Abstract
Rising antibiotic resistance is a global threat that is projected to cause more deaths than all cancers combined by 2050. In this review, we set to summarize the current state of antibiotic resistance, and to give an overview of the emerging technologies aimed to escape the pre-antibiotic era recurrence. We conducted a comprehensive literature survey of >150 original research and review articles indexed in the Web of Science using “antimicrobial resistance,” “diagnostics,” “therapeutics,” “disinfection,” “nosocomial infections,” “ESKAPE pathogens” as key words. We discuss the impact of nosocomial infections on the spread of multi-drug resistant bacteria, give an overview over existing and developing strategies for faster diagnostics of infectious diseases, review current and novel approaches in therapy of infectious diseases, and finally discuss strategies for hospital disinfection to prevent MDR bacteria spread.
Highlights
Antimicrobial resistance (AMR) is an evolutionary response of bacteria, viruses, and fungi to withstand antimicrobial drugs introduced into their environment
In this systematic review we will focus on the resistance in bacteria only and the reader is advised to go through other reviews on viral and fungal resistance (Srinivasan et al, 2014; Fuentefria et al, 2018; Poole and James, 2018; Lampejo, 2020)
Infections caused by resistant bacteria cause 68,000 deaths in the EU/EEA and the United States combined (Cassini et al, 2019; Center for Disease Control and Prevention (CDC), 2019), and are contributing to US €55 billion economic loss in the United States and to €1.6 billion in the EU/EEA annually (Ahmad and Khan, 2019)
Summary
Antimicrobial resistance (AMR) is an evolutionary response of bacteria, viruses, and fungi to withstand antimicrobial drugs introduced into their environment. Mechanisms include either mutations in existing genes, for example in intracellular targets (Musser James et al, 2020) or core metabolic genes (Lopatkin et al, 2021) or acquisition of new antibiotic resistance genes (ARGs) through horizontal gene transfer (HGT) (Eichenberger and Thaden, 2019) The latter enables intra- and inter-species transmission of ARGs and is responsible for an AMR pandemic (von Wintersdorff et al, 2016; Sun et al, 2019). A recent study from Greece reported that 90-days mortality risk was doubled in patients with HAI caused by carbapenem-resistant pathogens compared to patients without HAI (Kritsotakis et al, 2017) It is worth noting, though, that Greece is a country with highest consumption of antibiotics and with second largest disabilityadjusted life years burden due to AMR in the EU (OECD, 2019). But not least, we have to search for new therapeutic strategies to combat resistant bacterial infections
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