pseudomonas aeruginosa, however it has weaker activity against Gram-positive microorganisms and is not used for such infections."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "36981": {"category_aro_name": "ampicillin", "category_aro_cvterm_id": "36981", "category_aro_accession": "3000637", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ampicillin is a penicillin derivative that is highly acid stable, with its activity similar to benzylpenicillin."}, "35981": {"category_aro_name": "amoxicillin", "category_aro_cvterm_id": "35981", "category_aro_accession": "0000064", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amoxicillin is a moderate-spectrum, bacteriolytic, beta-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. A derivative of penicillin, it has a wider range of treatment but remains relatively ineffective against Gram-negative bacteria. It is commonly taken with clavulanic acid, a beta-lactamase inhibitor. Like other beta-lactams, amoxicillin interferes with the synthesis of peptidoglycan."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35979": {"category_aro_name": "ceftriaxone", "category_aro_cvterm_id": "35979", "category_aro_accession": "0000062", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftriaxone is a third-generation cephalosporin antibiotic. The presence of an aminothiazolyl sidechain increases ceftriazone's resistance to beta-lactamases. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria."}, "36468": {"category_aro_name": "sulfamethoxazole", "category_aro_cvterm_id": "36468", "category_aro_accession": "3000329", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfamethoxazole is a sulfonamide antibiotic usually taken with trimethoprim, a diaminopyrimidine antibiotic. Sulfamethoxazole inhibits dihydropteroate synthase, essential to tetrahydrofolic acid biosynthesis. This pathway generates compounds used in the synthesis of many amino acids and nucleotides."}, "36250": {"category_aro_name": "novobiocin", "category_aro_cvterm_id": "36250", "category_aro_accession": "3000111", "category_aro_class_name": "Antibiotic", "category_aro_description": "Novobiocin is an aminocoumarin antibiotic produced by Streptomyces spheroides and Streptomyces niveus, and binds DNA gyrase subunit B inhibiting ATP-dependent DNA supercoiling."}, "40957": {"category_aro_name": "trimethoprim-sulfamethoxazole", "category_aro_cvterm_id": "40957", "category_aro_accession": "3004024", "category_aro_class_name": "Antibiotic", "category_aro_description": "An antibiotic cocktail containing the diaminopyrimidine antibiotic Trimethoprim and the sulfonamide antibiotic sulfamethoxazole (1 TMP:5 SMX)."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36297": {"category_aro_name": "azithromycin", "category_aro_cvterm_id": "36297", "category_aro_accession": "3000158", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azithromycin is a 15-membered macrolide and falls under the subclass of azalide. Like other macrolides, azithromycin binds bacterial ribosomes to inhibit protein synthesis. The nitrogen substitution at the C-9a position prevents its degradation."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "2686": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36421": {"category_aro_name": "sulfonamide antibiotic", "category_aro_cvterm_id": "36421", "category_aro_accession": "3000282", "category_aro_class_name": "Drug Class", "category_aro_description": "Sulfonamides are broad spectrum, synthetic antibiotics that contain the sulfonamide group. Sulfonamides inhibit dihydropteroate synthase, which catalyzes the conversion of p-aminobenzoic acid to dihydropteroic acid as part of the tetrahydrofolic acid biosynthetic pathway. Tetrahydrofolic acid is essential for folate synthesis, a precursor of many nucleotides and amino acids. Many sulfamides are taken with trimethoprim, an inhibitor of dihydrofolate reductase, also disturbing the trihydrofolic acid synthesis pathway."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "40362": {"category_aro_name": "panipenem", "category_aro_cvterm_id": "40362", "category_aro_accession": "3003708", "category_aro_class_name": "Antibiotic", "category_aro_description": "Panipenem is a carbapenem antibacterial agent with a broad spectrum of in vitro activity covering a wide range of Gram-negative and Gram-positive aerobic and anaerobic bacterial.  It is used in combination with betamipron to inhibit panipenem uptake into the renal tubule and prevent nephrotoxicity."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35996": {"category_aro_name": "clavulanate", "category_aro_cvterm_id": "35996", "category_aro_accession": "0000079", "category_aro_class_name": "Adjuvant", "category_aro_description": "Clavulanic acid is a beta-lactamase inhibitor (marketed by GlaxoSmithKline, formerly Beecham) combined with penicillin group antibiotics to overcome certain types of antibiotic resistance. It is used to overcome resistance in bacteria that secrete beta-lactamase, which otherwise inactivates most penicillins."}, "35990": {"category_aro_name": "meropenem", "category_aro_cvterm_id": "35990", "category_aro_accession": "0000073", "category_aro_class_name": "Antibiotic", "category_aro_description": "Meropenem is an ultra-broad spectrum injectable antibiotic used to treat a wide variety of infections, including meningitis and pneumonia. It is a beta-lactam and belongs to the subgroup of carbapenem, similar to imipenem and ertapenem."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "36689": {"category_aro_name": "aztreonam", "category_aro_cvterm_id": "36689", "category_aro_accession": "3000550", "category_aro_class_name": "Antibiotic", "category_aro_description": "Aztreonam was the first monobactam discovered, and is greatly effective against Gram-negative bacteria while inactive against Gram-positive bacteria. Artreonam is a poor substrate for beta-lactamases, and may even act as an inhibitor. In Gram-negative bacteria, Aztreonam interferes with filamentation, inhibiting cell division and leading to cell death."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36242": {"category_aro_name": "aminocoumarin antibiotic", "category_aro_cvterm_id": "36242", "category_aro_accession": "3000103", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminocoumarin antibiotics bind DNA gyrase subunit B to inhibit ATP-dependent DNA supercoiling."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35977": {"category_aro_name": "ceftazidime", "category_aro_cvterm_id": "35977", "category_aro_accession": "0000060", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftazidime is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria. Unlike most third-generation agents, it is active against Pseudomonas aeruginosa, however it has weaker activity against Gram-positive microorganisms and is not used for such infections."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35979": {"category_aro_name": "ceftriaxone", "category_aro_cvterm_id": "35979", "category_aro_accession": "0000062", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftriaxone is a third-generation cephalosporin antibiotic. The presence of an aminothiazolyl sidechain increases ceftriazone's resistance to beta-lactamases. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "36981": {"category_aro_name": "ampicillin", "category_aro_cvterm_id": "36981", "category_aro_accession": "3000637", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ampicillin is a penicillin derivative that is highly acid stable, with its activity similar to benzylpenicillin."}, "35981": {"category_aro_name": "amoxicillin", "category_aro_cvterm_id": "35981", "category_aro_accession": "0000064", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amoxicillin is a moderate-spectrum, bacteriolytic, beta-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. A derivative of penicillin, it has a wider range of treatment but remains relatively ineffective against Gram-negative bacteria. It is commonly taken with clavulanic acid, a beta-lactamase inhibitor. Like other beta-lactams, amoxicillin interferes with the synthesis of peptidoglycan."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36468": {"category_aro_name": "sulfamethoxazole", "category_aro_cvterm_id": "36468", "category_aro_accession": "3000329", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfamethoxazole is a sulfonamide antibiotic usually taken with trimethoprim, a diaminopyrimidine antibiotic. Sulfamethoxazole inhibits dihydropteroate synthase, essential to tetrahydrofolic acid biosynthesis. This pathway generates compounds used in the synthesis of many amino acids and nucleotides."}, "36250": {"category_aro_name": "novobiocin", "category_aro_cvterm_id": "36250", "category_aro_accession": "3000111", "category_aro_class_name": "Antibiotic", "category_aro_description": "Novobiocin is an aminocoumarin antibiotic produced by Streptomyces spheroides and Streptomyces niveus, and binds DNA gyrase subunit B inhibiting ATP-dependent DNA supercoiling."}, "40957": {"category_aro_name": "trimethoprim-sulfamethoxazole", "category_aro_cvterm_id": "40957", "category_aro_accession": "3004024", "category_aro_class_name": "Antibiotic", "category_aro_description": "An antibiotic cocktail containing the diaminopyrimidine antibiotic Trimethoprim and the sulfonamide antibiotic sulfamethoxazole (1 TMP:5 SMX)."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36297": {"category_aro_name": "azithromycin", "category_aro_cvterm_id": "36297", "category_aro_accession": "3000158", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azithromycin is a 15-membered macrolide and falls under the subclass of azalide. Like other macrolides, azithromycin binds bacterial ribosomes to inhibit protein synthesis. The nitrogen substitution at the C-9a position prevents its degradation."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "2680": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36421": {"category_aro_name": "sulfonamide antibiotic", "category_aro_cvterm_id": "36421", "category_aro_accession": "3000282", "category_aro_class_name": "Drug Class", "category_aro_description": "Sulfonamides are broad spectrum, synthetic antibiotics that contain the sulfonamide group. Sulfonamides inhibit dihydropteroate synthase, which catalyzes the conversion of p-aminobenzoic acid to dihydropteroic acid as part of the tetrahydrofolic acid biosynthetic pathway. Tetrahydrofolic acid is essential for folate synthesis, a precursor of many nucleotides and amino acids. Many sulfamides are taken with trimethoprim, an inhibitor of dihydrofolate reductase, also disturbing the trihydrofolic acid synthesis pathway."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "40362": {"category_aro_name": "panipenem", "category_aro_cvterm_id": "40362", "category_aro_accession": "3003708", "category_aro_class_name": "Antibiotic", "category_aro_description": "Panipenem is a carbapenem antibacterial agent with a broad spectrum of in vitro activity covering a wide range of Gram-negative and Gram-positive aerobic and anaerobic bacterial.  It is used in combination with betamipron to inhibit panipenem uptake into the renal tubule and prevent nephrotoxicity."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35996": {"category_aro_name": "clavulanate", "category_aro_cvterm_id": "35996", "category_aro_accession": "0000079", "category_aro_class_name": "Adjuvant", "category_aro_description": "Clavulanic acid is a beta-lactamase inhibitor (marketed by GlaxoSmithKline, formerly Beecham) combined with penicillin group antibiotics to overcome certain types of antibiotic resistance. It is used to overcome resistance in bacteria that secrete beta-lactamase, which otherwise inactivates most penicillins."}, "35990": {"category_aro_name": "meropenem", "category_aro_cvterm_id": "35990", "category_aro_accession": "0000073", "category_aro_class_name": "Antibiotic", "category_aro_description": "Meropenem is an ultra-broad spectrum injectable antibiotic used to treat a wide variety of infections, including meningitis and pneumonia. It is a beta-lactam and belongs to the subgroup of carbapenem, similar to imipenem and ertapenem."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "36689": {"category_aro_name": "aztreonam", "category_aro_cvterm_id": "36689", "category_aro_accession": "3000550", "category_aro_class_name": "Antibiotic", "category_aro_description": "Aztreonam was the first monobactam discovered, and is greatly effective against Gram-negative bacteria while inactive against Gram-positive bacteria. Artreonam is a poor substrate for beta-lactamases, and may even act as an inhibitor. In Gram-negative bacteria, Aztreonam interferes with filamentation, inhibiting cell division and leading to cell death."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36242": {"category_aro_name": "aminocoumarin antibiotic", "category_aro_cvterm_id": "36242", "category_aro_accession": "3000103", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminocoumarin antibiotics bind DNA gyrase subunit B to inhibit ATP-dependent DNA supercoiling."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35977": {"category_aro_name": "ceftazidime", "category_aro_cvterm_id": "35977", "category_aro_accession": "0000060", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftazidime is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria. Unlike most third-generation agents, it is active against Pseudomonas aeruginosa, however it has weaker activity against Gram-positive microorganisms and is not used for such infections."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35979": {"category_aro_name": "ceftriaxone", "category_aro_cvterm_id": "35979", "category_aro_accession": "0000062", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftriaxone is a third-generation cephalosporin antibiotic. The presence of an aminothiazolyl sidechain increases ceftriazone's resistance to beta-lactamases. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "36981": {"category_aro_name": "ampicillin", "category_aro_cvterm_id": "36981", "category_aro_accession": "3000637", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ampicillin is a penicillin derivative that is highly acid stable, with its activity similar to benzylpenicillin."}, "35981": {"category_aro_name": "amoxicillin", "category_aro_cvterm_id": "35981", "category_aro_accession": "0000064", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amoxicillin is a moderate-spectrum, bacteriolytic, beta-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. A derivative of penicillin, it has a wider range of treatment but remains relatively ineffective against Gram-negative bacteria. It is commonly taken with clavulanic acid, a beta-lactamase inhibitor. Like other beta-lactams, amoxicillin interferes with the synthesis of peptidoglycan."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36468": {"category_aro_name": "sulfamethoxazole", "category_aro_cvterm_id": "36468", "category_aro_accession": "3000329", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfamethoxazole is a sulfonamide antibiotic usually taken with trimethoprim, a diaminopyrimidine antibiotic. Sulfamethoxazole inhibits dihydropteroate synthase, essential to tetrahydrofolic acid biosynthesis. This pathway generates compounds used in the synthesis of many amino acids and nucleotides."}, "36250": {"category_aro_name": "novobiocin", "category_aro_cvterm_id": "36250", "category_aro_accession": "3000111", "category_aro_class_name": "Antibiotic", "category_aro_description": "Novobiocin is an aminocoumarin antibiotic produced by Streptomyces spheroides and Streptomyces niveus, and binds DNA gyrase subunit B inhibiting ATP-dependent DNA supercoiling."}, "40957": {"category_aro_name": "trimethoprim-sulfamethoxazole", "category_aro_cvterm_id": "40957", "category_aro_accession": "3004024", "category_aro_class_name": "Antibiotic", "category_aro_description": "An antibiotic cocktail containing the diaminopyrimidine antibiotic Trimethoprim and the sulfonamide antibiotic sulfamethoxazole (1 TMP:5 SMX)."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36297": {"category_aro_name": "azithromycin", "category_aro_cvterm_id": "36297", "category_aro_accession": "3000158", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azithromycin is a 15-membered macrolide and falls under the subclass of azalide. Like other macrolides, azithromycin binds bacterial ribosomes to inhibit protein synthesis. The nitrogen substitution at the C-9a position prevents its degradation."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "2681": {"$update": {"ARO_category": {"35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "41448": {"category_aro_name": "antibiotic resistance fabG", "category_aro_cvterm_id": "41448", "category_aro_accession": "3004284", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "fabG is a 3-oxoacyl-acyl carrier protein reductase involved in lipid metabolism and fatty acid biosynthesis. The bacterial biocide Triclosan blocks the final reduction step in fatty acid elongation, inhibiting biosynthesis. Point mutations in fabG can confer resistance to Triclosan."}, "37250": {"category_aro_name": "triclosan", "category_aro_cvterm_id": "37250", "category_aro_accession": "3000870", "category_aro_class_name": "Drug Class", "category_aro_description": "Triclosan is a common antibacterial agent added to many consumer products as a biocide.  It is an inhibitor of fatty acid biosynthesis by blocking enoyl-carrier protein reductase (FabI)."}}, "ARO_name": "Escherichia coli fabG mutations conferring resistance to triclosan"}}, "2682": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36421": {"category_aro_name": "sulfonamide antibiotic", "category_aro_cvterm_id": "36421", "category_aro_accession": "3000282", "category_aro_class_name": "Drug Class", "category_aro_description": "Sulfonamides are broad spectrum, synthetic antibiotics that contain the sulfonamide group. Sulfonamides inhibit dihydropteroate synthase, which catalyzes the conversion of p-aminobenzoic acid to dihydropteroic acid as part of the tetrahydrofolic acid biosynthetic pathway. Tetrahydrofolic acid is essential for folate synthesis, a precursor of many nucleotides and amino acids. Many sulfamides are taken with trimethoprim, an inhibitor of dihydrofolate reductase, also disturbing the trihydrofolic acid synthesis pathway."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "40362": {"category_aro_name": "panipenem", "category_aro_cvterm_id": "40362", "category_aro_accession": "3003708", "category_aro_class_name": "Antibiotic", "category_aro_description": "Panipenem is a carbapenem antibacterial agent with a broad spectrum of in vitro activity covering a wide range of Gram-negative and Gram-positive aerobic and anaerobic bacterial.  It is used in combination with betamipron to inhibit panipenem uptake into the renal tubule and prevent nephrotoxicity."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35996": {"category_aro_name": "clavulanate", "category_aro_cvterm_id": "35996", "category_aro_accession": "0000079", "category_aro_class_name": "Adjuvant", "category_aro_description": "Clavulanic acid is a beta-lactamase inhibitor (marketed by GlaxoSmithKline, formerly Beecham) combined with penicillin group antibiotics to overcome certain types of antibiotic resistance. It is used to overcome resistance in bacteria that secrete beta-lactamase, which otherwise inactivates most penicillins."}, "35990": {"category_aro_name": "meropenem", "category_aro_cvterm_id": "35990", "category_aro_accession": "0000073", "category_aro_class_name": "Antibiotic", "category_aro_description": "Meropenem is an ultra-broad spectrum injectable antibiotic used to treat a wide variety of infections, including meningitis and pneumonia. It is a beta-lactam and belongs to the subgroup of carbapenem, similar to imipenem and ertapenem."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "36689": {"category_aro_name": "aztreonam", "category_aro_cvterm_id": "36689", "category_aro_accession": "3000550", "category_aro_class_name": "Antibiotic", "category_aro_description": "Aztreonam was the first monobactam discovered, and is greatly effective against Gram-negative bacteria while inactive against Gram-positive bacteria. Artreonam is a poor substrate for beta-lactamases, and may even act as an inhibitor. In Gram-negative bacteria, Aztreonam interferes with filamentation, inhibiting cell division and leading to cell death."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36242": {"category_aro_name": "aminocoumarin antibiotic", "category_aro_cvterm_id": "36242", "category_aro_accession": "3000103", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminocoumarin antibiotics bind DNA gyrase subunit B to inhibit ATP-dependent DNA supercoiling."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35977": {"category_aro_name": "ceftazidime", "category_aro_cvterm_id": "35977", "category_aro_accession": "0000060", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftazidime is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria. Unlike most third-generation agents, it is active against Pseudomonas aeruginosa, however it has weaker activity against Gram-positive microorganisms and is not used for such infections."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35979": {"category_aro_name": "ceftriaxone", "category_aro_cvterm_id": "35979", "category_aro_accession": "0000062", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftriaxone is a third-generation cephalosporin antibiotic. The presence of an aminothiazolyl sidechain increases ceftriazone's resistance to beta-lactamases. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "36981": {"category_aro_name": "ampicillin", "category_aro_cvterm_id": "36981", "category_aro_accession": "3000637", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ampicillin is a penicillin derivative that is highly acid stable, with its activity similar to benzylpenicillin."}, "35981": {"category_aro_name": "amoxicillin", "category_aro_cvterm_id": "35981", "category_aro_accession": "0000064", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amoxicillin is a moderate-spectrum, bacteriolytic, beta-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. A derivative of penicillin, it has a wider range of treatment but remains relatively ineffective against Gram-negative bacteria. It is commonly taken with clavulanic acid, a beta-lactamase inhibitor. Like other beta-lactams, amoxicillin interferes with the synthesis of peptidoglycan."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36468": {"category_aro_name": "sulfamethoxazole", "category_aro_cvterm_id": "36468", "category_aro_accession": "3000329", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfamethoxazole is a sulfonamide antibiotic usually taken with trimethoprim, a diaminopyrimidine antibiotic. Sulfamethoxazole inhibits dihydropteroate synthase, essential to tetrahydrofolic acid biosynthesis. This pathway generates compounds used in the synthesis of many amino acids and nucleotides."}, "36250": {"category_aro_name": "novobiocin", "category_aro_cvterm_id": "36250", "category_aro_accession": "3000111", "category_aro_class_name": "Antibiotic", "category_aro_description": "Novobiocin is an aminocoumarin antibiotic produced by Streptomyces spheroides and Streptomyces niveus, and binds DNA gyrase subunit B inhibiting ATP-dependent DNA supercoiling."}, "40957": {"category_aro_name": "trimethoprim-sulfamethoxazole", "category_aro_cvterm_id": "40957", "category_aro_accession": "3004024", "category_aro_class_name": "Antibiotic", "category_aro_description": "An antibiotic cocktail containing the diaminopyrimidine antibiotic Trimethoprim and the sulfonamide antibiotic sulfamethoxazole (1 TMP:5 SMX)."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36297": {"category_aro_name": "azithromycin", "category_aro_cvterm_id": "36297", "category_aro_accession": "3000158", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azithromycin is a 15-membered macrolide and falls under the subclass of azalide. Like other macrolides, azithromycin binds bacterial ribosomes to inhibit protein synthesis. The nitrogen substitution at the C-9a position prevents its degradation."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "2683": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36421": {"category_aro_name": "sulfonamide antibiotic", "category_aro_cvterm_id": "36421", "category_aro_accession": "3000282", "category_aro_class_name": "Drug Class", "category_aro_description": "Sulfonamides are broad spectrum, synthetic antibiotics that contain the sulfonamide group. Sulfonamides inhibit dihydropteroate synthase, which catalyzes the conversion of p-aminobenzoic acid to dihydropteroic acid as part of the tetrahydrofolic acid biosynthetic pathway. Tetrahydrofolic acid is essential for folate synthesis, a precursor of many nucleotides and amino acids. Many sulfamides are taken with trimethoprim, an inhibitor of dihydrofolate reductase, also disturbing the trihydrofolic acid synthesis pathway."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "40362": {"category_aro_name": "panipenem", "category_aro_cvterm_id": "40362", "category_aro_accession": "3003708", "category_aro_class_name": "Antibiotic", "category_aro_description": "Panipenem is a carbapenem antibacterial agent with a broad spectrum of in vitro activity covering a wide range of Gram-negative and Gram-positive aerobic and anaerobic bacterial.  It is used in combination with betamipron to inhibit panipenem uptake into the renal tubule and prevent nephrotoxicity."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35996": {"category_aro_name": "clavulanate", "category_aro_cvterm_id": "35996", "category_aro_accession": "0000079", "category_aro_class_name": "Adjuvant", "category_aro_description": "Clavulanic acid is a beta-lactamase inhibitor (marketed by GlaxoSmithKline, formerly Beecham) combined with penicillin group antibiotics to overcome certain types of antibiotic resistance. It is used to overcome resistance in bacteria that secrete beta-lactamase, which otherwise inactivates most penicillins."}, "35990": {"category_aro_name": "meropenem", "category_aro_cvterm_id": "35990", "category_aro_accession": "0000073", "category_aro_class_name": "Antibiotic", "category_aro_description": "Meropenem is an ultra-broad spectrum injectable antibiotic used to treat a wide variety of infections, including meningitis and pneumonia. It is a beta-lactam and belongs to the subgroup of carbapenem, similar to imipenem and ertapenem."