Abstract
Worldwide, infections are resuming their role as highly effective killing diseases, as current treatments are failing to respond to the growing problem of antimicrobial resistance (AMR). The social and economic burden of AMR seems ever rising, with health- and research-related organizations rushing to collaborate on a worldwide scale to find effective solutions. Resistant bacteria are spreading even in first-world nations, being found not only in healthcare-related settings, but also in food and in the environment. In this minireview, the impact of AMR in healthcare systems and the major bacteria behind it are highlighted. Ecological aspects of AMR evolution and the complexity of its molecular mechanisms are explained. Major concepts, such as intrinsic, acquired and adaptive resistance, as well as tolerance and heteroresistance, are also clarified. More importantly, the problematic of biofilms and their role in AMR, namely their main resistance and tolerance mechanisms, are elucidated. Finally, some of the most promising anti-biofilm strategies being investigated are reviewed. Much is still to be done regarding the study of AMR and the discovery of new anti-biofilm strategies. Gladly, considerable research on this topic is generated every day and increasingly concerted actions are being engaged globally to try and tackle this problem.
Highlights
Antibiotic discovery had an unprecedented role in medical advances, saving countless lives by mitigating infectious diseases, but the rapid global emergence of resistant bacteria over the last decades has been imperilling their worth (Martens and Demain 2017; World Health Organization (WHO) 2017a)
The solution for the hitches caused by one of the smallest life forms on this planet, i.e. bacteria, remains an unsolved riddle, as these microorganisms do not cease to amaze with their ability to circumvent every “curve ball” thrown their way
The complex issue of antimicrobial resistance (AMR), it seems, is a “many-fronts battle”, with biofilm formation being a substantial portion of the problem
Summary
Antibiotic discovery had an unprecedented role in medical advances, saving countless lives by mitigating infectious diseases, but the rapid global emergence of resistant bacteria over the last decades has been imperilling their worth (Martens and Demain 2017; WHO 2017a). High levels of AMR can be achieved through intrinsic restricted or selective outer membrane permeability, drug efflux pump systems, and/or expression of intrinsic antibiotic resistance genes (Blair et al 2015).
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