scholarly journals Approaches for Mitigating Microbial Biofilm-Related Drug Resistance: A Focus on Micro- and Nanotechnologies

Molecules ◽  
2021 ◽  
Vol 26 (7) ◽  
pp. 1870
Author(s):  
Harinash Rao ◽  
Sulin Choo ◽  
Sri Raja Rajeswari Mahalingam ◽  
Diajeng Sekar Adisuri ◽  
Priya Madhavan ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Physiological State ◽  
Persister Cells ◽  
Microbial Biofilm ◽  
Antimicrobial Coatings ◽  
Drug Efflux Pumps ◽  
Lock Therapy ◽  
Related Drug ◽  
Healthcare Associated ◽  
Potential Therapeutics

Biofilms play an essential role in chronic and healthcare-associated infections and are more resistant to antimicrobials compared to their planktonic counterparts due to their (1) physiological state, (2) cell density, (3) quorum sensing abilities, (4) presence of extracellular matrix, (5) upregulation of drug efflux pumps, (6) point mutation and overexpression of resistance genes, and (7) presence of persister cells. The genes involved and their implications in antimicrobial resistance are well defined for bacterial biofilms but are understudied in fungal biofilms. Potential therapeutics for biofilm mitigation that have been reported include (1) antimicrobial photodynamic therapy, (2) antimicrobial lock therapy, (3) antimicrobial peptides, (4) electrical methods, and (5) antimicrobial coatings. These approaches exhibit promising characteristics for addressing the impending crisis of antimicrobial resistance (AMR). Recently, advances in the micro- and nanotechnology field have propelled the development of novel biomaterials and approaches to combat biofilms either independently, in combination or as antimicrobial delivery systems. In this review, we will summarize the general principles of clinically important microbial biofilm formation with a focus on fungal biofilms. We will delve into the details of some novel micro- and nanotechnology approaches that have been developed to combat biofilms and the possibility of utilizing them in a clinical setting.

scholarly journals Clinical and microbiological characteristics of nosocomial, healthcare-associated, and community-acquired Klebsiella pneumoniae infections in Guangzhou, China

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Tingting Le ◽  
Ling Wang ◽  
Chaoying Zeng ◽  
Leiwen Fu ◽  
Zhihua Liu ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Bacterial Resistance ◽  
Empirical Therapy ◽  
Clonal Diversity ◽  
Extended Spectrum Beta Lactamase ◽  
Microbiological Characteristics ◽  
Carbapenemase Gene ◽  
Cross Transmission ◽  
Healthcare Associated

Abstract Background Klebsiella pneumoniae (K. pneumoniae) is a common pathogen associated with hospital and community-onset infections. This study aimed to compare the clinical and microbiological characteristics of nosocomial, healthcare-associated (HCA), and community-acquired (CA) K. pneumoniae infections. Methods Clinical data were extracted from electronic medical records and analyzed retrospectively. Antimicrobial susceptibility and extended-spectrum beta-lactamase (ESBL) production were determined for all identified strains. Carbapenemase and ESBL genes were amplified by PCR. Genotyping of carbapenem-resistant K. pneumoniae (CRKP) and ESBL-producing strains was performed by pulsed-field gel electrophoresis (PFGE). Results Of 379 K. pneumoniae infections, 98 (25.9%) were nosocomial, 195 (51.5%) were healthcare-associated, and 86 (22.6%) were community-acquired. Hematological malignancy (OR = 4.467), and hypertension (OR = 2.08) and cerebral vascular disease (OR = 2.486) were associated with nosocomial and HCA infections respectively, when compared to CA infections. Overall, the incidence of antimicrobial resistance for the majority of agents tested was similar between nosocomial and HCA infections (P > 0.05) and both groups had a higher incidence than CA infections (P < 0.05). Moreover, 95.1% (78/82) of CRKP strains were isolated from the nosocomial and HCA groups. The blaKPC was the most prevalent carbapenemase gene among CRKP strains (80.5%, 66/82). ESBL-producing strains were prevalent among nosocomial (40.8%), HCA (35.9%) and CA groups (24.4%). The blaCTX-M-9-group and blaCTX-M-1-group genes were predominant in nosocomial (65.0%) and CA strains (66.7%), respectively. PFGE results showed ESBL-producing and CRKP strains were genetically diverse. Identical PFGE profiles were observed among HCA and nosocomial strains. Conclusions Nosocomial and HCA K. pneumoniae infections presented similar clinical features and antimicrobial resistance, and both two types of infections were different to CA infections. CRKP and ESBL-producing strains were disseminated mainly in HCA and nosocomial groups, and showed a clonal diversity. The cross transmission of CRKP was existed among HCA and nosocomial patients. This finding suggests that similar empirical therapy should be considered for patients with nosocomial and HCA K. pneumoniae infections and bacterial resistance surveillance of these infections is necessary.