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "36689": {"category_aro_name": "aztreonam", "category_aro_cvterm_id": "36689", "category_aro_accession": "3000550", "category_aro_class_name": "Antibiotic", "category_aro_description": "Aztreonam was the first monobactam discovered, and is greatly effective against Gram-negative bacteria while inactive against Gram-positive bacteria. Artreonam is a poor substrate for beta-lactamases, and may even act as an inhibitor. In Gram-negative bacteria, Aztreonam interferes with filamentation, inhibiting cell division and leading to cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "36242": {"category_aro_name": "aminocoumarin antibiotic", "category_aro_cvterm_id": "36242", "category_aro_accession": "3000103", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminocoumarin antibiotics bind DNA gyrase subunit B to inhibit ATP-dependent DNA supercoiling."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35977": {"category_aro_name": "ceftazidime", "category_aro_cvterm_id": "35977", "category_aro_accession": "0000060", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftazidime is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria. Unlike most third-generation agents, it is active against Pseudomonas aeruginosa, however it has weaker activity against Gram-positive microorganisms and is not used for such infections."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35979": {"category_aro_name": "ceftriaxone", "category_aro_cvterm_id": "35979", "category_aro_accession": "0000062", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftriaxone is a third-generation cephalosporin antibiotic. The presence of an aminothiazolyl sidechain increases ceftriazone's resistance to beta-lactamases. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "40523": {"category_aro_name": "ticarcillin", "category_aro_cvterm_id": "40523", "category_aro_accession": "3003832", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ticarcillin is a carboxypenicillin used for the treatment of Gram-negative bacteria, particularly P. aeruginosa. Ticarcillin's antibiotic properties arise from its ability to prevent cross-linking of peptidoglycan during cell wall synthesis, when the bacteria try to divide, causing cell death."}, "36981": {"category_aro_name": "ampicillin", "category_aro_cvterm_id": "36981", "category_aro_accession": "3000637", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ampicillin is a penicillin derivative that is highly acid stable, with its activity similar to benzylpenicillin."}, "35981": {"category_aro_name": "amoxicillin", "category_aro_cvterm_id": "35981", "category_aro_accession": "0000064", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amoxicillin is a moderate-spectrum, bacteriolytic, beta-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. A derivative of penicillin, it has a wider range of treatment but remains relatively ineffective against Gram-negative bacteria. It is commonly taken with clavulanic acid, a beta-lactamase inhibitor. Like other beta-lactams, amoxicillin interferes with the synthesis of peptidoglycan."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36468": {"category_aro_name": "sulfamethoxazole", "category_aro_cvterm_id": "36468", "category_aro_accession": "3000329", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfamethoxazole is a sulfonamide antibiotic usually taken with trimethoprim, a diaminopyrimidine antibiotic. Sulfamethoxazole inhibits dihydropteroate synthase, essential to tetrahydrofolic acid biosynthesis. This pathway generates compounds used in the synthesis of many amino acids and nucleotides."}, "36250": {"category_aro_name": "novobiocin", "category_aro_cvterm_id": "36250", "category_aro_accession": "3000111", "category_aro_class_name": "Antibiotic", "category_aro_description": "Novobiocin is an aminocoumarin antibiotic produced by Streptomyces spheroides and Streptomyces niveus, and binds DNA gyrase subunit B inhibiting ATP-dependent DNA supercoiling."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "40957": {"category_aro_name": "trimethoprim-sulfamethoxazole", "category_aro_cvterm_id": "40957", "category_aro_accession": "3004024", "category_aro_class_name": "Antibiotic", "category_aro_description": "An antibiotic cocktail containing the diaminopyrimidine antibiotic Trimethoprim and the sulfonamide antibiotic sulfamethoxazole (1 TMP:5 SMX)."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36297": {"category_aro_name": "azithromycin", "category_aro_cvterm_id": "36297", "category_aro_accession": "3000158", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azithromycin is a 15-membered macrolide and falls under the subclass of azalide. Like other macrolides, azithromycin binds bacterial ribosomes to inhibit protein synthesis. The nitrogen substitution at the C-9a position prevents its degradation."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "99": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "98": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "91": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}, "36590": {"$insert": {"category_aro_class_name": "Efflux Regulator"}}}, "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35973": {"category_aro_name": "oxacillin", "category_aro_cvterm_id": "35973", "category_aro_accession": "0000056", "category_aro_class_name": "Antibiotic", "category_aro_description": "Oxacillin is a penicillinase-resistant beta-lactam. It is similar to methicillin, and has replaced methicillin in clinical use. Oxacillin, especially in combination with other antibiotics, is effective against many penicillinase-producing strains of Staphylococcus aureus and Staphylococcus epidermidis."}, "35930": {"category_aro_name": "cloxacillin", "category_aro_cvterm_id": "35930", "category_aro_accession": "0000011", "category_aro_class_name": "Antibiotic", "category_aro_description": "Cloxacillin is a semisynthetic, isoxazolyl penicillin derivative in the beta-lactam class of antibiotics. It interferes with peptidogylcan synthesis and is commonly used for treating penicillin-resistant Staphylococcus aureus infections."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}}}}}, "90": {"$update": {"ARO_category": {"36308": {"category_aro_name": "rifampin", "category_aro_cvterm_id": "36308", "category_aro_accession": "3000169", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifampin is a semi-synthetic rifamycin, and inhibits RNA synthesis by binding to RNA polymerase. Rifampin is the mainstay agent for the treatment of tuberculosis, leprosy and complicated Gram-positive infections."}, "36673": {"category_aro_name": "rifapentine", "category_aro_cvterm_id": "36673", "category_aro_accession": "3000534", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifapentine is a semisynthetic rifamycin that inhibits DNA-dependent RNA synthesis. It is often used in the treatment of tuberculosis and leprosy."}, "36669": {"category_aro_name": "rifabutin", "category_aro_cvterm_id": "36669", "category_aro_accession": "3000530", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifabutin is a semisynthetic rifamycin used in tuberculosis therapy. It inhibits DNA-dependent RNA synthesis."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36349": {"category_aro_name": "rifamycin-resistant beta-subunit of RNA polymerase (rpoB)", "category_aro_cvterm_id": "36349", "category_aro_accession": "3000210", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Rifampin resistant RNA polymerases include amino acids substitutions which disrupt the affinity of rifampin for its binding site. These mutations are frequently concentrated in the rif I region of the beta-subunit and most often involve amino acids which make direct interactions with rifampin. However, mutations which also confer resistance can occur outside this region and may involve amino acids which do not directly make contact with rifampin."}, "35998": {"category_aro_name": "antibiotic target replacement", "category_aro_cvterm_id": "35998", "category_aro_accession": "0001002", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Replacement or substitution of antibiotic action target, which process will result in antibiotic resistance."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36656": {"category_aro_name": "rifaximin", "category_aro_cvterm_id": "36656", "category_aro_accession": "3000517", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifaximin is a semi-synthetic rifamycin used to treat traveller's diarrhea. Rifaximin inhibits RNA synthesis by binding to the beta subunit of bacterial RNA polymerase."}, "36296": {"category_aro_name": "rifamycin antibiotic", "category_aro_cvterm_id": "36296", "category_aro_accession": "3000157", "category_aro_class_name": "Drug Class", "category_aro_description": "Rifamycin antibiotics are a group of broad-spectrum ansamycin antibiotics that inhibit bacterial RNA polymerase by binding to a highly conserved region, blocking the oligonucleotide exit tunnel, and preventing the extension of nascent mRNAs."}}}}, "93": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "92": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "95": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "94": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "97": {"$update": {"ARO_category": {"36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36635": {"category_aro_name": "vanXY", "category_aro_cvterm_id": "36635", "category_aro_accession": "3000496", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "VanXY is a protein with both D,D-carboxypeptidase and D,D-dipeptidase activity, found in Enterococcus gallinarum. It cleaves and removes the terminal D-Ala of peptidoglycan subunits for the incorporation of D-Ser by VanC. D-Ala-D-Ser has low binding affinity with vancomycin."}}}}, "96": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1623": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "39772": {"category_aro_name": "GIM beta-lactamase", "category_aro_cvterm_id": "39772", "category_aro_accession": "3003195", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "The GIM beta-lactamases are isolated from Pseudomonas aeruginosa. They are located in a distinct integron structure. They confers high broad spectrum resistant, including all \u00df-lactams, aminoglycosides and quinolones."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "1622": {"$update": {"ARO_category": {"36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36011": {"category_aro_name": "vanW", "category_aro_cvterm_id": "36011", "category_aro_accession": "3000002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "vanW is an accessory gene, with unknown function, found on vancomycin resistance operons."}}}}, "1621": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "1620": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "1627": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "1626": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"37018": {"category_aro_name": "dalfopristin", "category_aro_cvterm_id": "37018", "category_aro_accession": "3000674", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dalfopristin is a water-soluble semi-synthetic derivative of pristinamycin IIA. It is produced by Streptomyces pristinaespiralis and is used in combination with quinupristin in a 7:3 ratio. Both work together to inhibit protein synthesis, and is active against Gram-positive bacteria."}, "37716": {"category_aro_name": "pleuromutilin", "category_aro_cvterm_id": "37716", "category_aro_accession": "3001317", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pleuromutilin is a natural product antibiotic produced by Clitopilus passeckerianus. Related antibiotics of clinical significance, such as tiamulin and retapamulin, are semi-synthetic derivatives of this compound."}, "36002": {"category_aro_name": "ATP-binding cassette (ABC) antibiotic efflux pump", "category_aro_cvterm_id": "36002", "category_aro_accession": "0010001", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. ATP-binding cassette (ABC) transporters are present in all cells of all organisms and use the energy of ATP binding/hydrolysis to transport substrates across cell membranes."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "37013": {"category_aro_name": "pristinamycin IIA", "category_aro_cvterm_id": "37013", "category_aro_accession": "3000669", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin IIA is a streptogramin A antibiotic."}, "37014": {"category_aro_name": "pleuromutilin antibiotic", "category_aro_cvterm_id": "37014", "category_aro_accession": "3000670", "category_aro_class_name": "Drug Class", "category_aro_description": "Pleuromutilins are natural fungal products that target bacterial protein translation by binding the the 23S rRNA, blocking the ribosome P site at the 50S subunit. They are mostly used for agriculture and veterinary purposes."}, "37016": {"category_aro_name": "madumycin II", "category_aro_cvterm_id": "37016", "category_aro_accession": "3000672", "category_aro_class_name": "Antibiotic", "category_aro_description": "Madumycin II is a streptogramin A antibiotic."}, "37017": {"category_aro_name": "griseoviridin", "category_aro_cvterm_id": "37017", "category_aro_accession": "3000673", "category_aro_class_name": "Antibiotic", "category_aro_description": "Griseoviridin is a streptogramin A antibiotic."}, "35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}}}}}, "1625": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1624": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36002": {"category_aro_name": "ATP-binding cassette (ABC) antibiotic efflux pump", "category_aro_cvterm_id": "36002", "category_aro_accession": "0010001", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. ATP-binding cassette (ABC) transporters are present in all cells of all organisms and use the energy of ATP binding/hydrolysis to transport substrates across cell membranes."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}}}}}, "1999": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "1998": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "1629": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "1628": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "559": {"$update": {"ARO_category": {"36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36635": {"category_aro_name": "vanXY", "category_aro_cvterm_id": "36635", "category_aro_accession": "3000496", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "VanXY is a protein with both D,D-carboxypeptidase and D,D-dipeptidase activity, found in Enterococcus gallinarum. It cleaves and removes the terminal D-Ala of peptidoglycan subunits for the incorporation of D-Ser by VanC. D-Ala-D-Ser has low binding affinity with vancomycin."}}}}, "558": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}}}}}, "555": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "554": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "557": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "556": {"$update": {"ARO_category": {"36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36216": {"category_aro_name": "vanY", "category_aro_cvterm_id": "36216", "category_aro_accession": "3000077", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "VanY is a D,D-carboxypeptidase that cleaves removes the terminal D-Ala from peptidoglycan for the addition of D-Lactate. The D-Ala-D-Lac peptidoglycan subunits have reduced binding affinity with vancomycin compared to D-Ala-D-Ala."}}}}, "551": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "550": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "553": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "36030": {"category_aro_name": "VIM beta-lactamase", "category_aro_cvterm_id": "36030", "category_aro_accession": "3000021", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "The Verone integron-encoded metallo-beta-lactamase (VIM) family was reported from Italy in 1999. There are, to date, 23 reported variants.  VIM enzymes mostly occur in P. aeruginosa, also P. putida and, very rarely, Enterobacteriaceae. Integron-associated, sometimes within plasmids. Hydrolyses all beta-lactams except monobactams, and evades all beta-lactam inhibitors.  There is a strong incidence of these in East Asia."}}}}, "552": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "1502": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1439": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "1199": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "1198": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}}}}}, "1191": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36193": {"category_aro_name": "acridine dye", "category_aro_cvterm_id": "36193", "category_aro_accession": "3000054", "category_aro_class_name": "Drug Class", "category_aro_description": "Acridine dyes are cell permeable, basic molecules with an acridine chromophore. These compounds intercalate DNA. The image shown represents the core structure of the acridine family, with specific dyes containing varying substituents."}, "35964": {"category_aro_name": "lincomycin", "category_aro_cvterm_id": "35964", "category_aro_accession": "0000046", "category_aro_class_name": "Antibiotic", "category_aro_description": "Lincomycin is a lincosamide antibiotic that comes from the actinomyces Streptomyces lincolnensis. It binds to the 23s portion of the 50S subunit of bacterial ribosomes and inhibit early elongation of peptide chain by inhibiting transpeptidase reaction."}, "35965": {"category_aro_name": "puromycin", "category_aro_cvterm_id": "35965", "category_aro_accession": "0000047", "category_aro_class_name": "Antibiotic", "category_aro_description": "Puromycin is an aminonucleoside antibiotic, derived from Streptomyces alboniger, that causes premature chain termination during ribosomal protein translation."}, "35963": {"category_aro_name": "acriflavin", "category_aro_cvterm_id": "35963", "category_aro_accession": "0000045", "category_aro_class_name": "Antibiotic", "category_aro_description": "Acriflavin is a topical antiseptic. It has the form of an orange or brown powder. It may be harmful in the eyes or if inhaled. Acriflavine is also used as treatment for external fungal infections of aquarium fish."}, "36174": {"category_aro_name": "nucleoside antibiotic", "category_aro_cvterm_id": "36174", "category_aro_accession": "3000034", "category_aro_class_name": "Drug Class", "category_aro_description": "Nucleoside antibiotics are made of modified nucleosides and nucleotides with wide-ranging activities and means of antibacterial effects. This drug class includes aminonucleoside antibiotics, which contain an amino group."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "1190": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1193": {"$update": {"ARO_category": {"35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}, "36699": {"category_aro_name": "Erm 23S ribosomal RNA methyltransferase", "category_aro_cvterm_id": "36699", "category_aro_accession": "3000560", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Erm proteins are part of the RNA methyltransferase family and methylate A2058 (E. coli nomenclature) of the 23S ribosomal RNA conferring degrees of resistance to Macrolides, Lincosamides and Streptogramin b. This is called the MLSb phenotype."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}}}}, "1192": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36182": {"category_aro_name": "VEB beta-lactamase", "category_aro_cvterm_id": "36182", "category_aro_accession": "3000043", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "VEB beta-lactamases or Vietnamese extended-spectrum beta-lactamases are class A beta-lactamases that confer high-level resistance to oxyimino cephalosporins and to aztreonam"}}}}, "1195": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "1194": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1197": {"$update": {"ARO_category": {"35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "40003": {"category_aro_name": "antibiotic resistant rpsL", "category_aro_cvterm_id": "40003", "category_aro_accession": "3003419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Ribosomal protein S12 stabilizes the highly conserved pseudoknot structure formed by 16S rRNA. Amino acid substitutions in RpsL affect the higher-order structure of 16S rRNA and confer antibiotic resistance"}, "35958": {"category_aro_name": "streptomycin", "category_aro_cvterm_id": "35958", "category_aro_accession": "0000040", "category_aro_class_name": "Antibiotic", "category_aro_description": "Streptomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Streptomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "1196": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1759": {"$update": {"ARO_category": {"36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}, "39340": {"category_aro_name": "van ligase", "category_aro_cvterm_id": "39340", "category_aro_accession": "3002906", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "van ligases synthesize alternative substrates for peptidoglycan synthesis that reduce vancomycin binding affinity."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}}}}, "1758": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1757": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}}}}}, "1756": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "1755": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "1754": {"$update": {"ARO_category": {"36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}, "39340": {"category_aro_name": "van ligase", "category_aro_cvterm_id": "39340", "category_aro_accession": "3002906", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "van ligases synthesize alternative substrates for peptidoglycan synthesis that reduce vancomycin binding affinity."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}}}}, "1753": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "1752": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "36251": {"category_aro_name": "multidrug and toxic compound extrusion (MATE) transporter", "category_aro_cvterm_id": "36251", "category_aro_accession": "3000112", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Multidrug and toxic compound extrusion (MATE) transporters utilize the cationic gradient across the membrane as an energy source. Although there is a diverse substrate specificity, almost all MATE transporters recognize fluoroquinolones. Arciflavine, ethidium and aminoglycosides are also good substrates."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}}}}}, "1751": {"$update": {"ARO_category": {"35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "37022": {"category_aro_name": "vernamycin B-gamma", "category_aro_cvterm_id": "37022", "category_aro_accession": "3000678", "category_aro_class_name": "Antibiotic", "category_aro_description": "Vernamycin B-gamma is a class B streptogramin derived from virginiamycin S1."}, "37247": {"category_aro_name": "oleandomycin", "category_aro_cvterm_id": "37247", "category_aro_accession": "3000867", "category_aro_class_name": "Antibiotic", "category_aro_description": "Oleandomycin is a 14-membered macrolide produced by Streptomyces antibioticus. It is ssimilar to erythromycin, and contains a desosamine amino sugar and an oleandrose sugar. It targets the 50S ribosomal subunit to prevent protein synthesis."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35974": {"category_aro_name": "telithromycin", "category_aro_cvterm_id": "35974", "category_aro_accession": "0000057", "category_aro_class_name": "Antibiotic", "category_aro_description": "Telithromycin is a semi-synthetic derivative of erythromycin. It is a 14-membered macrolide and is the first ketolide antibiotic to be used in clinics. Telithromycin binds the 50S subunit of the bacterial ribosome to inhibit protein synthesis."}, "36284": {"category_aro_name": "tylosin", "category_aro_cvterm_id": "36284", "category_aro_accession": "3000145", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tylosin is a 16-membered macrolide, naturally produced by Streptomyces fradiae. It interacts with the bacterial ribosome 50S subunit to inhibit protein synthesis."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}, "36315": {"category_aro_name": "dirithromycin", "category_aro_cvterm_id": "36315", "category_aro_accession": "3000176", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dirithromycin is an oxazine derivative of erythromycin, sharing the 14-carbon macrolide ring. The antibiotic binds to the 50S subunit of the ribosome to inhibit bacterial protein synthesis."}, "35982": {"category_aro_name": "clarithromycin", "category_aro_cvterm_id": "35982", "category_aro_accession": "0000065", "category_aro_class_name": "Antibiotic", "category_aro_description": "Clarithromycin is a methyl derivative of erythromycin, sharing the 14-carbon macrolide ring. The antibiotic binds to the 50S subunit of the ribosome and is used to treat pharyngitis, tonsillitis, acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, pneumonia (especially atypical pneumonias associated with Chlamydia pneumoniae or TWAR), and skin structure infections."}, "35983": {"category_aro_name": "clindamycin", "category_aro_cvterm_id": "35983", "category_aro_accession": "0000066", "category_aro_class_name": "Antibiotic", "category_aro_description": "Clindamycin is a lincosamide antibiotic that blocks A-site aminoacyl-tRNA binding. It is usually used to treat infections with anaerobic bacteria but can also be used to treat some protozoal diseases, such as malaria."}, "37018": {"category_aro_name": "dalfopristin", "category_aro_cvterm_id": "37018", "category_aro_accession": "3000674", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dalfopristin is a water-soluble semi-synthetic derivative of pristinamycin IIA. It is produced by Streptomyces pristinaespiralis and is used in combination with quinupristin in a 7:3 ratio. Both work together to inhibit protein synthesis, and is active against Gram-positive bacteria."}, "37019": {"category_aro_name": "pristinamycin IB", "category_aro_cvterm_id": "37019", "category_aro_accession": "3000675", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin IB is a class B streptogramin similar to pristinamycin IA, the former containing a N-methyl-4-(methylamino)phenylalanine instead of a N-methyl-4-(dimethylamino)phenylalanine in its class A streptogramin counterpart (one less methyl group)."