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Several molecular mechanisms of antibacterial resistance exist.
Intrinsic antibacterial resistance may be part of the genetic makeup of bacterial strains.
For example, an antibiotic target may be absent from the bacterial genome.
Acquired resistance results from a mutation in the bacterial chromosome or the acquisition of extra-chromosomal DNA.
Antibacterial-producing bacteria have evolved resistance mechanisms that have been shown to be similar to, and may have been transferred to, antibacterial-resistant strains.
The spread of antibacterial resistance often occurs through vertical transmission of mutations during growth and by genetic recombination of DNA by horizontal genetic exchange.
For instance, antibacterial resistance genes can be exchanged between different bacterial strains or species via plasmids that carry these resistance genes.
Plasmids that carry several different resistance genes can confer resistance to multiple antibacterials.
Cross-resistance to several antibacterials may also occur when a resistance mechanism encoded by a single gene conveys resistance to more than one antibacterial compound.

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