Healthcare associated pneumonia: An old concept at a hospital with high prevalence of antimicrobial resistance

MedPharmRes ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 17-21
Author(s):  
Lam Nguyen-Ho ◽  
Duong Hoang-Thai ◽  
Vu Le-Thuong ◽  
Ngoc Tran-Van
Keyword(s):  
Risk Factor ◽  
Antimicrobial Resistance ◽  
Multidrug Resistant ◽  
Community Acquired Pneumonia ◽  
Resistant Organism ◽  
Healthcare Associated Infection ◽  
Female Ratio ◽  
High Prevalence ◽  
Need To Evaluate ◽  
Healthcare Associated

Background: One of several reasons that the concept of healthcare-associated pneumonia (HCAP) was dismissed was the same presence of multidrug resistant organism (MDRO) between community-acquired pneumonia and HCAP at countries with the low prevalence of antimicrobial resistance (AMR). However, this finding could be unsuitable for countries with the high rates of AMR. Methods: A prospective observational study was conducted at the respiratory department of Cho Ray hospital from September 2015 to April 2016. All adult patients suitable for community acquired pneumonia (CAP) with risk factor for healthcare-associated infection were included. Results: We found out 130 subjects. The median age was 71 years (interquartile range 57-81). The male/female ratio was 1.55:1. Prior hospitalization was the most common risk factor for healthcare-associated infection. There were 35 cases (26.9%) with culture-positive (sputum and/or bronchial lavage). Isolated bacteria included Pseudomonas aeruginosa (9 cases), Klebsiella pneumoniae (9 cases), Escherichia coli (4 cases), Acinetobacter baumannii (6 cases), and Staphylococcus aureus (7 cases) with the characteristic of AMR similar to the bacterial spectrum associated with hospital-acquired pneumonia. Conclusion: MDROs were detected frequently in CAP patients with risk factor for healthcare-associated infection at the hospital with the high prevalence of AMR. This requires the urgent need to evaluate risk factors for MDRO infection in community-onset pneumonia when the concept of HCAP is no longer used.

scholarly journals Antimicrobial resistance: a global view from the 2013 World Healthcare-Associated Infections Forum

2013 ◽  
Vol 2 (1) ◽  
pp. 31 ◽  
Author(s):  
Angela Huttner ◽  
Stephan Harbarth ◽  
Jean Carlet ◽  
Sara Cosgrove ◽  
Herman Goossens ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Healthcare Associated Infections ◽  
Global View ◽  
Healthcare Associated

scholarly journals A Comprehensive Review on Current Progressions in Combating The Antimicrobial Resistance

2020 ◽  
Vol 11 (2) ◽  
pp. 1493-1504
Author(s):  
Bharatlal Sain ◽  
Manohar M ◽  
Gowda D V
Keyword(s):  
Photodynamic Therapy ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Biofilm Formation ◽  
Susceptibility Testing ◽  
Persister Cells ◽  
Comprehensive Review ◽  
Obligate Intracellular ◽  
Competitive Inhibitors ◽  
The World

Anti-microbial resistance (AMR) is the ability of a microbe to resist the effect of antibiotics. It has become the most important cause of concern throughout the world. AMR may develop a variety of mechanisms, including resistance, weakness or due to a certain therapeutic failure. The three major causes of resistance were identified to be over usage of anti-microbials, over-prescription, increased agricultural usage. The mechanism which leads to the development of AMR were found to be Metabolic Inactive Persister cells biofilm formation, Swarming, Obligate intracellular microbes, Reduced uptake and efflux pumps, Modification of the antibiotic binding site, Production of competitive inhibitors. Research is still being carried out and few methods successfully  delay or inhibit the progress of Resistance namely: Photodynamic therapy, which works on the principle of photosensitization, results in formation of ROS which destroy pathogenic cells, Vaccines, which strengthen the defence system to fight against foreign microorganisms efficiently, Antibiotic adjuvants, work by inhibiting any kind of mechanism related to the resistance increasing the drug’s antibacterial efficiency, Nano antibiotics which acts by interfering with the mechanisms for the development of the resistance and microfluidics give a better understanding of the bacteria and its superior antimicrobial susceptibility testing. Hence, in this review the above mechanisms of antimicrobial resistance as well the latest AMR combating strategies are been discussed.

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