}, "36723": {"category_aro_name": "quinupristin", "category_aro_cvterm_id": "36723", "category_aro_accession": "3000584", "category_aro_class_name": "Antibiotic", "category_aro_description": "Quinupristin is a type B streptogramin and a semisynthetic derivative of pristinamycin 1A. It is a component of the drug Synercid and interacts with the 50S subunit of the bacterial ribosome to inhibit protein synthesis."}, "36722": {"category_aro_name": "pristinamycin IA", "category_aro_cvterm_id": "36722", "category_aro_accession": "3000583", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin 1A is a type B streptogramin antibiotic produced by Streptomyces pristinaespiralis. It binds to the P site of the 50S subunit of the bacterial ribosome, preventing the extension of protein chains."}, "36699": {"category_aro_name": "Erm 23S ribosomal RNA methyltransferase", "category_aro_cvterm_id": "36699", "category_aro_accession": "3000560", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Erm proteins are part of the RNA methyltransferase family and methylate A2058 (E. coli nomenclature) of the 23S ribosomal RNA conferring degrees of resistance to Macrolides, Lincosamides and Streptogramin b. This is called the MLSb phenotype."}, "37013": {"category_aro_name": "pristinamycin IIA", "category_aro_cvterm_id": "37013", "category_aro_accession": "3000669", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin IIA is a streptogramin A antibiotic."}, "37016": {"category_aro_name": "madumycin II", "category_aro_cvterm_id": "37016", "category_aro_accession": "3000672", "category_aro_class_name": "Antibiotic", "category_aro_description": "Madumycin II is a streptogramin A antibiotic."}, "37017": {"category_aro_name": "griseoviridin", "category_aro_cvterm_id": "37017", "category_aro_accession": "3000673", "category_aro_class_name": "Antibiotic", "category_aro_description": "Griseoviridin is a streptogramin A antibiotic."}, "35964": {"category_aro_name": "lincomycin", "category_aro_cvterm_id": "35964", "category_aro_accession": "0000046", "category_aro_class_name": "Antibiotic", "category_aro_description": "Lincomycin is a lincosamide antibiotic that comes from the actinomyces Streptomyces lincolnensis. It binds to the 23s portion of the 50S subunit of bacterial ribosomes and inhibit early elongation of peptide chain by inhibiting transpeptidase reaction."}, "35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}, "35946": {"category_aro_name": "roxithromycin", "category_aro_cvterm_id": "35946", "category_aro_accession": "0000027", "category_aro_class_name": "Antibiotic", "category_aro_description": "Roxithromycin is a semi-synthetic, 14-carbon ring macrolide antibiotic derived from erythromycin. It is used to treat respiratory tract, urinary and soft tissue infections. Roxithromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}, "36295": {"category_aro_name": "spiramycin", "category_aro_cvterm_id": "36295", "category_aro_accession": "3000156", "category_aro_class_name": "Antibiotic", "category_aro_description": "Spiramycin is a 16-membered macrolide and is natural product produced by Streptomyces ambofaciens. It binds to the 50S subunit of bacterial ribosomes and inhibits peptidyl transfer activity to disrupt protein synthesis."}, "36297": {"category_aro_name": "azithromycin", "category_aro_cvterm_id": "36297", "category_aro_accession": "3000158", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azithromycin is a 15-membered macrolide and falls under the subclass of azalide. Like other macrolides, azithromycin binds bacterial ribosomes to inhibit protein synthesis. The nitrogen substitution at the C-9a position prevents its degradation."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}}}}, "1750": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1177": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36198": {"category_aro_name": "KPC beta-lactamase", "category_aro_cvterm_id": "36198", "category_aro_accession": "3000059", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Klebsiella pneumoniae carbapenem resistant (KPC) beta-lactamases are notorious for their ability to efficiently hydrolyze carbapenems, unlike other Ambler Class A beta-lactamases.  There are currently 9 variants reported worldwide.  These enzymes were first isolated from Klebsiella pneumoniae strains in 2001 in the United States.  Hospital outbreaks have since been reported in Greece and Israel and KPC carrying strains are now endemic to New York facilities.  KPC-1 and KPC-2 have been shown to be identical and are now referred to as KPC-2."}}}}, "1176": {"$update": {"ARO_category": {"36659": {"category_aro_name": "isoniazid", "category_aro_cvterm_id": "36659", "category_aro_accession": "3000520", "category_aro_class_name": "Drug Class", "category_aro_description": "Isoniazid is an organic compound that is the first-line anti tuberculosis medication in prevention and treatment. As a prodrug, it is activated by mycobacterial catalase-peroxidases such as M. tuberculosis KatG. Isoniazid inhibits mycolic acid synthesis, which prevents cell wall synthesis in mycobacteria."}, "40000": {"category_aro_name": "isoniazid resistant katG", "category_aro_cvterm_id": "40000", "category_aro_accession": "3003416", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Bifunctional enzyme with both catalase and broad-spectrum peroxidase activity. It is a catalase-peroxidases that catalyzes the activation of isoniazid. Mutations that arises within this protein cause changes that results in the inability for katG to activate antibiotics, conferring resistance"}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}}, "model_param": {"$update": {"40394": {"$update": {"param_value": {"$insert": {"8241": "Y304STOP"}}}}, "snp": {"$update": {"param_value": {"$insert": {"8255": "V473I", "8254": "V473D", "8257": "V473R", "8256": "V473K", "8251": "L472K", "8250": "Q471H", "8253": "L472I", "8252": "L472Q", "8239": "S303L", "8259": "V473S", "8258": "V473M", "8242": "D311N", "3716": "M255C", "3717": "M255I", "8246": "L430V", "3721": "W328F", "3722": "R418L", "3719": "T275V", "3718": "M255Y", "8248": "L436G", "8249": "Q471Y", "8264": "V473N", "8243": "D311S", "8240": "S303C", "8260": "V473F", "8261": "V473W", "8244": "L427I", "8263": "V473G", "3715": "W107F", "8262": "V473Y", "3720": "W321F", "8247": "T435R"}}, "clinical": {"$insert": {"8255": "V473I", "8254": "V473D", "8257": "V473R", "8256": "V473K", "8251": "L472K", "8250": "Q471H", "8253": "L472I", "8252": "L472Q", "8239": "S303L", "8259": "V473S", "8258": "V473M", "8264": "V473N", "8246": "L430V", "8247": "T435R", "8262": "V473Y", "8248": "L436G", "8249": "Q471Y", "8242": "D311N", "8243": "D311S", "8240": "S303C", "8260": "V473F", "8261": "V473W", "8244": "L427I", "8263": "V473G"}}}, "$insert": {"experimental": {"3715": "W107F", "3717": "M255I", "3716": "M255C", "3719": "T275V", "3718": "M255Y", "3720": "W321F", "3721": "W328F", "3722": "R418L"}}}}}}}, "1175": {"$update": {"ARO_category": {"36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "39856": {"category_aro_name": "daptomycin resistant cls", "category_aro_cvterm_id": "39856", "category_aro_accession": "3003272", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Cardiolipin synthetase catalyzes the formation of cardiolipin from two phosphatidylglycerol molecules. Cardiolipin is important in membrane translocation and permeabilization. Current known mutations on the enzyme confer resistance to daptomycin."}, "35985": {"category_aro_name": "daptomycin", "category_aro_cvterm_id": "35985", "category_aro_accession": "0000068", "category_aro_class_name": "Antibiotic", "category_aro_description": "Daptomycin is a novel lipopeptide antibiotic used in the treatment of certain infections caused by Gram-positive organisms. Daptomycin interferes with the bacterial cell membrane, reducing membrane potential and inhibiting cell wall synthesis."}}}}, "1174": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "1173": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "1172": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1171": {"$update": {"ARO_category": {"36667": {"category_aro_name": "chlortetracycline", "category_aro_cvterm_id": "36667", "category_aro_accession": "3000528", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chlortetracycline was an early, first-generation tetracycline antibiotic developed in the 1940's. It inhibits bacterial protein synthesis by binding to the 30S subunit of bacterial ribosomes, preventing the aminoacyl-tRNA from binding to the ribosome."}, "37011": {"category_aro_name": "demeclocycline", "category_aro_cvterm_id": "37011", "category_aro_accession": "3000667", "category_aro_class_name": "Antibiotic", "category_aro_description": "Demeclocycline is a tetracycline analog with 7-chloro and 6-methyl groups. Due to its fast absorption and slow excretion, it maintains higher effective blood levels compared to other tetracyclines."}, "37012": {"category_aro_name": "oxytetracycline", "category_aro_cvterm_id": "37012", "category_aro_accession": "3000668", "category_aro_class_name": "Antibiotic", "category_aro_description": "Oxytetracycline is a derivative of tetracycline with a 5-hydroxyl group. Its activity is similar to other tetracyclines."}, "36291": {"category_aro_name": "minocycline", "category_aro_cvterm_id": "36291", "category_aro_accession": "3000152", "category_aro_class_name": "Antibiotic", "category_aro_description": "Minocycline is second generation semi-synthetic derivative of the tetracycline group of antibiotics. It inhibits bacterial protein synthesis by binding to the 30S subunit of the bacterial ribosome and preventing the aminotransferase-tRNA from associating with the ribosome."}, "35986": {"category_aro_name": "doxycycline", "category_aro_cvterm_id": "35986", "category_aro_accession": "0000069", "category_aro_class_name": "Antibiotic", "category_aro_description": "Doxycycline is second generation semi-synthetic derivative of the tetracycline group of antibiotics. It inhibits bacterial protein synthesis by binding to the 30S subunit of the bacterial ribosome and preventing the aminotransferase-tRNA from associating with the ribosome."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35921": {"category_aro_name": "tetracycline-resistant ribosomal protection protein", "category_aro_cvterm_id": "35921", "category_aro_accession": "0000002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "A family of proteins known to bind to the 30S ribosomal subunit. This interaction prevents tetracycline and tetracycline derivatives from inhibiting ribosomal function. Thus, these proteins confer elevated resistance to tetracycline derivatives as a ribosomal protection protein."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}}}}, "1170": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "1179": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36029": {"category_aro_name": "IMP beta-lactamase", "category_aro_cvterm_id": "36029", "category_aro_accession": "3000020", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Plasmid mediated IMP-type carbapenemases, of which at least 26 varieties are currently known, became established in Japan in the 1990s in enteric gram-negative organisms, Pseudomonas and Acinetobacter species. Integron-associated, sometimes within plasmids. Hydrolyses all beta-lactams except monobactams, and evades all beta-lactam inhibitors."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "1178": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "511": {"$update": {"ARO_category": {"36476": {"category_aro_name": "iclaprim", "category_aro_cvterm_id": "36476", "category_aro_accession": "3000337", "category_aro_class_name": "Antibiotic", "category_aro_description": "Iclaprim is a bactericidal compound that inhibits dihydrofolate reductase. It is used against clinically important Gram-positive pathogens, including methicillin-sensitive Staphylococcus aureus and methicillin-resistant S. aureus."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36408": {"category_aro_name": "brodimoprim", "category_aro_cvterm_id": "36408", "category_aro_accession": "3000269", "category_aro_class_name": "Antibiotic", "category_aro_description": "Brodimoprim is a structural derivative of trimethoprim and an inhibitor of bacterial dihydrofolate reductase. The 4-methoxy group of trimethoprim is replaced with a bromine atom."}, "37617": {"category_aro_name": "trimethoprim resistant dihydrofolate reductase dfr", "category_aro_cvterm_id": "37617", "category_aro_accession": "3001218", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Alternative dihydropteroate synthase dfr present on plasmids produces alternate proteins that are less sensitive to trimethoprim from inhibiting its role in folate synthesis, thus conferring trimethoprim resistance."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "35998": {"category_aro_name": "antibiotic target replacement", "category_aro_cvterm_id": "35998", "category_aro_accession": "0001002", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Replacement or substitution of antibiotic action target, which process will result in antibiotic resistance."}, "36423": {"category_aro_name": "tetroxoprim", "category_aro_cvterm_id": "36423", "category_aro_accession": "3000284", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetroxoprim is a trimethoprim derivative that inhibits bacterial dihydrofolate reductase."}}}}, "510": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "1005": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}, "36590": {"$insert": {"category_aro_class_name": "Efflux Regulator"}}}, "$delete": ["35950"], "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36002": {"category_aro_name": "ATP-binding cassette (ABC) antibiotic efflux pump", "category_aro_cvterm_id": "36002", "category_aro_accession": "0010001", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. ATP-binding cassette (ABC) transporters are present in all cells of all organisms and use the energy of ATP binding/hydrolysis to transport substrates across cell membranes."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "37250": {"category_aro_name": "triclosan", "category_aro_cvterm_id": "37250", "category_aro_accession": "3000870", "category_aro_class_name": "Drug Class", "category_aro_description": "Triclosan is a common antibacterial agent added to many consumer products as a biocide.  It is an inhibitor of fatty acid biosynthesis by blocking enoyl-carrier protein reductase (FabI)."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "37084": {"category_aro_name": "cefalotin", "category_aro_cvterm_id": "37084", "category_aro_accession": "3000704", "category_aro_class_name": "Antibiotic", "category_aro_description": "Cefalotin is a semisynthetic cephalosporin antibiotic activate against staphylococci. It is resistant to staphylococci beta-lactamases but hydrolyzed by enterobacterial beta-lactamases."}, "35949": {"category_aro_name": "tigecycline", "category_aro_cvterm_id": "35949", "category_aro_accession": "0000030", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tigecycline is an glycylcycline antibiotic. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35960": {"category_aro_name": "glycylcycline", "category_aro_cvterm_id": "35960", "category_aro_accession": "0000042", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycylcyclines are a new class of antibiotics derived from tetracycline. These tetracycline analogues are specifically designed to overcome two common mechanisms of tetracycline resistance. Presently, there is only one glycylcycline antibiotic for clinical use: tigecycline. It works by inhibiting action of the prokaryotic 30S ribosome, preventing the binding of aminoacyl-tRNA."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "36981": {"category_aro_name": "ampicillin", "category_aro_cvterm_id": "36981", "category_aro_accession": "3000637", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ampicillin is a penicillin derivative that is highly acid stable, with its activity similar to benzylpenicillin."}, "36308": {"category_aro_name": "rifampin", "category_aro_cvterm_id": "36308", "category_aro_accession": "3000169", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifampin is a semi-synthetic rifamycin, and inhibits RNA synthesis by binding to RNA polymerase. Rifampin is the mainstay agent for the treatment of tuberculosis, leprosy and complicated Gram-positive infections."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "36296": {"category_aro_name": "rifamycin antibiotic", "category_aro_cvterm_id": "36296", "category_aro_accession": "3000157", "category_aro_class_name": "Drug Class", "category_aro_description": "Rifamycin antibiotics are a group of broad-spectrum ansamycin antibiotics that inhibit bacterial RNA polymerase by binding to a highly conserved region, blocking the oligonucleotide exit tunnel, and preventing the extension of nascent mRNAs."}}}}}, "1285": {"$update": {"ARO_description": "SAT-2 is a plasmid-mediated streptothricin acetyltransferase, which confers resistance to streptothricin, a nucleoside antibiotic. Originally described from an E. coli plasmid sequence by Heim et al., 1989.", "ARO_category": {"37249": {"category_aro_name": "streptothricin acetyltransferase (SAT)", "category_aro_cvterm_id": "37249", "category_aro_accession": "3000869", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "AcetylCoA dependent acetyltransferase that acetylate streptothricins such as nourseothricin at position 16 (beta position of beta-lysine)."}, "35931": {"category_aro_name": "streptothricin", "category_aro_cvterm_id": "35931", "category_aro_accession": "0000012", "category_aro_class_name": "Antibiotic", "category_aro_description": "Streptothricins are a group of N-glycoside antibiotics that include a carbamoylated D-glucosamine to which are attached a series of L-beta-lysine residues at position 2 and a streptolidine at position 1.  Streptothricins vary by the number of beta-lysine residues (from 1 (nourseothricin) to 7) and target protein synthesis in bacteria and eukaryotes."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36174": {"category_aro_name": "nucleoside antibiotic", "category_aro_cvterm_id": "36174", "category_aro_accession": "3000034", "category_aro_class_name": "Drug Class", "category_aro_description": "Nucleoside antibiotics are made of modified nucleosides and nucleotides with wide-ranging activities and means of antibacterial effects. This drug class includes aminonucleoside antibiotics, which contain an amino group."}}, "ARO_name": "SAT-2"}}, "1284": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36199": {"category_aro_name": "IND beta-lactamase", "category_aro_cvterm_id": "36199", "category_aro_accession": "3000060", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "IND beta-lactamases are class B carbapenem-hydrolyzing beta-lactamases"}}}}, "1287": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "512": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "1281": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1280": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "1283": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36198": {"category_aro_name": "KPC beta-lactamase", "category_aro_cvterm_id": "36198", "category_aro_accession": "3000059", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Klebsiella pneumoniae carbapenem resistant (KPC) beta-lactamases are notorious for their ability to efficiently hydrolyze carbapenems, unlike other Ambler Class A beta-lactamases.  There are currently 9 variants reported worldwide.  These enzymes were first isolated from Klebsiella pneumoniae strains in 2001 in the United States.  Hospital outbreaks have since been reported in Greece and Israel and KPC carrying strains are now endemic to New York facilities.  KPC-1 and KPC-2 have been shown to be identical and are now referred to as KPC-2."}}}}, "1282": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "41370": {"category_aro_name": "SIM beta-lactamase", "category_aro_cvterm_id": "41370", "category_aro_accession": "3004206", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SIM beta-lactamases are Class B beta-lactamases that are capable of hydrolyzing a wide variety of beta-lactams, including penicillins, narrow- to expanded-spectrum cephalosporins, and carbapenem. The SIM family of beta-lactamases appear to be transferable through integrons."}}}}, "1003": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1289": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "38817": {"category_aro_name": "OKP beta-lactamase", "category_aro_cvterm_id": "38817", "category_aro_accession": "3002417", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OKP beta-lactamases are chromosomal class A beta-lactamase that confer resistance to penicillins and early cephalosporins in Klebsiella pneumoniae. OKP beta-lactamases can be subdivided into two groups: OKP-A and OKP-B which diverge by about 4.2%"}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "1288": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "514": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36236": {"category_aro_name": "LEN beta-lactamase", "category_aro_cvterm_id": "36236", "category_aro_accession": "3000097", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "LEN beta-lactamases are chromosomal class A beta-lactamases that confer resistance to ampicillin, amoxicillin, carbenicillin, and ticarcillin but not to extended-spectrum beta-lactams."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}}}}, "1579": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "1578": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "689": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "688": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36222": {"category_aro_name": "MOX beta-lactamase", "category_aro_cvterm_id": "36222", "category_aro_accession": "3000083", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "MOX beta-lactamases are plasmid-mediated AmpC-type beta-lactamases."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "685": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "684": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "687": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35940": {"category_aro_name": "ribostamycin", "category_aro_cvterm_id": "35940", "category_aro_accession": "0000021", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ribostamycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Ribostamycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "37001": {"category_aro_name": "paromomycin", "category_aro_cvterm_id": "37001", "category_aro_accession": "3000657", "category_aro_class_name": "Antibiotic", "category_aro_description": "An aminoglycoside antibiotic used for the treatment of parasitic infections. It is similar to neomycin sharing a similar spectrum of activity, but its hydroxyl group at the 6'-position instead of an amino group makes it resistant to AAC(6') modifying enzymes."}, "36265": {"category_aro_name": "APH(3')", "category_aro_cvterm_id": "36265", "category_aro_accession": "3000126", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Phosphorylation of 2-deoxystreptamine aminoglycosides on the hydroxyl group at position 3'"}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "36997": {"category_aro_name": "G418", "category_aro_cvterm_id": "36997", "category_aro_accession": "3000653", "category_aro_class_name": "Antibiotic", "category_aro_description": "A gentamicin class aminoglycoside antibiotic often used in mammalian cell culture work as a selectable marker for the neo cassette (APH3')."}, "35924": {"category_aro_name": "neomycin", "category_aro_cvterm_id": "35924", "category_aro_accession": "0000005", "category_aro_class_name": "Antibiotic", "category_aro_description": "Neomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Neomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "686": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "681": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "680": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "683": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "682": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "1227": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35957": {"category_aro_name": "spectinomycin", "category_aro_cvterm_id": "35957", "category_aro_accession": "0000039", "category_aro_class_name": "Antibiotic", "category_aro_description": "Spectinomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Spectinomycin works by binding to the bacterial 30S ribosomal subunit inhibiting translation."}, "41439": {"category_aro_name": "ANT(3'')", "category_aro_cvterm_id": "41439", "category_aro_accession": "3004275", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Nucleotidylylation of streptomycin at the hydroxyl group at position 3''"}, "35958": {"category_aro_name": "streptomycin", "category_aro_cvterm_id": "35958", "category_aro_accession": "0000040", "category_aro_class_name": "Antibiotic", "category_aro_description": "Streptomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Streptomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "1226": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}}}}}, "1240": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36472": {"category_aro_name": "macrolide phosphotransferase (MPH)", "category_aro_cvterm_id": "36472", "category_aro_accession": "3000333", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Macrolide phosphotransferases (MPH) are enzymes encoded by macrolide phosphotransferase genes (mph genes). These enzymes phosphorylate macrolides in GTP dependent manner at 2'-OH of desosamine sugar thereby inactivating them. Characterized MPH's are differentiated based on their substrate specificity."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}}}}, "621": {"$update": {"ARO_category": {"35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "37022": {"category_aro_name": "vernamycin B-gamma", "category_aro_cvterm_id": "37022", "category_aro_accession": "3000678", "category_aro_class_name": "Antibiotic", "category_aro_description": "Vernamycin B-gamma is a class B streptogramin derived from virginiamycin S1."}, "37247": {"category_aro_name": "oleandomycin", "category_aro_cvterm_id": "37247", "category_aro_accession": "3000867", "category_aro_class_name": "Antibiotic", "category_aro_description": "Oleandomycin is a 14-membered macrolide produced by Streptomyces antibioticus. It is ssimilar to erythromycin, and contains a desosamine amino sugar and an oleandrose sugar. It targets the 50S ribosomal subunit to prevent protein synthesis."