Multidrug-resistant bacteria

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A variety of different bacteria - testing for antimicrobial resistance Antimicrobial resistance.jpg
A variety of different bacteria - testing for antimicrobial resistance

Multidrug-resistant (MDR) bacteria are bacteria that are resistant to three or more classes of antimicrobial drugs. [1] MDR bacteria have seen an increase in prevalence in recent years[ clarification needed ] [2] and pose serious risks to public health. MDR bacteria can be broken into 3 main categories: Gram-positive, Gram-negative, and other (acid-stain). These bacteria employ various adaptations to avoid or mitigate the damage done by antimicrobials. With increased access to modern medicine there has been a sharp increase in the amount of antibiotics consumed. [3] Given the abundant use of antibiotics there has been a considerable increase in the evolution of antimicrobial resistance factors, now outpacing the development of new antibiotics. [4]

Contents

Examples identified as serious threats to public health

Examples of MDR bacteria identified as serious threats to public health include: [5]

Gram-positive MDR bacteria
Gram-negative MDR bacteria
Other MDR bacteria

Microbial adaptations

MDR bacteria employ a plurality of adaptations to overcome the environmental insults caused by antibiotics. Bacteria are capable of sharing these resistance factors in a process called horizontal gene transfer where resistant bacteria share genetic information that encodes resistance to the naive population. [6]

Alternative antimicrobial methods

Phage therapy

Bacteriophage therapy, commonly known as 'phage therapy,' uses bacteria-specific viruses to kill antibiotic resistant bacteria. Phage therapy offers considerably higher specificity as the phage can be engineered to only infect a certain bacteria species. [9] Phage therapy also allows for the possibility of biofilm penetration in cases where antibiotics are ineffective due to the increased resistance of biofilm-forming pathogens. [9] One major drawback to phage therapy is the evolution of phage-resistant microbes which was seen in a majority of phage therapy experiments aimed to treat sepsis and intestinal infection. [10] Recent studies suggest that development of phage resistance comes as a trade-off for antibiotic resistance and can be used to create antibiotic-sensitive populations. [10] [11]

References

  1. ↑ Magiorakos, A.-P.; Srinivasan, A.; Carey, R.B.; Carmeli, Y.; Falagas, M.E.; Giske, C.G.; Harbarth, S.; Hindler, J.F.; Kahlmeter, G.; Olsson-Liljequist, B.; Paterson, D.L. (March 2012). "Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance". Clinical Microbiology and Infection. 18 (3): 268–281. doi: 10.1111/j.1469-0691.2011.03570.x . PMID   21793988.
  2. ↑ Bae, Songmee; Lee, Jaehoon; Lee, Jaehwa; Kim, Eunah; Lee, Sunhwa; Yu, Jaeyon; Kang, Yeonho (January 2010). "Antimicrobial Resistance in Haemophilus influenzae Respiratory Tract Isolates in Korea: Results of a Nationwide Acute Respiratory Infections Surveillance". Antimicrobial Agents and Chemotherapy. 54 (1): 65–71. doi:10.1128/AAC.00966-09. ISSN   0066-4804. PMC   2798543 . PMID   19884366.
  3. ↑ Sample, Ian (2018-03-26). "Calls to rein in antibiotic use after study shows 65% increase worldwide". The Guardian. ISSN   0261-3077 . Retrieved 2020-11-09.
  4. ↑ Ventola, C. Lee (April 2015). "The antibiotic resistance crisis: part 1: causes and threats". P & T: A Peer-Reviewed Journal for Formulary Management. 40 (4): 277–283. ISSN   1052-1372. PMC   4378521 . PMID   25859123.
  5. ↑ CDC (2020-10-28). "Antibiotic-resistant Germs: New Threats". Centers for Disease Control and Prevention. Retrieved 2020-11-09.
  6. ↑ Arnold, Brian J.; Huang, I-Ting; Hanage, William P. (April 2022). "Horizontal gene transfer and adaptive evolution in bacteria" . Nature Reviews Microbiology. 20 (4): 206–218. doi:10.1038/s41579-021-00650-4. ISSN   1740-1526. PMID   34773098. S2CID   244076968.
  7. 1 2 3 Munita, Jose M.; Arias, Cesar A. (April 2016). "Mechanisms of Antibiotic Resistance". Microbiology Spectrum. 4 (2). doi:10.1128/microbiolspec.VMBF-0016-2015. ISSN   2165-0497. PMC   4888801 . PMID   27227291.
  8. ↑ Du, Dijun; Wang-Kan, Xuan; Neuberger, Arthur; van Veen, Hendrik W.; Pos, Klaas M.; Piddock, Laura J. V.; Luisi, Ben F. (September 2018). "Multidrug efflux pumps: structure, function and regulation" . Nature Reviews Microbiology. 16 (9): 523–539. doi:10.1038/s41579-018-0048-6. ISSN   1740-1534. PMID   30002505. S2CID   49666287.
  9. 1 2 Lin, Derek M; Koskella, Britt; Lin, Henry C (2017). "Phage therapy: An alternative to antibiotics in the age of multi-drug resistance". World Journal of Gastrointestinal Pharmacology and Therapeutics. 8 (3): 162–173. doi: 10.4292/wjgpt.v8.i3.162 . ISSN   2150-5349. PMC   5547374 . PMID   28828194.
  10. 1 2 Oechslin, Frank (2018-06-30). "Resistance Development to Bacteriophages Occurring during Bacteriophage Therapy". Viruses. 10 (7): 351. doi: 10.3390/v10070351 . ISSN   1999-4915. PMC   6070868 . PMID   29966329.
  11. ↑ Chan, Benjamin K.; Sistrom, Mark; Wertz, John E.; Kortright, Kaitlyn E.; Narayan, Deepak; Turner, Paul E. (July 2016). "Phage selection restores antibiotic sensitivity in MDR Pseudomonas aeruginosa". Scientific Reports. 6 (1): 26717. Bibcode:2016NatSR...626717C. doi:10.1038/srep26717. ISSN   2045-2322. PMC   4880932 . PMID   27225966.
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