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35974": {"category_aro_name": "telithromycin", "category_aro_cvterm_id": "35974", "category_aro_accession": "0000057", "category_aro_class_name": "Antibiotic", "category_aro_description": "Telithromycin is a semi-synthetic derivative of erythromycin. It is a 14-membered macrolide and is the first ketolide antibiotic to be used in clinics. Telithromycin binds the 50S subunit of the bacterial ribosome to inhibit protein synthesis."}, "36284": {"category_aro_name": "tylosin", "category_aro_cvterm_id": "36284", "category_aro_accession": "3000145", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tylosin is a 16-membered macrolide, naturally produced by Streptomyces fradiae. It interacts with the bacterial ribosome 50S subunit to inhibit protein synthesis."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}, "36315": {"category_aro_name": "dirithromycin", "category_aro_cvterm_id": "36315", "category_aro_accession": "3000176", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dirithromycin is an oxazine derivative of erythromycin, sharing the 14-carbon macrolide ring. The antibiotic binds to the 50S subunit of the ribosome to inhibit bacterial protein synthesis."}, "35982": {"category_aro_name": "clarithromycin", "category_aro_cvterm_id": "35982", "category_aro_accession": "0000065", "category_aro_class_name": "Antibiotic", "category_aro_description": "Clarithromycin is a methyl derivative of erythromycin, sharing the 14-carbon macrolide ring. The antibiotic binds to the 50S subunit of the ribosome and is used to treat pharyngitis, tonsillitis, acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, pneumonia (especially atypical pneumonias associated with Chlamydia pneumoniae or TWAR), and skin structure infections."}, "35983": {"category_aro_name": "clindamycin", "category_aro_cvterm_id": "35983", "category_aro_accession": "0000066", "category_aro_class_name": "Antibiotic", "category_aro_description": "Clindamycin is a lincosamide antibiotic that blocks A-site aminoacyl-tRNA binding. It is usually used to treat infections with anaerobic bacteria but can also be used to treat some protozoal diseases, such as malaria."}, "37018": {"category_aro_name": "dalfopristin", "category_aro_cvterm_id": "37018", "category_aro_accession": "3000674", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dalfopristin is a water-soluble semi-synthetic derivative of pristinamycin IIA. It is produced by Streptomyces pristinaespiralis and is used in combination with quinupristin in a 7:3 ratio. Both work together to inhibit protein synthesis, and is active against Gram-positive bacteria."}, "37019": {"category_aro_name": "pristinamycin IB", "category_aro_cvterm_id": "37019", "category_aro_accession": "3000675", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin IB is a class B streptogramin similar to pristinamycin IA, the former containing a N-methyl-4-(methylamino)phenylalanine instead of a N-methyl-4-(dimethylamino)phenylalanine in its class A streptogramin counterpart (one less methyl group)."}, "36723": {"category_aro_name": "quinupristin", "category_aro_cvterm_id": "36723", "category_aro_accession": "3000584", "category_aro_class_name": "Antibiotic", "category_aro_description": "Quinupristin is a type B streptogramin and a semisynthetic derivative of pristinamycin 1A. It is a component of the drug Synercid and interacts with the 50S subunit of the bacterial ribosome to inhibit protein synthesis."}, "36722": {"category_aro_name": "pristinamycin IA", "category_aro_cvterm_id": "36722", "category_aro_accession": "3000583", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin 1A is a type B streptogramin antibiotic produced by Streptomyces pristinaespiralis. It binds to the P site of the 50S subunit of the bacterial ribosome, preventing the extension of protein chains."}, "36699": {"category_aro_name": "Erm 23S ribosomal RNA methyltransferase", "category_aro_cvterm_id": "36699", "category_aro_accession": "3000560", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Erm proteins are part of the RNA methyltransferase family and methylate A2058 (E. coli nomenclature) of the 23S ribosomal RNA conferring degrees of resistance to Macrolides, Lincosamides and Streptogramin b. This is called the MLSb phenotype."}, "37013": {"category_aro_name": "pristinamycin IIA", "category_aro_cvterm_id": "37013", "category_aro_accession": "3000669", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin IIA is a streptogramin A antibiotic."}, "37016": {"category_aro_name": "madumycin II", "category_aro_cvterm_id": "37016", "category_aro_accession": "3000672", "category_aro_class_name": "Antibiotic", "category_aro_description": "Madumycin II is a streptogramin A antibiotic."}, "37017": {"category_aro_name": "griseoviridin", "category_aro_cvterm_id": "37017", "category_aro_accession": "3000673", "category_aro_class_name": "Antibiotic", "category_aro_description": "Griseoviridin is a streptogramin A antibiotic."}, "35964": {"category_aro_name": "lincomycin", "category_aro_cvterm_id": "35964", "category_aro_accession": "0000046", "category_aro_class_name": "Antibiotic", "category_aro_description": "Lincomycin is a lincosamide antibiotic that comes from the actinomyces Streptomyces lincolnensis. It binds to the 23s portion of the 50S subunit of bacterial ribosomes and inhibit early elongation of peptide chain by inhibiting transpeptidase reaction."}, "35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}, "35946": {"category_aro_name": "roxithromycin", "category_aro_cvterm_id": "35946", "category_aro_accession": "0000027", "category_aro_class_name": "Antibiotic", "category_aro_description": "Roxithromycin is a semi-synthetic, 14-carbon ring macrolide antibiotic derived from erythromycin. It is used to treat respiratory tract, urinary and soft tissue infections. Roxithromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}, "36295": {"category_aro_name": "spiramycin", "category_aro_cvterm_id": "36295", "category_aro_accession": "3000156", "category_aro_class_name": "Antibiotic", "category_aro_description": "Spiramycin is a 16-membered macrolide and is natural product produced by Streptomyces ambofaciens. It binds to the 50S subunit of bacterial ribosomes and inhibits peptidyl transfer activity to disrupt protein synthesis."}, "36297": {"category_aro_name": "azithromycin", "category_aro_cvterm_id": "36297", "category_aro_accession": "3000158", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azithromycin is a 15-membered macrolide and falls under the subclass of azalide. Like other macrolides, azithromycin binds bacterial ribosomes to inhibit protein synthesis. The nitrogen substitution at the C-9a position prevents its degradation."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}}}}, "873": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36198": {"category_aro_name": "KPC beta-lactamase", "category_aro_cvterm_id": "36198", "category_aro_accession": "3000059", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Klebsiella pneumoniae carbapenem resistant (KPC) beta-lactamases are notorious for their ability to efficiently hydrolyze carbapenems, unlike other Ambler Class A beta-lactamases.  There are currently 9 variants reported worldwide.  These enzymes were first isolated from Klebsiella pneumoniae strains in 2001 in the United States.  Hospital outbreaks have since been reported in Greece and Israel and KPC carrying strains are now endemic to New York facilities.  KPC-1 and KPC-2 have been shown to be identical and are now referred to as KPC-2."}}}}, "1224": {"$update": {"ARO_category": {"35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}, "36699": {"category_aro_name": "Erm 23S ribosomal RNA methyltransferase", "category_aro_cvterm_id": "36699", "category_aro_accession": "3000560", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Erm proteins are part of the RNA methyltransferase family and methylate A2058 (E. coli nomenclature) of the 23S ribosomal RNA conferring degrees of resistance to Macrolides, Lincosamides and Streptogramin b. This is called the MLSb phenotype."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}}}}, "627": {"$update": {"ARO_category": {"36308": {"category_aro_name": "rifampin", "category_aro_cvterm_id": "36308", "category_aro_accession": "3000169", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifampin is a semi-synthetic rifamycin, and inhibits RNA synthesis by binding to RNA polymerase. Rifampin is the mainstay agent for the treatment of tuberculosis, leprosy and complicated Gram-positive infections."}, "36673": {"category_aro_name": "rifapentine", "category_aro_cvterm_id": "36673", "category_aro_accession": "3000534", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifapentine is a semisynthetic rifamycin that inhibits DNA-dependent RNA synthesis. It is often used in the treatment of tuberculosis and leprosy."}, "36669": {"category_aro_name": "rifabutin", "category_aro_cvterm_id": "36669", "category_aro_accession": "3000530", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifabutin is a semisynthetic rifamycin used in tuberculosis therapy. It inhibits DNA-dependent RNA synthesis."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36349": {"category_aro_name": "rifamycin-resistant beta-subunit of RNA polymerase (rpoB)", "category_aro_cvterm_id": "36349", "category_aro_accession": "3000210", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Rifampin resistant RNA polymerases include amino acids substitutions which disrupt the affinity of rifampin for its binding site. These mutations are frequently concentrated in the rif I region of the beta-subunit and most often involve amino acids which make direct interactions with rifampin. However, mutations which also confer resistance can occur outside this region and may involve amino acids which do not directly make contact with rifampin."}, "35998": {"category_aro_name": "antibiotic target replacement", "category_aro_cvterm_id": "35998", "category_aro_accession": "0001002", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Replacement or substitution of antibiotic action target, which process will result in antibiotic resistance."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36656": {"category_aro_name": "rifaximin", "category_aro_cvterm_id": "36656", "category_aro_accession": "3000517", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifaximin is a semi-synthetic rifamycin used to treat traveller's diarrhea. Rifaximin inhibits RNA synthesis by binding to the beta subunit of bacterial RNA polymerase."}, "36296": {"category_aro_name": "rifamycin antibiotic", "category_aro_cvterm_id": "36296", "category_aro_accession": "3000157", "category_aro_class_name": "Drug Class", "category_aro_description": "Rifamycin antibiotics are a group of broad-spectrum ansamycin antibiotics that inhibit bacterial RNA polymerase by binding to a highly conserved region, blocking the oligonucleotide exit tunnel, and preventing the extension of nascent mRNAs."}}}}, "1222": {"$update": {"ARO_category": {"35944": {"category_aro_name": "fosfomycin", "category_aro_cvterm_id": "35944", "category_aro_accession": "0000025", "category_aro_class_name": "Drug Class", "category_aro_description": "Fosfomycin (also known as phosphomycin and phosphonomycin) is a broad-spectrum antibiotic produced by certain Streptomyces species. It is effective on gram positive and negative bacteria as it targets the cell wall, an essential feature shared by both bacteria. Its specific target is MurA (MurZ in E.coli), which attaches phosphoenolpyruvate (PEP) to UDP-N-acetylglucosamine, a step of commitment to cell wall synthesis. In the active site of MurA, the active cysteine molecule is alkylated which stops the catalytic reaction."}, "36272": {"category_aro_name": "fosfomycin thiol transferase", "category_aro_cvterm_id": "36272", "category_aro_accession": "3000133", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Catalyzes the addition of a thiol group from a nucleophilic molecule to fosfomycin."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}}}}, "1221": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "624": {"$update": {"ARO_category": {"36308": {"category_aro_name": "rifampin", "category_aro_cvterm_id": "36308", "category_aro_accession": "3000169", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifampin is a semi-synthetic rifamycin, and inhibits RNA synthesis by binding to RNA polymerase. Rifampin is the mainstay agent for the treatment of tuberculosis, leprosy and complicated Gram-positive infections."}, "36673": {"category_aro_name": "rifapentine", "category_aro_cvterm_id": "36673", "category_aro_accession": "3000534", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifapentine is a semisynthetic rifamycin that inhibits DNA-dependent RNA synthesis. It is often used in the treatment of tuberculosis and leprosy."}, "36669": {"category_aro_name": "rifabutin", "category_aro_cvterm_id": "36669", "category_aro_accession": "3000530", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifabutin is a semisynthetic rifamycin used in tuberculosis therapy. It inhibits DNA-dependent RNA synthesis."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36349": {"category_aro_name": "rifamycin-resistant beta-subunit of RNA polymerase (rpoB)", "category_aro_cvterm_id": "36349", "category_aro_accession": "3000210", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Rifampin resistant RNA polymerases include amino acids substitutions which disrupt the affinity of rifampin for its binding site. These mutations are frequently concentrated in the rif I region of the beta-subunit and most often involve amino acids which make direct interactions with rifampin. However, mutations which also confer resistance can occur outside this region and may involve amino acids which do not directly make contact with rifampin."}, "35998": {"category_aro_name": "antibiotic target replacement", "category_aro_cvterm_id": "35998", "category_aro_accession": "0001002", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Replacement or substitution of antibiotic action target, which process will result in antibiotic resistance."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36656": {"category_aro_name": "rifaximin", "category_aro_cvterm_id": "36656", "category_aro_accession": "3000517", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifaximin is a semi-synthetic rifamycin used to treat traveller's diarrhea. Rifaximin inhibits RNA synthesis by binding to the beta subunit of bacterial RNA polymerase."}, "36296": {"category_aro_name": "rifamycin antibiotic", "category_aro_cvterm_id": "36296", "category_aro_accession": "3000157", "category_aro_class_name": "Drug Class", "category_aro_description": "Rifamycin antibiotics are a group of broad-spectrum ansamycin antibiotics that inhibit bacterial RNA polymerase by binding to a highly conserved region, blocking the oligonucleotide exit tunnel, and preventing the extension of nascent mRNAs."}}}}, "2743": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "37250": {"category_aro_name": "triclosan", "category_aro_cvterm_id": "37250", "category_aro_accession": "3000870", "category_aro_class_name": "Drug Class", "category_aro_description": "Triclosan is a common antibacterial agent added to many consumer products as a biocide.  It is an inhibitor of fatty acid biosynthesis by blocking enoyl-carrier protein reductase (FabI)."}, "36308": {"category_aro_name": "rifampin", "category_aro_cvterm_id": "36308", "category_aro_accession": "3000169", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifampin is a semi-synthetic rifamycin, and inhibits RNA synthesis by binding to RNA polymerase. Rifampin is the mainstay agent for the treatment of tuberculosis, leprosy and complicated Gram-positive infections."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35977": {"category_aro_name": "ceftazidime", "category_aro_cvterm_id": "35977", "category_aro_accession": "0000060", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ceftazidime is a third-generation cephalosporin antibiotic. Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gram-negative bacteria. Unlike most third-generation agents, it is active against Pseudomonas aeruginosa, however it has weaker activity against Gram-positive microorganisms and is not used for such infections."}, "37084": {"category_aro_name": "cefalotin", "category_aro_cvterm_id": "37084", "category_aro_accession": "3000704", "category_aro_class_name": "Antibiotic", "category_aro_description": "Cefalotin is a semisynthetic cephalosporin antibiotic activate against staphylococci. It is resistant to staphylococci beta-lactamases but hydrolyzed by enterobacterial beta-lactamases."}, "35949": {"category_aro_name": "tigecycline", "category_aro_cvterm_id": "35949", "category_aro_accession": "0000030", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tigecycline is an glycylcycline antibiotic. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35960": {"category_aro_name": "glycylcycline", "category_aro_cvterm_id": "35960", "category_aro_accession": "0000042", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycylcyclines are a new class of antibiotics derived from tetracycline. These tetracycline analogues are specifically designed to overcome two common mechanisms of tetracycline resistance. Presently, there is only one glycylcycline antibiotic for clinical use: tigecycline. It works by inhibiting action of the prokaryotic 30S ribosome, preventing the binding of aminoacyl-tRNA."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "36981": {"category_aro_name": "ampicillin", "category_aro_cvterm_id": "36981", "category_aro_accession": "3000637", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ampicillin is a penicillin derivative that is highly acid stable, with its activity similar to benzylpenicillin."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "36296": {"category_aro_name": "rifamycin antibiotic", "category_aro_cvterm_id": "36296", "category_aro_accession": "3000157", "category_aro_class_name": "Drug Class", "category_aro_description": "Rifamycin antibiotics are a group of broad-spectrum ansamycin antibiotics that inhibit bacterial RNA polymerase by binding to a highly conserved region, blocking the oligonucleotide exit tunnel, and preventing the extension of nascent mRNAs."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "407": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1370": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35953": {"category_aro_name": "sisomicin", "category_aro_cvterm_id": "35953", "category_aro_accession": "0000035", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sisomicin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Sisomicin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36484": {"category_aro_name": "AAC(6')", "category_aro_cvterm_id": "36484", "category_aro_accession": "3000345", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Acetylation of the aminoglycoside antibiotic on the amino group at position 6'."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "35966": {"category_aro_name": "kanamycin A", "category_aro_cvterm_id": "35966", "category_aro_accession": "0000049", "category_aro_class_name": "Antibiotic", "category_aro_description": "Kanamycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Kanamycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35926": {"category_aro_name": "dibekacin", "category_aro_cvterm_id": "35926", "category_aro_accession": "0000007", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dibekacin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Dibekacin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36998": {"category_aro_name": "arbekacin", "category_aro_cvterm_id": "36998", "category_aro_accession": "3000654", "category_aro_class_name": "Antibiotic", "category_aro_description": "A synthetic derivative (1-N-(4-amino-2-hydroxybutyryl) of dibekacin used in Japan. It is active against methicillin-resistant Staph. aureus and shows synergy with ampicillin when treating gentamicin and vancomycin resistant enterocci."}, "36999": {"category_aro_name": "gentamicin B", "category_aro_cvterm_id": "36999", "category_aro_accession": "3000655", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gentamicin B is a semisynthetic aminoglycoside antibacterial."}, "35956": {"category_aro_name": "netilmicin", "category_aro_cvterm_id": "35956", "category_aro_accession": "0000038", "category_aro_class_name": "Antibiotic", "category_aro_description": "Netilmicin is a member of the aminoglycoside family of antibiotics. These antibiotics have the ability to kill a wide variety of bacteria by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth. Netilmicin is not absorbed from the gut and is therefore only given by injection or infusion. It is only used in the treatment of serious infections particularly those resistant to gentamicin."}, "35932": {"category_aro_name": "amikacin", "category_aro_cvterm_id": "35932", "category_aro_accession": "0000013", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amikacin is an aminoglycoside antibiotic that works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36996": {"category_aro_name": "isepamicin", "category_aro_cvterm_id": "36996", "category_aro_accession": "3000652", "category_aro_class_name": "Antibiotic", "category_aro_description": "A semi-synthetic derivative of gentamicin B (hydroxyamino propionyl genamicin B). It is modified to combat microbial inactivation and has a slightly larger spectrum of activity compared to other aminoglycosides, including Ser marcescens, Enterobacteria, and K pneumoniae."}, "35924": {"category_aro_name": "neomycin", "category_aro_cvterm_id": "35924", "category_aro_accession": "0000005", "category_aro_class_name": "Antibiotic", "category_aro_description": "Neomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Neomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35969": {"category_aro_name": "tobramycin", "category_aro_cvterm_id": "35969", "category_aro_accession": "0000052", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tobramycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Tobramycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "405": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1372": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35966": {"category_aro_name": "kanamycin A", "category_aro_cvterm_id": "35966", "category_aro_accession": "0000049", "category_aro_class_name": "Antibiotic", "category_aro_description": "Kanamycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Kanamycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "41440": {"category_aro_name": "ANT(2'')", "category_aro_cvterm_id": "41440", "category_aro_accession": "3004276", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Nucelotidylylation of streptomycin at the hydroxyl group at position 2''."}, "36999": {"category_aro_name": "gentamicin B", "category_aro_cvterm_id": "36999", "category_aro_accession": "3000655", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gentamicin B is a semisynthetic aminoglycoside antibacterial."}, "35933": {"category_aro_name": "gentamicin C", "category_aro_cvterm_id": "35933", "category_aro_accession": "0000014", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gentamicin C is a mixture of gentamicin C1, gentamicin C1a, and gentamicin C2 (these differ in substituents at position C6'). Gentamicin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "35969": {"category_aro_name": "tobramycin", "category_aro_cvterm_id": "35969", "category_aro_accession": "0000052", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tobramycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Tobramycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "1375": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "1374": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "41361": {"category_aro_name": "blaZ beta-lactamase", "category_aro_cvterm_id": "41361", "category_aro_accession": "3004197", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "blaZ beta-lactamases are Class A beta-lactamases. These beta-lactamases are responsible for penicillin resistance in Staphylococcus aures."}}}}, "1377": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "400": {"$update": {"ARO_category": {"36237": {"category_aro_name": "PDC beta-lactamase", "category_aro_cvterm_id": "36237", "category_aro_accession": "3000098", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "PDC beta-lactamases are class C beta-lactamases that are found in Pseudomonas aeruginosa."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "1379": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1378": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36461": {"category_aro_name": "AAC(3)", "category_aro_cvterm_id": "36461", "category_aro_accession": "3000322", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Acetylation of the aminoglycoside antibiotic on the amino group at position 3."}, "37001": {"category_aro_name": "paromomycin", "category_aro_cvterm_id": "37001", "category_aro_accession": "3000657", "category_aro_class_name": "Antibiotic", "category_aro_description": "An aminoglycoside antibiotic used for the treatment of parasitic infections. It is similar to neomycin sharing a similar spectrum of activity, but its hydroxyl group at the 6'-position instead of an amino group makes it resistant to AAC(6') modifying enzymes."}, "35966": {"category_aro_name": "kanamycin A", "category_aro_cvterm_id": "35966", "category_aro_accession": "0000049", "category_aro_class_name": "Antibiotic", "category_aro_description": "Kanamycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Kanamycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "35924": {"category_aro_name": "neomycin", "category_aro_cvterm_id": "35924", "category_aro_accession": "0000005", "category_aro_class_name": "Antibiotic", "category_aro_description": "Neomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Neomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35943": {"category_aro_name": "butirosin", "category_aro_cvterm_id": "35943", "category_aro_accession": "0000024", "category_aro_class_name": "Antibiotic", "category_aro_description": "Butirosin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Butirosin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "1342": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36595": {"category_aro_name": "thiamphenicol", "category_aro_cvterm_id": "36595", "category_aro_accession": "3000456", "category_aro_class_name": "Antibiotic", "category_aro_description": "Derivative of Chloramphenicol. The nitro group (-NO2) is substituted by a sulfomethyl group (-SO2CH3)."}, "36261": {"category_aro_name": "chloramphenicol acetyltransferase (CAT)", "category_aro_cvterm_id": "36261", "category_aro_accession": "3000122", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Inactivates chloramphenicol by addition of an acyl group. cat is used to describe many variants of the chloramphenicol acetyltransferase gene in a range of organisms including Acinetobacter calcoaceticus, Agrobacterium tumefaciens, Bacillus clausii, Bacillus subtilis, Campylobacter coli, Enterococcus faecalis, Enterococcus faecium, Lactococcus lactis, Listeria monocytogenes, Listonella anguillarum Morganella morganii, Photobacterium damselae subsp. piscicida, Proteus mirabilis, Salmonella typhi, Serratia marcescens, Shigella flexneri, Staphylococcus aureus, Staphylococcus haemolyticus, Staphylococcus intermedius, Streptococcus agalactiae, Streptococcus suis and Streptomyces acrimycini"}, "36521": {"category_aro_name": "azidamfenicol", "category_aro_cvterm_id": "36521", "category_aro_accession": "3000382", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azidamfenicol is a water soluble derivative of chloramphenicol, sharing the same mode of action of inhibiting peptide synthesis by interacting with the 23S RNA of the 50S ribosomal subunit."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}, "409": {"$update": {"ARO_category": {"36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36713": {"category_aro_name": "vanR", "category_aro_cvterm_id": "36713", "category_aro_accession": "3000574", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "VanR is a OmpR-family transcriptional activator in the VanSR regulatory system. When activated by VanS, it promotes cotranscription of VanA, VanH, and VanX."}, "35947": {"category_aro_name": "vancomycin", "category_aro_cvterm_id": "35947", "category_aro_accession": "0000028", "category_aro_class_name": "Antibiotic", "category_aro_description": "Vancomycin is a glycopeptide antibiotic used in the prophylaxis and treatment of infections caused by Gram-positive bacteria. Vancomycin inhibits the synthesis of peptidoglycan, the major component of the cell wall of gram-positive bacteria. Its mechanism of action is unusual in that it acts by binding precursors of peptidoglycan, rather than by interacting with an enzyme."}}}}, "408": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "453": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$delete": ["36590"], "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35971": {"category_aro_name": "penicillin", "category_aro_cvterm_id": "35971", "category_aro_accession": "0000054", "category_aro_class_name": "Antibiotic", "category_aro_description": "Penicillin (sometimes abbreviated PCN) is a beta-lactam antibiotic used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms. It works by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36297": {"category_aro_name": "azithromycin", "category_aro_cvterm_id": "36297", "category_aro_accession": "3000158", "category_aro_class_name": "Antibiotic", "category_aro_description": "Azithromycin is a 15-membered macrolide and falls under the subclass of azalide. Like other macrolides, azithromycin binds bacterial ribosomes to inhibit protein synthesis. The nitrogen substitution at the C-9a position prevents its degradation."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}}}}}, "2747": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}}}}}, "454": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36198": {"category_aro_name": "KPC beta-lactamase", "category_aro_cvterm_id": "36198", "category_aro_accession": "3000059", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Klebsiella pneumoniae carbapenem resistant (KPC) beta-lactamases are notorious for their ability to efficiently hydrolyze carbapenems, unlike other Ambler Class A beta-lactamases.  There are currently 9 variants reported worldwide.  These enzymes were first isolated from Klebsiella pneumoniae strains in 2001 in the United States.  Hospital outbreaks have since been reported in Greece and Israel and KPC carrying strains are now endemic to New York facilities.  KPC-1 and KPC-2 have been shown to be identical and are now referred to as KPC-2."}}}}, "2746": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "35933": {"category_aro_name": "gentamicin C", "category_aro_cvterm_id": "35933", "category_aro_accession": "0000014", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gentamicin C is a mixture of gentamicin C1, gentamicin C1a, and gentamicin C2 (these differ in substituents at position C6'). Gentamicin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35932": {"category_aro_name": "amikacin", "category_aro_cvterm_id": "35932", "category_aro_accession": "0000013", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amikacin is an aminoglycoside antibiotic that works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "35969": {"category_aro_name": "tobramycin", "category_aro_cvterm_id": "35969", "category_aro_accession": "0000052", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tobramycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Tobramycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}}}}}, "1345": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}}}}}, "2749": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36360": {"category_aro_name": "lincosamide nucleotidyltransferase (LNU)", "category_aro_cvterm_id": "36360", "category_aro_accession": "3000221", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Resistance to the lincosamide antibiotic by ATP-dependent modification of the 3' and/or 4'-hydroxyl groups of the methylthiolincosamide sugar."}, "35964": {"category_aro_name": "lincomycin", "category_aro_cvterm_id": "35964", "category_aro_accession": "0000046", "category_aro_class_name": "Antibiotic", "category_aro_description": "Lincomycin is a lincosamide antibiotic that comes from the actinomyces Streptomyces lincolnensis. It binds to the 23s portion of the 50S subunit of bacterial ribosomes and inhibit early elongation of peptide chain by inhibiting transpeptidase reaction."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}}}}, "1346": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "1347": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1245": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "379": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "378": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "371": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "370": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "373": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "36197": {"category_aro_name": "MIR beta-lactamase", "category_aro_cvterm_id": "36197", "category_aro_accession": "3000058", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "MIR beta-lactamases are plasmid-mediated beta-lactamases that confer resistance to oxyimino- and alpha-methoxy beta-lactams"}}}}, "372": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}}}}}, "375": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "35942": {"category_aro_name": "enoxacin", "category_aro_cvterm_id": "35942", "category_aro_accession": "0000023", "category_aro_class_name": "Antibiotic", "category_aro_description": "Enoxacin belongs to a group called fluoroquinolones. Its mode of action depends upon blocking bacterial DNA replication by binding itself to DNA gyrase and causing double-stranded breaks in the bacterial chromosome."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}}}}}, "374": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "377": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36251": {"category_aro_name": "multidrug and toxic compound extrusion (MATE) transporter", "category_aro_cvterm_id": "36251", "category_aro_accession": "3000112", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Multidrug and toxic compound extrusion (MATE) transporters utilize the cationic gradient across the membrane as an energy source. Although there is a diverse substrate specificity, almost all MATE transporters recognize fluoroquinolones. Arciflavine, ethidium and aminoglycosides are also good substrates."}, "35949": {"category_aro_name": "tigecycline", "category_aro_cvterm_id": "35949", "category_aro_accession": "0000030", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tigecycline is an glycylcycline antibiotic. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35960": {"category_aro_name": "glycylcycline", "category_aro_cvterm_id": "35960", "category_aro_accession": "0000042", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycylcyclines are a new class of antibiotics derived from tetracycline. These tetracycline analogues are specifically designed to overcome two common mechanisms of tetracycline resistance. Presently, there is only one glycylcycline antibiotic for clinical use: tigecycline. It works by inhibiting action of the prokaryotic 30S ribosome, preventing the binding of aminoacyl-tRNA."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}}}}}, "376": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36360": {"category_aro_name": "lincosamide nucleotidyltransferase (LNU)", "category_aro_cvterm_id": "36360", "category_aro_accession": "3000221", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Resistance to the lincosamide antibiotic by ATP-dependent modification of the 3' and/or 4'-hydroxyl groups of the methylthiolincosamide sugar."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}}}}, "393": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "392": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "41369": {"category_aro_name": "TUS beta-lactamase", "category_aro_cvterm_id": "41369", "category_aro_accession": "3004205", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TUS beta-lactamases are Class B beta-lactamases that can hydrolyze a variety of beta-lactams, such as cephems and carbapenems"}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "391": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "36030": {"category_aro_name": "VIM beta-lactamase", "category_aro_cvterm_id": "36030", "category_aro_accession": "3000021", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "The Verone integron-encoded metallo-beta-lactamase (VIM) family was reported from Italy in 1999. There are, to date, 23 reported variants.  VIM enzymes mostly occur in P. aeruginosa, also P. putida and, very rarely, Enterobacteriaceae. Integron-associated, sometimes within plasmids. Hydrolyses all beta-lactams except monobactams, and evades all beta-lactam inhibitors.  There is a strong incidence of these in East Asia."}}}}, "390": {"$update": {"ARO_category": {"36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36210": {"category_aro_name": "vanS", "category_aro_cvterm_id": "36210", "category_aro_accession": "3000071", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "VanS is similar to histidine protein kinases like EnvZ and acts as a response regulator by activating VanR. VanS is required for high level transcription of other van glycopeptide resistance genes."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "35947": {"category_aro_name": "vancomycin", "category_aro_cvterm_id": "35947", "category_aro_accession": "0000028", "category_aro_class_name": "Antibiotic", "category_aro_description": "Vancomycin is a glycopeptide antibiotic used in the prophylaxis and treatment of infections caused by Gram-positive bacteria. Vancomycin inhibits the synthesis of peptidoglycan, the major component of the cell wall of gram-positive bacteria. Its mechanism of action is unusual in that it acts by binding precursors of peptidoglycan, rather than by interacting with an enzyme."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}}}}, "397": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "396": {"$update": {"ARO_category": {"36463": {"category_aro_name": "sulfadiazine", "category_aro_cvterm_id": "36463", "category_aro_accession": "3000324", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfadiazine is a potent inhibitor of dihydropteroate synthase, interfering with the tetrahydrofolic biosynthesis pathway. Tetrahydrofolic acid is essential for folate synthesis, a precursor to many nucleotides and amino acids."}, "36466": {"category_aro_name": "sulfadoxine", "category_aro_cvterm_id": "36466", "category_aro_accession": "3000327", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfadoxine is an inhibitor of dihydropteroate synthase, interfering with the tetrahydrofolic biosynthesis pathway. Tetrahydrofolic acid is essential for folate synthesis, a precursor to many nucleotides and amino acids."}, "37027": {"category_aro_name": "sulfacetamide", "category_aro_cvterm_id": "37027", "category_aro_accession": "3000683", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfacetamide is a very soluable sulfonamide antibiotic previously used to treat urinary tract infections. Its relatively low activity and toxicity to those with Stevens-Johnson syndrome have reduced its use and availability."}, "36464": {"category_aro_name": "sulfadimidine", "category_aro_cvterm_id": "36464", "category_aro_accession": "3000325", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfadimidine is an alkaline sulfonamide antibiotic that inhibits dihydropteroate synthase, and enzyme in the tetrahydrofolic acid biosynthesis pathway. This interferes with the production of folate, which is a precursor to many amino acids and nucleotides."}, "37028": {"category_aro_name": "mafenide", "category_aro_cvterm_id": "37028", "category_aro_accession": "3000684", "category_aro_class_name": "Antibiotic", "category_aro_description": "Mafenide is a sulfonamide used topically for treating burns."}, "36468": {"category_aro_name": "sulfamethoxazole", "category_aro_cvterm_id": "36468", "category_aro_accession": "3000329", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfamethoxazole is a sulfonamide antibiotic usually taken with trimethoprim, a diaminopyrimidine antibiotic. Sulfamethoxazole inhibits dihydropteroate synthase, essential to tetrahydrofolic acid biosynthesis. This pathway generates compounds used in the synthesis of many amino acids and nucleotides."}, "36469": {"category_aro_name": "sulfisoxazole", "category_aro_cvterm_id": "36469", "category_aro_accession": "3000330", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfisoxazole is an inhibitor of dihydropteroate synthase, interfering with the tetrahydrofolic biosynthesis pathway. Tetrahydrofolic acid is essential for folate synthesis, a precursor to many nucleotides and amino acids."}, "41402": {"category_aro_name": "sulfonamide resistant sul", "category_aro_cvterm_id": "41402", "category_aro_accession": "3004238", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "The sul genes encode forms of dihydropteroate synthase that confer resistance to sulfonamide."}, "39996": {"category_aro_name": "dapsone", "category_aro_cvterm_id": "39996", "category_aro_accession": "3003412", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dapsone is a sulfone in which it inhibits folic acid synthesis, such as the dihydropteroate synthase."}, "39985": {"category_aro_name": "sulfone antibiotic", "category_aro_cvterm_id": "39985", "category_aro_accession": "3003401", "category_aro_class_name": "Drug Class", "category_aro_description": "A sulfone active against a wide range of bacteria but mainly employed for its actions against mycobacterium laprae. Its mechanism of action  involves inhibition of folic acid synthesis in susceptible organisms."}, "37043": {"category_aro_name": "sulfamethizole", "category_aro_cvterm_id": "37043", "category_aro_accession": "3000699", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfamethizole is a short-acting sulfonamide that inhibits dihydropteroate synthetase."}, "37042": {"category_aro_name": "sulfasalazine", "category_aro_cvterm_id": "37042", "category_aro_accession": "3000698", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sulfasalazine is a derivative of the early sulfonamide sulfapyridine (salicylazosulfapyridine). It was developed to increase water solubility and is taken orally for ulcerative colitis."}, "35998": {"category_aro_name": "antibiotic target replacement", "category_aro_cvterm_id": "35998", "category_aro_accession": "0001002", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Replacement or substitution of antibiotic action target, which process will result in antibiotic resistance."}, "36421": {"category_aro_name": "sulfonamide antibiotic", "category_aro_cvterm_id": "36421", "category_aro_accession": "3000282", "category_aro_class_name": "Drug Class", "category_aro_description": "Sulfonamides are broad spectrum, synthetic antibiotics that contain the sulfonamide group. Sulfonamides inhibit dihydropteroate synthase, which catalyzes the conversion of p-aminobenzoic acid to dihydropteroic acid as part of the tetrahydrofolic acid biosynthetic pathway. Tetrahydrofolic acid is essential for folate synthesis, a precursor of many nucleotides and amino acids. Many sulfamides are taken with trimethoprim, an inhibitor of dihydrofolate reductase, also disturbing the trihydrofolic acid synthesis pathway."}}}}, "395": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35981": {"category_aro_name": "amoxicillin", "category_aro_cvterm_id": "35981", "category_aro_accession": "0000064", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amoxicillin is a moderate-spectrum, bacteriolytic, beta-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. A derivative of penicillin, it has a wider range of treatment but remains relatively ineffective against Gram-negative bacteria. It is commonly taken with clavulanic acid, a beta-lactamase inhibitor. Like other beta-lactams, amoxicillin interferes with the synthesis of peptidoglycan."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "41397": {"category_aro_name": "blaF family beta-lactamase", "category_aro_cvterm_id": "41397", "category_aro_accession": "3004233", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Class A Beta-lactamases first isolated from Mycobacterium fortuitum."}}}}, "394": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "399": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "36197": {"category_aro_name": "MIR beta-lactamase", "category_aro_cvterm_id": "36197", "category_aro_accession": "3000058", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "MIR beta-lactamases are plasmid-mediated beta-lactamases that confer resistance to oxyimino- and alpha-methoxy beta-lactams"}}}}, "398": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "1247": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "2303": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "35972": {"category_aro_name": "bicyclomycin", "category_aro_cvterm_id": "35972", "category_aro_accession": "0000055", "category_aro_class_name": "Drug Class", "category_aro_description": "Bicyclomycin represents a unique class of antibiotics, discovered in 1972. It is obtained by the fermentation of Streptomyces sapporonensis. In the crystalline form bicyclomycin is observed to be rhombic or monoclinic, depending on the solvent used. This antibiotic kills bacteria by inhibiting the Rho transcription terminator factor, halting ribonucleic acid (RNA) synthesis."}}}}}, "2306": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}, "36590": {"$insert": {"category_aro_class_name": "Efflux Regulator"}}}, "$delete": ["35950"], "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "37250": {"category_aro_name": "triclosan", "category_aro_cvterm_id": "37250", "category_aro_accession": "3000870", "category_aro_class_name": "Drug Class", "category_aro_description": "Triclosan is a common antibacterial agent added to many consumer products as a biocide.  It is an inhibitor of fatty acid biosynthesis by blocking enoyl-carrier protein reductase (FabI)."}, "36308": {"category_aro_name": "rifampin", "category_aro_cvterm_id": "36308", "category_aro_accession": "3000169", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifampin is a semi-synthetic rifamycin, and inhibits RNA synthesis by binding to RNA polymerase. Rifampin is the mainstay agent for the treatment of tuberculosis, leprosy and complicated Gram-positive infections."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "37084": {"category_aro_name": "cefalotin", "category_aro_cvterm_id": "37084", "category_aro_accession": "3000704", "category_aro_class_name": "Antibiotic", "category_aro_description": "Cefalotin is a semisynthetic cephalosporin antibiotic activate against staphylococci. It is resistant to staphylococci beta-lactamases but hydrolyzed by enterobacterial beta-lactamases."}, "35949": {"category_aro_name": "tigecycline", "category_aro_cvterm_id": "35949", "category_aro_accession": "0000030", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tigecycline is an glycylcycline antibiotic. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35960": {"category_aro_name": "glycylcycline", "category_aro_cvterm_id": "35960", "category_aro_accession": "0000042", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycylcyclines are a new class of antibiotics derived from tetracycline. These tetracycline analogues are specifically designed to overcome two common mechanisms of tetracycline resistance. Presently, there is only one glycylcycline antibiotic for clinical use: tigecycline. It works by inhibiting action of the prokaryotic 30S ribosome, preventing the binding of aminoacyl-tRNA."}, "36981": {"category_aro_name": "ampicillin", "category_aro_cvterm_id": "36981", "category_aro_accession": "3000637", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ampicillin is a penicillin derivative that is highly acid stable, with its activity similar to benzylpenicillin."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36296": {"category_aro_name": "rifamycin antibiotic", "category_aro_cvterm_id": "36296", "category_aro_accession": "3000157", "category_aro_class_name": "Drug Class", "category_aro_description": "Rifamycin antibiotics are a group of broad-spectrum ansamycin antibiotics that inhibit bacterial RNA polymerase by binding to a highly conserved region, blocking the oligonucleotide exit tunnel, and preventing the extension of nascent mRNAs."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "245": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "244": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "247": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "246": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "241": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36211": {"category_aro_name": "ACT beta-lactamase", "category_aro_cvterm_id": "36211", "category_aro_accession": "3000072", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "ACT beta-lactamases, also known as AmpC beta-lactamases, are cephalosporinases that cannot be inhibited by clavulanate. These enzymes are encoded by genes located on the chromosome and can be induced by the presence of beta-lactam antibiotics. However recently, these genes have been found on plasmids and expressed at high constitutive levels in Escherichia coli and Klebsiella pneumoniae."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "240": {"$update": {"ARO_category": {"36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36713": {"category_aro_name": "vanR", "category_aro_cvterm_id": "36713", "category_aro_accession": "3000574", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "VanR is a OmpR-family transcriptional activator in the VanSR regulatory system. When activated by VanS, it promotes cotranscription of VanA, VanH, and VanX."}, "35947": {"category_aro_name": "vancomycin", "category_aro_cvterm_id": "35947", "category_aro_accession": "0000028", "category_aro_class_name": "Antibiotic", "category_aro_description": "Vancomycin is a glycopeptide antibiotic used in the prophylaxis and treatment of infections caused by Gram-positive bacteria. Vancomycin inhibits the synthesis of peptidoglycan, the major component of the cell wall of gram-positive bacteria. Its mechanism of action is unusual in that it acts by binding precursors of peptidoglycan, rather than by interacting with an enzyme."}}}}, "243": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "242": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "249": {"$update": {"ARO_category": {"41433": {"category_aro_name": "pmr phosphoethanolamine transferase", "category_aro_cvterm_id": "41433", "category_aro_accession": "3004269", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "This family of phosphoethanolamine transferase catalyze the addition of 4-amino-4-deoxy-L-arabinose (L-Ara4N) and phosphoethanolamine to lipid A, which impedes the binding of colistin to the cell membrane."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}}}}, "248": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "38817": {"category_aro_name": "OKP beta-lactamase", "category_aro_cvterm_id": "38817", "category_aro_accession": "3002417", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OKP beta-lactamases are chromosomal class A beta-lactamase that confer resistance to penicillins and early cephalosporins in Klebsiella pneumoniae. OKP beta-lactamases can be subdivided into two groups: OKP-A and OKP-B which diverge by about 4.2%"}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "2274": {"$update": {"ARO_category": {"35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "37697": {"category_aro_name": "non-erm 23S ribosomal RNA methyltransferase (G748)", "category_aro_cvterm_id": "37697", "category_aro_accession": "3001298", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Non-erm 23S ribosomal RNA methyltransferases modify guanosine 748 (E. coli numbering) to confer resistance to some macrolides and lincosamides"}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35936": {"category_aro_name": "lincosamide antibiotic", "category_aro_cvterm_id": "35936", "category_aro_accession": "0000017", "category_aro_class_name": "Drug Class", "category_aro_description": "Lincosamides (e.g. lincomycin, clindamycin) are a class of drugs which bind to the 23s portion of the 50S subunit of bacterial ribosomes. This interaction inhibits early elongation of peptide chains by inhibiting the transpeptidase reaction, acting similarly to macrolides."}}}}, "2277": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36472": {"category_aro_name": "macrolide phosphotransferase (MPH)", "category_aro_cvterm_id": "36472", "category_aro_accession": "3000333", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Macrolide phosphotransferases (MPH) are enzymes encoded by macrolide phosphotransferase genes (mph genes). These enzymes phosphorylate macrolides in GTP dependent manner at 2'-OH of desosamine sugar thereby inactivating them. Characterized MPH's are differentiated based on their substrate specificity."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}}}}, "2279": {"$update": {"ARO_category": {"36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "37243": {"category_aro_name": "defensin resistant mprF", "category_aro_cvterm_id": "37243", "category_aro_accession": "3000863", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "MprF is a integral membrane protein that modifies the negatively-charged phosphatidylglycerol on the membrane surface of both Gram-positive and Gram-negative bacteria. This confers resistance to cationic peptides that disrupt the cell membrane, including defensins."}, "37037": {"category_aro_name": "defensin", "category_aro_cvterm_id": "37037", "category_aro_accession": "3000693", "category_aro_class_name": "Antibiotic", "category_aro_description": "Defensins are natural cationic peptides that have antibiotic properties. It is part of the innate immune system of plants and animals."}}}}, "2278": {"$update": {"ARO_category": {"36585": {"category_aro_name": "antibiotic resistant isoleucyl-tRNA synthetase (ileS)", "category_aro_cvterm_id": "36585", "category_aro_accession": "3000446", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Mupirocin inhibits protein synthesis by interfering with isoleucyl-tRNA synthetase (ileS).  Mutations in ileS can confer low-level mupirocin resistance."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36693": {"category_aro_name": "mupirocin", "category_aro_cvterm_id": "36693", "category_aro_accession": "3000554", "category_aro_class_name": "Drug Class", "category_aro_description": "Mupirocin, also known as pseudomonic acid, is a bacteriostatic polyketide antibiotic from Pseudomonas fluorescens used to treat S. aureus and MRSA. It inhibits Ile tRNA synthetase."}}, "ARO_name": "Bifidobacterium ileS conferring resistance to mupirocin"}}, "2154": {"$update": {"ARO_category": {"35940": {"category_aro_name": "ribostamycin", "category_aro_cvterm_id": "35940", "category_aro_accession": "0000021", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ribostamycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Ribostamycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36998": {"category_aro_name": "arbekacin", "category_aro_cvterm_id": "36998", "category_aro_accession": "3000654", "category_aro_class_name": "Antibiotic", "category_aro_description": "A synthetic derivative (1-N-(4-amino-2-hydroxybutyryl) of dibekacin used in Japan. It is active against methicillin-resistant Staph. aureus and shows synergy with ampicillin when treating gentamicin and vancomycin resistant enterocci."}, "36999": {"category_aro_name": "gentamicin B", "category_aro_cvterm_id": "36999", "category_aro_accession": "3000655", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gentamicin B is a semisynthetic aminoglycoside antibacterial."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "36996": {"category_aro_name": "isepamicin", "category_aro_cvterm_id": "36996", "category_aro_accession": "3000652", "category_aro_class_name": "Antibiotic", "category_aro_description": "A semi-synthetic derivative of gentamicin B (hydroxyamino propionyl genamicin B). It is modified to combat microbial inactivation and has a slightly larger spectrum of activity compared to other aminoglycosides, including Ser marcescens, Enterobacteria, and K pneumoniae."}, "36997": {"category_aro_name": "G418", "category_aro_cvterm_id": "36997", "category_aro_accession": "3000653", "category_aro_class_name": "Antibiotic", "category_aro_description": "A gentamicin class aminoglycoside antibiotic often used in mammalian cell culture work as a selectable marker for the neo cassette (APH3')."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "36667": {"category_aro_name": "chlortetracycline", "category_aro_cvterm_id": "36667", "category_aro_accession": "3000528", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chlortetracycline was an early, first-generation tetracycline antibiotic developed in the 1940's. It inhibits bacterial protein synthesis by binding to the 30S subunit of bacterial ribosomes, preventing the aminoacyl-tRNA from binding to the ribosome."}, "37001": {"category_aro_name": "paromomycin", "category_aro_cvterm_id": "37001", "category_aro_accession": "3000657", "category_aro_class_name": "Antibiotic", "category_aro_description": "An aminoglycoside antibiotic used for the treatment of parasitic infections. It is similar to neomycin sharing a similar spectrum of activity, but its hydroxyl group at the 6'-position instead of an amino group makes it resistant to AAC(6') modifying enzymes."}, "35953": {"category_aro_name": "sisomicin", "category_aro_cvterm_id": "35953", "category_aro_accession": "0000035", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sisomicin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Sisomicin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35957": {"category_aro_name": "spectinomycin", "category_aro_cvterm_id": "35957", "category_aro_accession": "0000039", "category_aro_class_name": "Antibiotic", "category_aro_description": "Spectinomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Spectinomycin works by binding to the bacterial 30S ribosomal subunit inhibiting translation."}, "35956": {"category_aro_name": "netilmicin", "category_aro_cvterm_id": "35956", "category_aro_accession": "0000038", "category_aro_class_name": "Antibiotic", "category_aro_description": "Netilmicin is a member of the aminoglycoside family of antibiotics. These antibiotics have the ability to kill a wide variety of bacteria by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth. Netilmicin is not absorbed from the gut and is therefore only given by injection or infusion. It is only used in the treatment of serious infections particularly those resistant to gentamicin."}, "35955": {"category_aro_name": "apramycin", "category_aro_cvterm_id": "35955", "category_aro_accession": "0000037", "category_aro_class_name": "Antibiotic", "category_aro_description": "Apramycin is an aminoglycoside antibiotic used to treat different types of bacterial infections in animals. Apramycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35931": {"category_aro_name": "streptothricin", "category_aro_cvterm_id": "35931", "category_aro_accession": "0000012", "category_aro_class_name": "Antibiotic", "category_aro_description": "Streptothricins are a group of N-glycoside antibiotics that include a carbamoylated D-glucosamine to which are attached a series of L-beta-lysine residues at position 2 and a streptolidine at position 1.  Streptothricins vary by the number of beta-lysine residues (from 1 (nourseothricin) to 7) and target protein synthesis in bacteria and eukaryotes."}, "35922": {"category_aro_name": "astromicin", "category_aro_cvterm_id": "35922", "category_aro_accession": "0000003", "category_aro_class_name": "Antibiotic", "category_aro_description": "Astromicin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Astromicin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35933": {"category_aro_name": "gentamicin C", "category_aro_cvterm_id": "35933", "category_aro_accession": "0000014", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gentamicin C is a mixture of gentamicin C1, gentamicin C1a, and gentamicin C2 (these differ in substituents at position C6'). Gentamicin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35958": {"category_aro_name": "streptomycin", "category_aro_cvterm_id": "35958", "category_aro_accession": "0000040", "category_aro_class_name": "Antibiotic", "category_aro_description": "Streptomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Streptomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "40277": {"category_aro_name": "16s rRNA with mutation conferring resistance to aminoglycoside antibiotics", "category_aro_cvterm_id": "40277", "category_aro_accession": "3003666", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Point mutations in the 16S rRNA of bacteria can confer resistance to aminoglycosides."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36291": {"category_aro_name": "minocycline", "category_aro_cvterm_id": "36291", "category_aro_accession": "3000152", "category_aro_class_name": "Antibiotic", "category_aro_description": "Minocycline is second generation semi-synthetic derivative of the tetracycline group of antibiotics. It inhibits bacterial protein synthesis by binding to the 30S subunit of the bacterial ribosome and preventing the aminotransferase-tRNA from associating with the ribosome."}, "36353": {"category_aro_name": "hygromycin B", "category_aro_cvterm_id": "36353", "category_aro_accession": "3000214", "category_aro_class_name": "Antibiotic", "category_aro_description": "Hygromycin B is an aminoglycoside antibiotic used to treat different types of bacterial infections. Hygromycin B works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth. Hygromycin B has also been shown to interact with eukaryotic cells."}, "35986": {"category_aro_name": "doxycycline", "category_aro_cvterm_id": "35986", "category_aro_accession": "0000069", "category_aro_class_name": "Antibiotic", "category_aro_description": "Doxycycline is second generation semi-synthetic derivative of the tetracycline group of antibiotics. It inhibits bacterial protein synthesis by binding to the 30S subunit of the bacterial ribosome and preventing the aminotransferase-tRNA from associating with the ribosome."}, "35932": {"category_aro_name": "amikacin", "category_aro_cvterm_id": "35932", "category_aro_accession": "0000013", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amikacin is an aminoglycoside antibiotic that works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "37036": {"category_aro_name": "bleomycin B2", "category_aro_cvterm_id": "37036", "category_aro_accession": "3000692", "category_aro_class_name": "Antibiotic", "category_aro_description": "Bleomycin B2 is a glycopeptide antibiotic produced by Streptomyces verticillus taken as a mixture of bleomycins. It induces stand breaks in bacterial nucleic acids."}, "37034": {"category_aro_name": "bleomycinic acid", "category_aro_cvterm_id": "37034", "category_aro_accession": "3000690", "category_aro_class_name": "Antibiotic", "category_aro_description": "Bleomycinic acid is a glycopeptide antibiotic produced by Streptomyces verticillus taken as a mixture of bleomycins. It induces stand breaks in bacterial nucleic acids."}, "37035": {"category_aro_name": "bleomycin A2", "category_aro_cvterm_id": "37035", "category_aro_accession": "3000691", "category_aro_class_name": "Antibiotic", "category_aro_description": "Bleomycin A2 is a glycopeptide antibiotic produced by Streptomyces verticillus taken as a mixture of bleomycins. It induces stand breaks in bacterial nucleic acids."}, "37011": {"category_aro_name": "demeclocycline", "category_aro_cvterm_id": "37011", "category_aro_accession": "3000667", "category_aro_class_name": "Antibiotic", "category_aro_description": "Demeclocycline is a tetracycline analog with 7-chloro and 6-methyl groups. Due to its fast absorption and slow excretion, it maintains higher effective blood levels compared to other tetracyclines."}, "37012": {"category_aro_name": "oxytetracycline", "category_aro_cvterm_id": "37012", "category_aro_accession": "3000668", "category_aro_class_name": "Antibiotic", "category_aro_description": "Oxytetracycline is a derivative of tetracycline with a 5-hydroxyl group. Its activity is similar to other tetracyclines."}, "35966": {"category_aro_name": "kanamycin A", "category_aro_cvterm_id": "35966", "category_aro_accession": "0000049", "category_aro_class_name": "Antibiotic", "category_aro_description": "Kanamycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Kanamycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35949": {"category_aro_name": "tigecycline", "category_aro_cvterm_id": "35949", "category_aro_accession": "0000030", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tigecycline is an glycylcycline antibiotic. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35960": {"category_aro_name": "glycylcycline", "category_aro_cvterm_id": "35960", "category_aro_accession": "0000042", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycylcyclines are a new class of antibiotics derived from tetracycline. These tetracycline analogues are specifically designed to overcome two common mechanisms of tetracycline resistance. Presently, there is only one glycylcycline antibiotic for clinical use: tigecycline. It works by inhibiting action of the prokaryotic 30S ribosome, preventing the binding of aminoacyl-tRNA."}, "36174": {"category_aro_name": "nucleoside antibiotic", "category_aro_cvterm_id": "36174", "category_aro_accession": "3000034", "category_aro_class_name": "Drug Class", "category_aro_description": "Nucleoside antibiotics are made of modified nucleosides and nucleotides with wide-ranging activities and means of antibacterial effects. This drug class includes aminonucleoside antibiotics, which contain an amino group."}, "35969": {"category_aro_name": "tobramycin", "category_aro_cvterm_id": "35969", "category_aro_accession": "0000052", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tobramycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Tobramycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35926": {"category_aro_name": "dibekacin", "category_aro_cvterm_id": "35926", "category_aro_accession": "0000007", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dibekacin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Dibekacin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35924": {"category_aro_name": "neomycin", "category_aro_cvterm_id": "35924", "category_aro_accession": "0000005", "category_aro_class_name": "Antibiotic", "category_aro_description": "Neomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Neomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35943": {"category_aro_name": "butirosin", "category_aro_cvterm_id": "35943", "category_aro_accession": "0000024", "category_aro_class_name": "Antibiotic", "category_aro_description": "Butirosin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Butirosin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "179": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "178": {"$update": {"ARO_category": {"36015": {"category_aro_name": "vanH", "category_aro_cvterm_id": "36015", "category_aro_accession": "3000006", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "VanH is a D-specific alpha-ketoacid dehydrogenase that synthesizes D-lactate. D-lactate is incorporated into the end of the peptidoglycan subunits, decreasing vancomycin binding affinity."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}, "35948": {"category_aro_name": "teicoplanin", "category_aro_cvterm_id": "35948", "category_aro_accession": "0000029", "category_aro_class_name": "Antibiotic", "category_aro_description": "Teicoplanin is a glycopeptide antibiotic used in the prophylaxis and treatment of serious infections caused by Gram-positive bacteria. Teicoplanin has a unique acyl-aliphatic chain, and binds to cell wall precursors to inhibit transglycosylation  and transpeptidation."}, "36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "35947": {"category_aro_name": "vancomycin", "category_aro_cvterm_id": "35947", "category_aro_accession": "0000028", "category_aro_class_name": "Antibiotic", "category_aro_description": "Vancomycin is a glycopeptide antibiotic used in the prophylaxis and treatment of infections caused by Gram-positive bacteria. Vancomycin inhibits the synthesis of peptidoglycan, the major component of the cell wall of gram-positive bacteria. Its mechanism of action is unusual in that it acts by binding precursors of peptidoglycan, rather than by interacting with an enzyme."}}}}, "177": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36029": {"category_aro_name": "IMP beta-lactamase", "category_aro_cvterm_id": "36029", "category_aro_accession": "3000020", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Plasmid mediated IMP-type carbapenemases, of which at least 26 varieties are currently known, became established in Japan in the 1990s in enteric gram-negative organisms, Pseudomonas and Acinetobacter species. Integron-associated, sometimes within plasmids. Hydrolyses all beta-lactams except monobactams, and evades all beta-lactam inhibitors."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "176": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "175": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "174": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "39434": {"category_aro_name": "CfxA beta-lactamase", "category_aro_cvterm_id": "39434", "category_aro_accession": "3003000", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "cfxA beta-lactamases are class A beta-lactamases"}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "173": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36308": {"category_aro_name": "rifampin", "category_aro_cvterm_id": "36308", "category_aro_accession": "3000169", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifampin is a semi-synthetic rifamycin, and inhibits RNA synthesis by binding to RNA polymerase. Rifampin is the mainstay agent for the treatment of tuberculosis, leprosy and complicated Gram-positive infections."}, "36673": {"category_aro_name": "rifapentine", "category_aro_cvterm_id": "36673", "category_aro_accession": "3000534", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifapentine is a semisynthetic rifamycin that inhibits DNA-dependent RNA synthesis. It is often used in the treatment of tuberculosis and leprosy."}, "36669": {"category_aro_name": "rifabutin", "category_aro_cvterm_id": "36669", "category_aro_accession": "3000530", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifabutin is a semisynthetic rifamycin used in tuberculosis therapy. It inhibits DNA-dependent RNA synthesis."}, "36529": {"category_aro_name": "rifampin ADP-ribosyltransferase (Arr)", "category_aro_cvterm_id": "36529", "category_aro_accession": "3000390", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Enzyme responsible for the ADP-ribosylative inactivation of rifampin at the 23-OH position using NAD+."}, "36296": {"category_aro_name": "rifamycin antibiotic", "category_aro_cvterm_id": "36296", "category_aro_accession": "3000157", "category_aro_class_name": "Drug Class", "category_aro_description": "Rifamycin antibiotics are a group of broad-spectrum ansamycin antibiotics that inhibit bacterial RNA polymerase by binding to a highly conserved region, blocking the oligonucleotide exit tunnel, and preventing the extension of nascent mRNAs."}, "36656": {"category_aro_name": "rifaximin", "category_aro_cvterm_id": "36656", "category_aro_accession": "3000517", "category_aro_class_name": "Antibiotic", "category_aro_description": "Rifaximin is a semi-synthetic rifamycin used to treat traveller's diarrhea. Rifaximin inhibits RNA synthesis by binding to the beta subunit of bacterial RNA polymerase."}}}}, "172": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "171": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "170": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36029": {"category_aro_name": "IMP beta-lactamase", "category_aro_cvterm_id": "36029", "category_aro_accession": "3000020", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Plasmid mediated IMP-type carbapenemases, of which at least 26 varieties are currently known, became established in Japan in the 1990s in enteric gram-negative organisms, Pseudomonas and Acinetobacter species. Integron-associated, sometimes within plasmids. Hydrolyses all beta-lactams except monobactams, and evades all beta-lactam inhibitors."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "2051": {"$update": {"ARO_category": {"36476": {"category_aro_name": "iclaprim", "category_aro_cvterm_id": "36476", "category_aro_accession": "3000337", "category_aro_class_name": "Antibiotic", "category_aro_description": "Iclaprim is a bactericidal compound that inhibits dihydrofolate reductase. It is used against clinically important Gram-positive pathogens, including methicillin-sensitive Staphylococcus aureus and methicillin-resistant S. aureus."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36408": {"category_aro_name": "brodimoprim", "category_aro_cvterm_id": "36408", "category_aro_accession": "3000269", "category_aro_class_name": "Antibiotic", "category_aro_description": "Brodimoprim is a structural derivative of trimethoprim and an inhibitor of bacterial dihydrofolate reductase. The 4-methoxy group of trimethoprim is replaced with a bromine atom."}, "37617": {"category_aro_name": "trimethoprim resistant dihydrofolate reductase dfr", "category_aro_cvterm_id": "37617", "category_aro_accession": "3001218", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Alternative dihydropteroate synthase dfr present on plasmids produces alternate proteins that are less sensitive to trimethoprim from inhibiting its role in folate synthesis, thus conferring trimethoprim resistance."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "35998": {"category_aro_name": "antibiotic target replacement", "category_aro_cvterm_id": "35998", "category_aro_accession": "0001002", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Replacement or substitution of antibiotic action target, which process will result in antibiotic resistance."}, "36423": {"category_aro_name": "tetroxoprim", "category_aro_cvterm_id": "36423", "category_aro_accession": "3000284", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetroxoprim is a trimethoprim derivative that inhibits bacterial dihydrofolate reductase."}}}}, "2050": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "2053": {"$update": {"ARO_category": {"36476": {"category_aro_name": "iclaprim", "category_aro_cvterm_id": "36476", "category_aro_accession": "3000337", "category_aro_class_name": "Antibiotic", "category_aro_description": "Iclaprim is a bactericidal compound that inhibits dihydrofolate reductase. It is used against clinically important Gram-positive pathogens, including methicillin-sensitive Staphylococcus aureus and methicillin-resistant S. aureus."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36408": {"category_aro_name": "brodimoprim", "category_aro_cvterm_id": "36408", "category_aro_accession": "3000269", "category_aro_class_name": "Antibiotic", "category_aro_description": "Brodimoprim is a structural derivative of trimethoprim and an inhibitor of bacterial dihydrofolate reductase. The 4-methoxy group of trimethoprim is replaced with a bromine atom."}, "37617": {"category_aro_name": "trimethoprim resistant dihydrofolate reductase dfr", "category_aro_cvterm_id": "37617", "category_aro_accession": "3001218", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Alternative dihydropteroate synthase dfr present on plasmids produces alternate proteins that are less sensitive to trimethoprim from inhibiting its role in folate synthesis, thus conferring trimethoprim resistance."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "35998": {"category_aro_name": "antibiotic target replacement", "category_aro_cvterm_id": "35998", "category_aro_accession": "0001002", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Replacement or substitution of antibiotic action target, which process will result in antibiotic resistance."}, "36423": {"category_aro_name": "tetroxoprim", "category_aro_cvterm_id": "36423", "category_aro_accession": "3000284", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetroxoprim is a trimethoprim derivative that inhibits bacterial dihydrofolate reductase."}}}}, "2052": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36266": {"category_aro_name": "APH(3'')", "category_aro_cvterm_id": "36266", "category_aro_accession": "3000127", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Phosphorylation of streptomycin on the hydroxyl group at position 3''"}, "35958": {"category_aro_name": "streptomycin", "category_aro_cvterm_id": "35958", "category_aro_accession": "0000040", "category_aro_class_name": "Antibiotic", "category_aro_description": "Streptomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Streptomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "2055": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "41390": {"category_aro_name": "subclass B3 LRA beta-lactamase", "category_aro_cvterm_id": "41390", "category_aro_accession": "3004226", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Beta-lactamases that are part of the LRA gene family and are classified as B3 (metallo-) beta-lactamases."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "2054": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}, "36002": {"category_aro_name": "ATP-binding cassette (ABC) antibiotic efflux pump", "category_aro_cvterm_id": "36002", "category_aro_accession": "0010001", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. ATP-binding cassette (ABC) transporters are present in all cells of all organisms and use the energy of ATP binding/hydrolysis to transport substrates across cell membranes."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}}}}}, "2057": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "2056": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "36193": {"category_aro_name": "acridine dye", "category_aro_cvterm_id": "36193", "category_aro_accession": "3000054", "category_aro_class_name": "Drug Class", "category_aro_description": "Acridine dyes are cell permeable, basic molecules with an acridine chromophore. These compounds intercalate DNA. The image shown represents the core structure of the acridine family, with specific dyes containing varying substituents."}, "35965": {"category_aro_name": "puromycin", "category_aro_cvterm_id": "35965", "category_aro_accession": "0000047", "category_aro_class_name": "Antibiotic", "category_aro_description": "Puromycin is an aminonucleoside antibiotic, derived from Streptomyces alboniger, that causes premature chain termination during ribosomal protein translation."}, "35963": {"category_aro_name": "acriflavin", "category_aro_cvterm_id": "35963", "category_aro_accession": "0000045", "category_aro_class_name": "Antibiotic", "category_aro_description": "Acriflavin is a topical antiseptic. It has the form of an orange or brown powder. It may be harmful in the eyes or if inhaled. Acriflavine is also used as treatment for external fungal infections of aquarium fish."}, "36174": {"category_aro_name": "nucleoside antibiotic", "category_aro_cvterm_id": "36174", "category_aro_accession": "3000034", "category_aro_class_name": "Drug Class", "category_aro_description": "Nucleoside antibiotics are made of modified nucleosides and nucleotides with wide-ranging activities and means of antibacterial effects. This drug class includes aminonucleoside antibiotics, which contain an amino group."}}}}}, "2059": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "38817": {"category_aro_name": "OKP beta-lactamase", "category_aro_cvterm_id": "38817", "category_aro_accession": "3002417", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OKP beta-lactamases are chromosomal class A beta-lactamase that confer resistance to penicillins and early cephalosporins in Klebsiella pneumoniae. OKP beta-lactamases can be subdivided into two groups: OKP-A and OKP-B which diverge by about 4.2%"}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "2058": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "36600": {"category_aro_name": "florfenicol", "category_aro_cvterm_id": "36600", "category_aro_accession": "3000461", "category_aro_class_name": "Antibiotic", "category_aro_description": "Florfenicol is a fluorine derivative of chloramphenicol, where the nitro group (-NO2) is substituted by a sulfomethyl group (-SO2CH3) and the hydroxyl group (-OH), by a fluorine group (-F). The action mechanism is the same as chloramphenicol's, where the antibiotic binds to the 23S RNA of the 50S subunit of bacterial ribosomes to inhibit protein synthesis."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "1500": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36290": {"category_aro_name": "APH(6)", "category_aro_cvterm_id": "36290", "category_aro_accession": "3000151", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Phosphorylation of streptomycin on the hydroxyl group at position 6"}, "35958": {"category_aro_name": "streptomycin", "category_aro_cvterm_id": "35958", "category_aro_accession": "0000040", "category_aro_class_name": "Antibiotic", "category_aro_description": "Streptomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Streptomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "1501": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "1506": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36211": {"category_aro_name": "ACT beta-lactamase", "category_aro_cvterm_id": "36211", "category_aro_accession": "3000072", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "ACT beta-lactamases, also known as AmpC beta-lactamases, are cephalosporinases that cannot be inhibited by clavulanate. These enzymes are encoded by genes located on the chromosome and can be induced by the presence of beta-lactam antibiotics. However recently, these genes have been found on plasmids and expressed at high constitutive levels in Escherichia coli and Klebsiella pneumoniae."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "1507": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}}}}}, "1504": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "1977": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35953": {"category_aro_name": "sisomicin", "category_aro_cvterm_id": "35953", "category_aro_accession": "0000035", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sisomicin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Sisomicin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36484": {"category_aro_name": "AAC(6')", "category_aro_cvterm_id": "36484", "category_aro_accession": "3000345", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Acetylation of the aminoglycoside antibiotic on the amino group at position 6'."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "35966": {"category_aro_name": "kanamycin A", "category_aro_cvterm_id": "35966", "category_aro_accession": "0000049", "category_aro_class_name": "Antibiotic", "category_aro_description": "Kanamycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Kanamycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35926": {"category_aro_name": "dibekacin", "category_aro_cvterm_id": "35926", "category_aro_accession": "0000007", "category_aro_class_name": "Antibiotic", "category_aro_description": "Dibekacin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Dibekacin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36998": {"category_aro_name": "arbekacin", "category_aro_cvterm_id": "36998", "category_aro_accession": "3000654", "category_aro_class_name": "Antibiotic", "category_aro_description": "A synthetic derivative (1-N-(4-amino-2-hydroxybutyryl) of dibekacin used in Japan. It is active against methicillin-resistant Staph. aureus and shows synergy with ampicillin when treating gentamicin and vancomycin resistant enterocci."}, "36999": {"category_aro_name": "gentamicin B", "category_aro_cvterm_id": "36999", "category_aro_accession": "3000655", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gentamicin B is a semisynthetic aminoglycoside antibacterial."}, "35956": {"category_aro_name": "netilmicin", "category_aro_cvterm_id": "35956", "category_aro_accession": "0000038", "category_aro_class_name": "Antibiotic", "category_aro_description": "Netilmicin is a member of the aminoglycoside family of antibiotics. These antibiotics have the ability to kill a wide variety of bacteria by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth. Netilmicin is not absorbed from the gut and is therefore only given by injection or infusion. It is only used in the treatment of serious infections particularly those resistant to gentamicin."}, "35932": {"category_aro_name": "amikacin", "category_aro_cvterm_id": "35932", "category_aro_accession": "0000013", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amikacin is an aminoglycoside antibiotic that works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36996": {"category_aro_name": "isepamicin", "category_aro_cvterm_id": "36996", "category_aro_accession": "3000652", "category_aro_class_name": "Antibiotic", "category_aro_description": "A semi-synthetic derivative of gentamicin B (hydroxyamino propionyl genamicin B). It is modified to combat microbial inactivation and has a slightly larger spectrum of activity compared to other aminoglycosides, including Ser marcescens, Enterobacteria, and K pneumoniae."}, "35924": {"category_aro_name": "neomycin", "category_aro_cvterm_id": "35924", "category_aro_accession": "0000005", "category_aro_class_name": "Antibiotic", "category_aro_description": "Neomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Neomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35969": {"category_aro_name": "tobramycin", "category_aro_cvterm_id": "35969", "category_aro_accession": "0000052", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tobramycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Tobramycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "1600": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}, "36590": {"$insert": {"category_aro_class_name": "Efflux Regulator"}}}, "$delete": ["39418", "40190"], "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36002": {"category_aro_name": "ATP-binding cassette (ABC) antibiotic efflux pump", "category_aro_cvterm_id": "36002", "category_aro_accession": "0010001", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. ATP-binding cassette (ABC) transporters are present in all cells of all organisms and use the energy of ATP binding/hydrolysis to transport substrates across cell membranes."}, "36968": {"category_aro_name": "colistin B", "category_aro_cvterm_id": "36968", "category_aro_accession": "3000624", "category_aro_class_name": "Antibiotic", "category_aro_description": "Colistin B, or polymyxin E2, has a 6-heptanoic acid lipid tail. Polymyxins disrupt the cell membrane of Gram-negative bacteria."}, "41433": {"category_aro_name": "pmr phosphoethanolamine transferase", "category_aro_cvterm_id": "41433", "category_aro_accession": "3004269", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "This family of phosphoethanolamine transferase catalyze the addition of 4-amino-4-deoxy-L-arabinose (L-Ara4N) and phosphoethanolamine to lipid A, which impedes the binding of colistin to the cell membrane."}, "36966": {"category_aro_name": "colistin A", "category_aro_cvterm_id": "36966", "category_aro_accession": "3000622", "category_aro_class_name": "Antibiotic", "category_aro_description": "Colistin A, or polymyxin E1, has a 6-octanoic acid lipid tail. Polymyxins disrupt the cell membrane of Gram-negative bacteria."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}}}}}, "2697": {"$update": {"ARO_category": {"36192": {"category_aro_name": "peptide antibiotic", "category_aro_cvterm_id": "36192", "category_aro_accession": "3000053", "category_aro_class_name": "Drug Class", "category_aro_description": "Peptide antibiotics have a wide range of antibacterial mechanisms, depending on the amino acids that make up the antibiotic, although most act to disrupt the cell membrane in some manner. Subclasses of peptide antibiotics can include additional sidechains of other types, such as lipids in the case of the lipopeptide antibiotics."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36666": {"category_aro_name": "polyamine antibiotic", "category_aro_cvterm_id": "36666", "category_aro_accession": "3000527", "category_aro_class_name": "Drug Class", "category_aro_description": "Polyamine antibiotics are organic compounds having two or more primary amino groups."}, "41131": {"category_aro_name": "Edeine acetyltransferase", "category_aro_cvterm_id": "41131", "category_aro_accession": "3004064", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Edeine acetyltransferase enzymes catalyze the transfer of an acetyl group to active edeine, converting it to an inactive form in vivo. This mechanism is used for high-level self-resistance in edeine-producing Brevibacillus spp."}}}}, "2695": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "37007": {"category_aro_name": "ofloxacin", "category_aro_cvterm_id": "37007", "category_aro_accession": "3000663", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ofloxacin is a 6-fluoro, 7-piperazinyl quinolone with a methyl-substituted oxazine ring. It has a broad spectrum of activity including many enterobacteria and mycoplasma but most anaerobes are resistant."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36242": {"category_aro_name": "aminocoumarin antibiotic", "category_aro_cvterm_id": "36242", "category_aro_accession": "3000103", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminocoumarin antibiotics bind DNA gyrase subunit B to inhibit ATP-dependent DNA supercoiling."}, "36250": {"category_aro_name": "novobiocin", "category_aro_cvterm_id": "36250", "category_aro_accession": "3000111", "category_aro_class_name": "Antibiotic", "category_aro_description": "Novobiocin is an aminocoumarin antibiotic produced by Streptomyces spheroides and Streptomyces niveus, and binds DNA gyrase subunit B inhibiting ATP-dependent DNA supercoiling."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "35933": {"category_aro_name": "gentamicin C", "category_aro_cvterm_id": "35933", "category_aro_accession": "0000014", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gentamicin C is a mixture of gentamicin C1, gentamicin C1a, and gentamicin C2 (these differ in substituents at position C6'). Gentamicin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}}}}}, "2694": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "37007": {"category_aro_name": "ofloxacin", "category_aro_cvterm_id": "37007", "category_aro_accession": "3000663", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ofloxacin is a 6-fluoro, 7-piperazinyl quinolone with a methyl-substituted oxazine ring. It has a broad spectrum of activity including many enterobacteria and mycoplasma but most anaerobes are resistant."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36242": {"category_aro_name": "aminocoumarin antibiotic", "category_aro_cvterm_id": "36242", "category_aro_accession": "3000103", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminocoumarin antibiotics bind DNA gyrase subunit B to inhibit ATP-dependent DNA supercoiling."}, "36250": {"category_aro_name": "novobiocin", "category_aro_cvterm_id": "36250", "category_aro_accession": "3000111", "category_aro_class_name": "Antibiotic", "category_aro_description": "Novobiocin is an aminocoumarin antibiotic produced by Streptomyces spheroides and Streptomyces niveus, and binds DNA gyrase subunit B inhibiting ATP-dependent DNA supercoiling."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "2693": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}, "36590": {"$insert": {"category_aro_class_name": "Efflux Regulator"}}}, "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "37007": {"category_aro_name": "ofloxacin", "category_aro_cvterm_id": "37007", "category_aro_accession": "3000663", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ofloxacin is a 6-fluoro, 7-piperazinyl quinolone with a methyl-substituted oxazine ring. It has a broad spectrum of activity including many enterobacteria and mycoplasma but most anaerobes are resistant."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36242": {"category_aro_name": "aminocoumarin antibiotic", "category_aro_cvterm_id": "36242", "category_aro_accession": "3000103", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminocoumarin antibiotics bind DNA gyrase subunit B to inhibit ATP-dependent DNA supercoiling."}, "36250": {"category_aro_name": "novobiocin", "category_aro_cvterm_id": "36250", "category_aro_accession": "3000111", "category_aro_class_name": "Antibiotic", "category_aro_description": "Novobiocin is an aminocoumarin antibiotic produced by Streptomyces spheroides and Streptomyces niveus, and binds DNA gyrase subunit B inhibiting ATP-dependent DNA supercoiling."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "35933": {"category_aro_name": "gentamicin C", "category_aro_cvterm_id": "35933", "category_aro_accession": "0000014", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gentamicin C is a mixture of gentamicin C1, gentamicin C1a, and gentamicin C2 (these differ in substituents at position C6'). Gentamicin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}}}}}, "1975": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}, "35963": {"category_aro_name": "acriflavin", "category_aro_cvterm_id": "35963", "category_aro_accession": "0000045", "category_aro_class_name": "Antibiotic", "category_aro_description": "Acriflavin is a topical antiseptic. It has the form of an orange or brown powder. It may be harmful in the eyes or if inhaled. Acriflavine is also used as treatment for external fungal infections of aquarium fish."}, "36193": {"category_aro_name": "acridine dye", "category_aro_cvterm_id": "36193", "category_aro_accession": "3000054", "category_aro_class_name": "Drug Class", "category_aro_description": "Acridine dyes are cell permeable, basic molecules with an acridine chromophore. These compounds intercalate DNA. The image shown represents the core structure of the acridine family, with specific dyes containing varying substituents."}}}}}, "2691": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}, "36590": {"$insert": {"category_aro_class_name": "Efflux Regulator"}}}, "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "37007": {"category_aro_name": "ofloxacin", "category_aro_cvterm_id": "37007", "category_aro_accession": "3000663", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ofloxacin is a 6-fluoro, 7-piperazinyl quinolone with a methyl-substituted oxazine ring. It has a broad spectrum of activity including many enterobacteria and mycoplasma but most anaerobes are resistant."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36242": {"category_aro_name": "aminocoumarin antibiotic", "category_aro_cvterm_id": "36242", "category_aro_accession": "3000103", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminocoumarin antibiotics bind DNA gyrase subunit B to inhibit ATP-dependent DNA supercoiling."}, "36250": {"category_aro_name": "novobiocin", "category_aro_cvterm_id": "36250", "category_aro_accession": "3000111", "category_aro_class_name": "Antibiotic", "category_aro_description": "Novobiocin is an aminocoumarin antibiotic produced by Streptomyces spheroides and Streptomyces niveus, and binds DNA gyrase subunit B inhibiting ATP-dependent DNA supercoiling."}, "35919": {"category_aro_name": "macrolide antibiotic", "category_aro_cvterm_id": "35919", "category_aro_accession": "0000000", "category_aro_class_name": "Drug Class", "category_aro_description": "Macrolides are a group of drugs (typically antibiotics) that have a large macrocyclic lactone ring of 12-16 carbons to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. Macrolides bind to the 50S-subunit of bacterial ribosomes, inhibiting the synthesis of vital proteins."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "35925": {"category_aro_name": "erythromycin", "category_aro_cvterm_id": "35925", "category_aro_accession": "0000006", "category_aro_class_name": "Antibiotic", "category_aro_description": "Erythromycin is a macrolide antibiotic with a 14-carbon ring that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people that have an allergy to penicillins. Erythromycin may possess bacteriocidal activity, particularly at higher concentrations by binding to the 50S subunit of the bacterial 70S rRNA complex, inhibiting peptidyl-tRNA translocation. Thus, protein synthesis and subsequently structure/function processes critical for life or replication are inhibited."}, "36526": {"category_aro_name": "phenicol antibiotic", "category_aro_cvterm_id": "36526", "category_aro_accession": "3000387", "category_aro_class_name": "Drug Class", "category_aro_description": "Phenicols are broad spectrum bacteriostatic antibiotics acting on bacterial protein synthesis. More specifically, the phenicols block peptide elongation by binding to the peptidyltansferase centre of the 70S ribosome."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}, "36524": {"category_aro_name": "chloramphenicol", "category_aro_cvterm_id": "36524", "category_aro_accession": "3000385", "category_aro_class_name": "Antibiotic", "category_aro_description": "Chloramphenicol is a bacteriostatic antimicrobial originally derived from the bacterium Streptomyces venezuelae. It was the first antibiotic to be manufactured synthetically on a large scale. It functions by inhibiting peptidyl transferase activity of the bacterial ribosome, binding to A2451 and A2452 residues in the 23S rRNA of the 50S ribosomal subunit and preventing peptide bond formation."}}}}}, "1974": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36003": {"category_aro_name": "major facilitator superfamily (MFS) antibiotic efflux pump", "category_aro_cvterm_id": "36003", "category_aro_accession": "0010002", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Major facilitator superfamily (MFS) transporters and ABC transporters comprise the two largest and most functionally diverse of the transporter superfamilies. However, MFS transporters are distinct from ABC transporters in both their primary sequence and structure and in the mechanism of energy coupling. As secondary transporters they are, like RND and SMR transporters, energized by the electrochemical proton gradient."}}}}}, "1973": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "1972": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1971": {"$update": {"ARO_category": {"36476": {"category_aro_name": "iclaprim", "category_aro_cvterm_id": "36476", "category_aro_accession": "3000337", "category_aro_class_name": "Antibiotic", "category_aro_description": "Iclaprim is a bactericidal compound that inhibits dihydrofolate reductase. It is used against clinically important Gram-positive pathogens, including methicillin-sensitive Staphylococcus aureus and methicillin-resistant S. aureus."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36408": {"category_aro_name": "brodimoprim", "category_aro_cvterm_id": "36408", "category_aro_accession": "3000269", "category_aro_class_name": "Antibiotic", "category_aro_description": "Brodimoprim is a structural derivative of trimethoprim and an inhibitor of bacterial dihydrofolate reductase. The 4-methoxy group of trimethoprim is replaced with a bromine atom."}, "37617": {"category_aro_name": "trimethoprim resistant dihydrofolate reductase dfr", "category_aro_cvterm_id": "37617", "category_aro_accession": "3001218", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Alternative dihydropteroate synthase dfr present on plasmids produces alternate proteins that are less sensitive to trimethoprim from inhibiting its role in folate synthesis, thus conferring trimethoprim resistance."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "35998": {"category_aro_name": "antibiotic target replacement", "category_aro_cvterm_id": "35998", "category_aro_accession": "0001002", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Replacement or substitution of antibiotic action target, which process will result in antibiotic resistance."}, "36423": {"category_aro_name": "tetroxoprim", "category_aro_cvterm_id": "36423", "category_aro_accession": "3000284", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetroxoprim is a trimethoprim derivative that inhibits bacterial dihydrofolate reductase."}}}}, "1970": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "1968": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36024": {"category_aro_name": "SHV beta-lactamase", "category_aro_cvterm_id": "36024", "category_aro_accession": "3000015", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SHV-1 shares 68 percent of its amino acids with TEM-1 and has a similar overall structure. The SHV-1 beta-lactamase is most commonly found in K. pneumoniae and is responsible for up to 20% of the plasmid-mediated ampicillin resistance in this species. ESBLs in this family also have amino acid changes around the active site, most commonly at positions 238 or 238 and 240. More than 60 SHV varieties are known."}}}}, "1969": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36189": {"category_aro_name": "tetracycline antibiotic", "category_aro_cvterm_id": "36189", "category_aro_accession": "3000050", "category_aro_class_name": "Drug Class", "category_aro_description": "These antibiotics are derived from tetracycline, a polyketide antibiotic that inhibits the 30S subunit of bacterial ribosomes."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36002": {"category_aro_name": "ATP-binding cassette (ABC) antibiotic efflux pump", "category_aro_cvterm_id": "36002", "category_aro_accession": "0010001", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. ATP-binding cassette (ABC) transporters are present in all cells of all organisms and use the energy of ATP binding/hydrolysis to transport substrates across cell membranes."}, "35968": {"category_aro_name": "tetracycline", "category_aro_cvterm_id": "35968", "category_aro_accession": "0000051", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetracycline is a broad-spectrum polyketide antibiotic produced by many Streptomyces. It works by inhibiting action of the prokaryotic 30S ribosome."}}}}}, "1618": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1619": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "41379": {"category_aro_name": "L1 family beta-lactamase", "category_aro_cvterm_id": "41379", "category_aro_accession": "3004215", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "This subclass B3 of beta-lactamses have the ability to hydrolyze cephalosporins."}}}}, "1616": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "1617": {"$update": {"ARO_category": {"36220": {"category_aro_name": "glycopeptide antibiotic", "category_aro_cvterm_id": "36220", "category_aro_accession": "3000081", "category_aro_class_name": "Drug Class", "category_aro_description": "Glycopeptide antibiotics are natural products produced non-ribosomally by Actinomycetales bacteria. With the exception of bleomycins, they act by binding the terminal D-Ala-D-Ala in peptidoglycan precursors of the growing bacterial cell wall and are generally active against Gram-positive bacteria.  This inhibits transglycosylation leading to cell death due to osmotic stress."}, "36373": {"category_aro_name": "glycopeptide resistance gene cluster", "category_aro_cvterm_id": "36373", "category_aro_accession": "3000234", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Genes that when expressed confer resistance to vancomycin and teicoplanin type antibiotics."}, "39340": {"category_aro_name": "van ligase", "category_aro_cvterm_id": "39340", "category_aro_accession": "3002906", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "van ligases synthesize alternative substrates for peptidoglycan synthesis that reduce vancomycin binding affinity."}, "35997": {"category_aro_name": "antibiotic target alteration", "category_aro_cvterm_id": "35997", "category_aro_accession": "0001001", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Mutational alteration or enzymatic modification of antibiotic target which results in antibiotic resistance."}}}}, "1614": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "1615": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35953": {"category_aro_name": "sisomicin", "category_aro_cvterm_id": "35953", "category_aro_accession": "0000035", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sisomicin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Sisomicin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36267": {"category_aro_name": "APH(2'')", "category_aro_cvterm_id": "36267", "category_aro_accession": "3000128", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Phosphorylation of 2-deoxystreptamine aminoglycosides on the hydroxyl group at position 2''"}, "36996": {"category_aro_name": "isepamicin", "category_aro_cvterm_id": "36996", "category_aro_accession": "3000652", "category_aro_class_name": "Antibiotic", "category_aro_description": "A semi-synthetic derivative of gentamicin B (hydroxyamino propionyl genamicin B). It is modified to combat microbial inactivation and has a slightly larger spectrum of activity compared to other aminoglycosides, including Ser marcescens, Enterobacteria, and K pneumoniae."}, "35966": {"category_aro_name": "kanamycin A", "category_aro_cvterm_id": "35966", "category_aro_accession": "0000049", "category_aro_class_name": "Antibiotic", "category_aro_description": "Kanamycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Kanamycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "36998": {"category_aro_name": "arbekacin", "category_aro_cvterm_id": "36998", "category_aro_accession": "3000654", "category_aro_class_name": "Antibiotic", "category_aro_description": "A synthetic derivative (1-N-(4-amino-2-hydroxybutyryl) of dibekacin used in Japan. It is active against methicillin-resistant Staph. aureus and shows synergy with ampicillin when treating gentamicin and vancomycin resistant enterocci."}, "36999": {"category_aro_name": "gentamicin B", "category_aro_cvterm_id": "36999", "category_aro_accession": "3000655", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gentamicin B is a semisynthetic aminoglycoside antibacterial."}, "35956": {"category_aro_name": "netilmicin", "category_aro_cvterm_id": "35956", "category_aro_accession": "0000038", "category_aro_class_name": "Antibiotic", "category_aro_description": "Netilmicin is a member of the aminoglycoside family of antibiotics. These antibiotics have the ability to kill a wide variety of bacteria by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth. Netilmicin is not absorbed from the gut and is therefore only given by injection or infusion. It is only used in the treatment of serious infections particularly those resistant to gentamicin."}, "35933": {"category_aro_name": "gentamicin C", "category_aro_cvterm_id": "35933", "category_aro_accession": "0000014", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gentamicin C is a mixture of gentamicin C1, gentamicin C1a, and gentamicin C2 (these differ in substituents at position C6'). Gentamicin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35932": {"category_aro_name": "amikacin", "category_aro_cvterm_id": "35932", "category_aro_accession": "0000013", "category_aro_class_name": "Antibiotic", "category_aro_description": "Amikacin is an aminoglycoside antibiotic that works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}, "35969": {"category_aro_name": "tobramycin", "category_aro_cvterm_id": "35969", "category_aro_accession": "0000052", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tobramycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Tobramycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "1960": {"$update": {"ARO_category": {"$update": {"36298": {"$insert": {"category_aro_class_name": "Efflux Component"}}}, "$insert": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36001": {"category_aro_name": "antibiotic efflux", "category_aro_cvterm_id": "36001", "category_aro_accession": "0010000", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Antibiotic resistance via the transport of antibiotics out of the cell."}, "36005": {"category_aro_name": "resistance-nodulation-cell division (RND) antibiotic efflux pump", "category_aro_cvterm_id": "36005", "category_aro_accession": "0010004", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Directed pumping of antibiotic out of a cell to confer resistance. Resistance-nodulation-division (RND) proteins are found in both prokaryotic and eukaryotic cells and have diverse substrate specificities and physiological roles. However, there are relatively few RND transporters and they are secondary transporters, energized not by ATP binding/hydrolysis but by proton movement down the transmembrane electrochemical gradient."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}}}}}, "1613": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "1610": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1611": {"$update": {"ARO_category": {"35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36194": {"category_aro_name": "SME beta-lactamase", "category_aro_cvterm_id": "36194", "category_aro_accession": "3000055", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "SME beta-lactamases are chromosome-mediated class A beta-lactamases that hydrolyze carbapenems in Serratia marcescens."}}}}, "1768": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "1769": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "1762": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35957": {"category_aro_name": "spectinomycin", "category_aro_cvterm_id": "35957", "category_aro_accession": "0000039", "category_aro_class_name": "Antibiotic", "category_aro_description": "Spectinomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Spectinomycin works by binding to the bacterial 30S ribosomal subunit inhibiting translation."}, "41439": {"category_aro_name": "ANT(3'')", "category_aro_cvterm_id": "41439", "category_aro_accession": "3004275", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Nucleotidylylation of streptomycin at the hydroxyl group at position 3''"}, "35958": {"category_aro_name": "streptomycin", "category_aro_cvterm_id": "35958", "category_aro_accession": "0000040", "category_aro_class_name": "Antibiotic", "category_aro_description": "Streptomycin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Streptomycin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth."}, "35935": {"category_aro_name": "aminoglycoside antibiotic", "category_aro_cvterm_id": "35935", "category_aro_accession": "0000016", "category_aro_class_name": "Drug Class", "category_aro_description": "Aminoglycosides are a group of antibiotics that are mostly effective against Gram-negative bacteria. These molecules consist of aminated sugars attached to a dibasic cyclitol. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth."}}}}, "1763": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "36196": {"category_aro_name": "NDM beta-lactamase", "category_aro_cvterm_id": "36196", "category_aro_accession": "3000057", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "NDM beta-lactamases or New Delhi metallo-beta-lactamases are class B beta-lactamases that confer resistance to a broad range of antibiotics including carbapenems, cephalosporins and penicillins."}}}}, "1760": {"$update": {"ARO_category": {"37010": {"category_aro_name": "sparfloxacin", "category_aro_cvterm_id": "37010", "category_aro_accession": "3000666", "category_aro_class_name": "Antibiotic", "category_aro_description": "Sparfloxacin is a dimethylpiperazinyl difluoroquinolone that acts by inhibiting DNA gyrase. It is active against aerobic Gram-positive and Gram-negative bacteria, as well as some mycobacteria. It has moderate activity against some anaerobes."}, "37006": {"category_aro_name": "norfloxacin", "category_aro_cvterm_id": "37006", "category_aro_accession": "3000662", "category_aro_class_name": "Antibiotic", "category_aro_description": "Norfloxacin is a 6-fluoro, 7-piperazinyl quinolone with a wide range of activity against Gram-negative bacteria. It is inactive against most anaerobes."}, "36558": {"category_aro_name": "quinolone resistance protein (qnr)", "category_aro_cvterm_id": "36558", "category_aro_accession": "3000419", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Qnr proteins are pentapeptide repeat proteins that mimic DNA and protect the cell from the activity of fluoroquinolone antibiotics"}, "37003": {"category_aro_name": "gatifloxacin", "category_aro_cvterm_id": "37003", "category_aro_accession": "3000659", "category_aro_class_name": "Antibiotic", "category_aro_description": "Gatifloxacin is an 8-methoxy, 7-piperazinyl, 6-fluoroquinolone that can be taken orally or by intravenous administration. It is active against most Gram-positive and Gram-negative bacteria, but inactive against non-fermenting Gram-negative rods including Pseudomonas aeruginosa."}, "35988": {"category_aro_name": "levofloxacin", "category_aro_cvterm_id": "35988", "category_aro_accession": "0000071", "category_aro_class_name": "Antibiotic", "category_aro_description": "Levofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. Its main target is topoisomerase IV, inhibiting its function and disrupting DNA replication."}, "35999": {"category_aro_name": "antibiotic target protection", "category_aro_cvterm_id": "35999", "category_aro_accession": "0001003", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Protection of antibiotic action target from antibiotic binding, which process will result in antibiotic resistance."}, "35954": {"category_aro_name": "ciprofloxacin", "category_aro_cvterm_id": "35954", "category_aro_accession": "0000036", "category_aro_class_name": "Antibiotic", "category_aro_description": "Ciprofloxacin is a bacteriocidal fluoroquinolone. It blocks bacterial DNA replication by binding to the toposiomerase II or IV-DNA complex (or cleavable complex), thereby causing double-stranded breaks in the bacterial chromosome."}, "35920": {"category_aro_name": "fluoroquinolone antibiotic", "category_aro_cvterm_id": "35920", "category_aro_accession": "0000001", "category_aro_class_name": "Drug Class", "category_aro_description": "The fluoroquinolones are a family of synthetic broad-spectrum antibiotics that are 4-quinolone-3-carboxylates. These compounds interact with topoisomerase II (DNA gyrase) to disrupt bacterial DNA replication, damage DNA, and cause cell death."}, "37005": {"category_aro_name": "nalidixic acid", "category_aro_cvterm_id": "37005", "category_aro_accession": "3000661", "category_aro_class_name": "Antibiotic", "category_aro_description": "Nalidixic acid is a quinolone derivative of naphthyridine active against many enterobacteria, but ineffective against Ps aeruginosa, Gram-positive bacteria, and anaerobes. Acquired resistance is common in nalidixic acid treatments."}, "35991": {"category_aro_name": "moxifloxacin", "category_aro_cvterm_id": "35991", "category_aro_accession": "0000074", "category_aro_class_name": "Antibiotic", "category_aro_description": "Moxifloxacin is a fourth generation synthetic fluoroquinolone chemotherapeutic agent, and has been shown to be significantly more active than levofloxacin (4 to 8 times more) against Streptococcus pneumoniae. It acts by inhibiting bacterial DNA topoisomerases."}}}}, "1761": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1766": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35939": {"category_aro_name": "carbapenem", "category_aro_cvterm_id": "35939", "category_aro_accession": "0000020", "category_aro_class_name": "Drug Class", "category_aro_description": "Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Carbapenem antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}, "36030": {"category_aro_name": "VIM beta-lactamase", "category_aro_cvterm_id": "36030", "category_aro_accession": "3000021", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "The Verone integron-encoded metallo-beta-lactamase (VIM) family was reported from Italy in 1999. There are, to date, 23 reported variants.  VIM enzymes mostly occur in P. aeruginosa, also P. putida and, very rarely, Enterobacteriaceae. Integron-associated, sometimes within plasmids. Hydrolyses all beta-lactams except monobactams, and evades all beta-lactam inhibitors.  There is a strong incidence of these in East Asia."}}}}, "1767": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "38817": {"category_aro_name": "OKP beta-lactamase", "category_aro_cvterm_id": "38817", "category_aro_accession": "3002417", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OKP beta-lactamases are chromosomal class A beta-lactamase that confer resistance to penicillins and early cephalosporins in Klebsiella pneumoniae. OKP beta-lactamases can be subdivided into two groups: OKP-A and OKP-B which diverge by about 4.2%"}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}}}}, "1764": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1765": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1142": {"$update": {"ARO_category": {"36476": {"category_aro_name": "iclaprim", "category_aro_cvterm_id": "36476", "category_aro_accession": "3000337", "category_aro_class_name": "Antibiotic", "category_aro_description": "Iclaprim is a bactericidal compound that inhibits dihydrofolate reductase. It is used against clinically important Gram-positive pathogens, including methicillin-sensitive Staphylococcus aureus and methicillin-resistant S. aureus."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36408": {"category_aro_name": "brodimoprim", "category_aro_cvterm_id": "36408", "category_aro_accession": "3000269", "category_aro_class_name": "Antibiotic", "category_aro_description": "Brodimoprim is a structural derivative of trimethoprim and an inhibitor of bacterial dihydrofolate reductase. The 4-methoxy group of trimethoprim is replaced with a bromine atom."}, "37617": {"category_aro_name": "trimethoprim resistant dihydrofolate reductase dfr", "category_aro_cvterm_id": "37617", "category_aro_accession": "3001218", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Alternative dihydropteroate synthase dfr present on plasmids produces alternate proteins that are less sensitive to trimethoprim from inhibiting its role in folate synthesis, thus conferring trimethoprim resistance."}, "36310": {"category_aro_name": "diaminopyrimidine antibiotic", "category_aro_cvterm_id": "36310", "category_aro_accession": "3000171", "category_aro_class_name": "Drug Class", "category_aro_description": "Diaminopyrimidines are a class of organic compounds containing a pyrimidine ring substituted by two amine groups.  They are inhibitors of dihydrofolate reductase, an enzyme critical for DNA synthesis."}, "35998": {"category_aro_name": "antibiotic target replacement", "category_aro_cvterm_id": "35998", "category_aro_accession": "0001002", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Replacement or substitution of antibiotic action target, which process will result in antibiotic resistance."}, "36423": {"category_aro_name": "tetroxoprim", "category_aro_cvterm_id": "36423", "category_aro_accession": "3000284", "category_aro_class_name": "Antibiotic", "category_aro_description": "Tetroxoprim is a trimethoprim derivative that inhibits bacterial dihydrofolate reductase."}}}}, "1143": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1140": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "1141": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1146": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "1147": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "36208": {"category_aro_name": "CMY beta-lactamase", "category_aro_cvterm_id": "36208", "category_aro_accession": "3000069", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "CMY beta-lactamases are plasmid-mediated class C beta-lactamases that encodes for resistance to cephamycins."}, "35962": {"category_aro_name": "cephamycin", "category_aro_cvterm_id": "35962", "category_aro_accession": "0000044", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephamycins are a group of beta-lactam antibiotics, very similar to cephalosporins. Together with cephalosporins, they form a sub-group of antibiotics known as cephems. Cephamycins are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The 7-alpha-methoxy group increases resistance to beta-lactamases."}}}}, "1144": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "37019": {"category_aro_name": "pristinamycin IB", "category_aro_cvterm_id": "37019", "category_aro_accession": "3000675", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin IB is a class B streptogramin similar to pristinamycin IA, the former containing a N-methyl-4-(methylamino)phenylalanine instead of a N-methyl-4-(dimethylamino)phenylalanine in its class A streptogramin counterpart (one less methyl group)."}, "36723": {"category_aro_name": "quinupristin", "category_aro_cvterm_id": "36723", "category_aro_accession": "3000584", "category_aro_class_name": "Antibiotic", "category_aro_description": "Quinupristin is a type B streptogramin and a semisynthetic derivative of pristinamycin 1A. It is a component of the drug Synercid and interacts with the 50S subunit of the bacterial ribosome to inhibit protein synthesis."}, "37022": {"category_aro_name": "vernamycin B-gamma", "category_aro_cvterm_id": "37022", "category_aro_accession": "3000678", "category_aro_class_name": "Antibiotic", "category_aro_description": "Vernamycin B-gamma is a class B streptogramin derived from virginiamycin S1."}, "36722": {"category_aro_name": "pristinamycin IA", "category_aro_cvterm_id": "36722", "category_aro_accession": "3000583", "category_aro_class_name": "Antibiotic", "category_aro_description": "Pristinamycin 1A is a type B streptogramin antibiotic produced by Streptomyces pristinaespiralis. It binds to the P site of the 50S subunit of the bacterial ribosome, preventing the extension of protein chains."}, "35945": {"category_aro_name": "streptogramin antibiotic", "category_aro_cvterm_id": "35945", "category_aro_accession": "0000026", "category_aro_class_name": "Drug Class", "category_aro_description": "Streptogramin antibiotics are natural products produced by various members of the Streptomyces genus. These antibiotics bind to the P site of the 50S subunit of bacterial ribosomes to inhibit protein synthesis. The family consists of two subgroups, type A and type B, which are simultaneously produced by the same bacterial species in a ratio of roughly 70:30."}, "36515": {"category_aro_name": "streptogramin vgb lyase", "category_aro_cvterm_id": "36515", "category_aro_accession": "3000376", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "vgb (Virginiamycin B) lyase inactivates type B streptogramin antibiotics by linearizing the streptogramin lactone ring at the ester linkage through an elimination mechanism, thus conferring resistance to these compounds."}}}}, "1145": {"$update": {"ARO_category": {"36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36025": {"category_aro_name": "CTX-M beta-lactamase", "category_aro_cvterm_id": "36025", "category_aro_accession": "3000016", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "These enzymes were named for their greater activity against cefotaxime than other oxyimino-beta-lactam substrates (eg, ceftazidime, ceftriaxone, or cefepime). Rather than arising by mutation, they represent examples of plasmid acquisition of beta-lactamase genes normally found on the chromosome of Kluyvera species, a group of rarely pathogenic commensal organisms. These enzymes are not very closely related to TEM or SHV beta-lactamases in that they show only approximately 40% identity with these two commonly isolated beta-lactamases. Despite their name, a few are more active on ceftazidime than cefotaxime.  CTX-M-15 was recently found in bacterial strains expressing NDM-1 and were responsible for resistance to aztreonam."}}}}, "1148": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1149": {"$update": {"ARO_category": {"36228": {"category_aro_name": "AER beta-lactamase", "category_aro_cvterm_id": "36228", "category_aro_accession": "3000089", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "AER beta-lactamases are capable of hydrolyzing arbenicillin."}, "36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}}}}, "690": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "692": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "40360": {"category_aro_name": "penem", "category_aro_cvterm_id": "40360", "category_aro_accession": "3003706", "category_aro_class_name": "Drug Class", "category_aro_description": "Penems are a class of unsaturated beta-lactam antibiotics with a broad spectrum of antibacterial activity and have a structure which renders them highly resistant to beta-lactamases. All penems are all synthetically made and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. They are structurally similar to carbapenems, however, where carbapenems have a carbon, penems have a sulfur."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "35923": {"category_aro_name": "monobactam", "category_aro_cvterm_id": "35923", "category_aro_accession": "0000004", "category_aro_class_name": "Drug Class", "category_aro_description": "Monobactams are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. Unlike penams and cephems, monobactams do not have any ring fused to its four-member lactam structure. Monobactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36023": {"category_aro_name": "TEM beta-lactamase", "category_aro_cvterm_id": "36023", "category_aro_accession": "3000014", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "TEM-1 is the most commonly-encountered beta-lactamase in gram-negative bacteria. Up to 90% of ampicillin resistance in E. coli is due to the production of TEM-1. Also responsible for the ampicillin and penicillin resistance that is seen in H. influenzae and N. gonorrhoeae in increasing numbers. Although TEM-type beta-lactamases are most often found in E. coli and K. pneumoniae, they are also found in other species of gram-negative bacteria with increasing frequency. The amino acid substitutions responsible for the ESBL phenotype cluster around the active site of the enzyme and change its configuration, allowing access to oxyimino-beta-lactam substrates. Opening the active site to beta-lactam substrates also typically enhances the susceptibility of the enzyme to b-lactamase inhibitors, such as clavulanic acid.  Although the inhibitor-resistant beta-lactamases are not ESBLs, they are often discussed with ESBLs because they are also derivatives of the classical TEM- or SHV-type enzymes. These enzymes were at first given the designation IRT for inhibitor-resistant TEM beta-lactamase; however, all have subsequently been renamed with numerical TEM designations. There are at least 19 distinct inhibitor-resistant TEM beta-lactamases. Inhibitor-resistant TEM beta-lactamases have been found mainly in clinical isolates of E. coli, but also some strains of K. pneumoniae, Klebsiella oxytoca, P. mirabilis, and Citrobacter freundii. Although the inhibitor-resistant TEM variants are resistant to inhibition by clavulanic acid and sulbactam, thereby showing clinical resistance to the beta-lactam-lactamase inhibitor combinations of amoxicillin-clavulanate (Co-amoxiclav), ticarcillin-clavulanate, and ampicillin/sulbactam, they normally remain susceptible to inhibition by tazobactam and subsequently the combination of piperacillin/tazobactam, although resistance has been described."}}}}, "693": {"$update": {"ARO_category": {"36017": {"category_aro_name": "penam", "category_aro_cvterm_id": "36017", "category_aro_accession": "3000008", "category_aro_class_name": "Drug Class", "category_aro_description": "Penams, often referred to as penicillins, are a group of antibiotics derived from Penicillium fungi. Penicillin antibiotics are historically significant because they are the first drugs that were effective against many previously serious diseases such as syphilis and Staphylococcus infections. Penicillins are still widely used today, though many types of bacteria are now resistant. All penicillins are beta-lactam antibiotics in the penam sub-group, and are used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms."}, "36000": {"category_aro_name": "antibiotic inactivation", "category_aro_cvterm_id": "36000", "category_aro_accession": "0001004", "category_aro_class_name": "Resistance Mechanism", "category_aro_description": "Enzymatic inactivation of antibiotic to confer drug resistance."}, "35951": {"category_aro_name": "cephalosporin", "category_aro_cvterm_id": "35951", "category_aro_accession": "0000032", "category_aro_class_name": "Drug Class", "category_aro_description": "Cephalosporins are a class of beta-lactam antibiotics, containing the beta-lactam ring fused with a dihydrothiazolidine ring. Together with cephamycins they belong to a sub-group called cephems. Cephalosporin are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms."}, "36026": {"category_aro_name": "OXA beta-lactamase", "category_aro_cvterm_id": "36026", "category_aro_accession": "3000017", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "OXA beta-lactamases were long recognized as a less common but also plasmid-mediated beta-lactamase variety that could hydrolyze oxacillin and related anti-staphylococcal penicillins. These beta-lactamases differ from the TEM and SHV enzymes in that they belong to molecular class D and functional group 2d. The OXA-type beta-lactamases confer resistance to ampicillin and cephalothin and are characterized by their high hydrolytic activity against oxacillin and cloxacillin and the fact that they are poorly inhibited by clavulanic acid. Amino acid substitutions in OXA enzymes can also give the ESBL phenotype. The OXA beta-lactamase family was originally created as a phenotypic rather than a genotypic group for a few beta-lactamases that had a specific hydrolysis profile. Therefore, there is as little as 20% sequence homology among some of the members of this family. However, recent additions to this family show some degree of homology to one or more of the existing members of the OXA beta-lactamase family. Some confer resistance predominantly to ceftazidime, but OXA-17 confers greater resistance to cefotaxime and cefepime than it does resistance to ceftazidime."}}}}, "1544": {"$update": {"ARO_category": {"36476": {"category_aro_name": "iclaprim", "category_aro_cvterm_id": "36476", "category_aro_accession": "3000337", "category_aro_class_name": "Antibiotic", "category_aro_description": "Iclaprim is a bactericidal compound that inhibits dihydrofolate reductase. It is used against clinically important Gram-positive pathogens, including methicillin-sensitive Staphylococcus aureus and methicillin-resistant S. aureus."}, "36327": {"category_aro_name": "trimethoprim", "category_aro_cvterm_id": "36327", "category_aro_accession": "3000188", "category_aro_class_name": "Antibiotic", "category_aro_description": "Trimethoprim is a synthetic 5-(3,4,5- trimethoxybenzyl) pyrimidine inhibitor of dihydrofolate reductase, inhibiting synthesis of tetrahydrofolic acid. Tetrahydrofolic acid is an essential precursor in the de novo synthesis of the DNA nucleotide thymidine. Trimethoprim is a bacteriostatic antibiotic mainly used in the prophylaxis and treatment of urinary tract infections in combination with sulfamethoxazole, a sulfonamide antibiotic."}, "36408": {"category_aro_name": "brodimoprim", "category_aro_cvterm_id": "36408", "category_aro_accession": "3000269", "category_aro_class_name": "Antibiotic", "category_aro_description": "Brodimoprim is a structural derivative of trimethoprim and an inhibitor of bacterial dihydrofolate reductase. The 4-methoxy group of trimethoprim is replaced with a bromine atom."}, "37617": {"category_aro_name": "trimethoprim resistant dihydrofolate reductase dfr", "category_aro_cvterm_id": "37617", "category_aro_accession": "3001218", "category_aro_class_name": "AMR Gene Family", "category_aro_description": "Alternative dihydropteroate synthase dfr present on plasmids produces alternate proteins that are less sensitive to trimethoprim from inhibiting its role in folate synthesis, thus conferring trimethoprim resistance."}, "36310": {"category_a