Abstract
Antibiotic resistance has increased significantly in the recent years, and has become a global problem for human health and the environment. As a result, several technologies for the controlling of health-care associated infections have been developed over the years. Thus, the most recent findings in hydrogel fabrication, particularly antimicrobial hydrogels, could offer valuable solutions for these biomedical challenges. In this review, we discuss the most promising strategies in the development of antimicrobial hydrogels and the application of hydrogels in the treatment of microbial infections. The latest advances in the development of inherently and composite antimicrobial hydrogels will be discussed, as well as hydrogels as carriers of antimicrobials, with a focus on antibiotics, metal nanoparticles, antimicrobial peptides, and biological extracts. The emergence of CRISR-Cas9 technology for removing the antimicrobial resistance has led the necessity of new and performant carriers for delivery of the CRISPR-Cas9 system. Different delivery systems, such as composite hydrogels and many types of nanoparticles, attracted a great deal of attention and will be also discussed in this review.
Highlights
Antimicrobial agents—such as antibiotics—have dramatically reduced the number of deaths from infectious diseases over time; they are often overused and discarded in the environment
Multi-drug resistance among the bacterial pathogens is of particular concern because they are responsible for many severe infections in hospitals, as well as the contamination of implants or devices introduced into the body as stents or catheters
Controlled antimicrobial release was obtained by different strategies, such as: physical incorporation of metal NPs in hydrogels as cellulose–polymer–Ag nanocomposite fibers [176], or Au NPs incorporated in composite hydrogels [144], NP-stabilized liposomes [152] and antibiotic-loaded NPs [177]
Summary
Antimicrobial agents—such as antibiotics—have dramatically reduced the number of deaths from infectious diseases over time; they are often overused and discarded in the environment. Hydrogels can serve as antimicrobials, as well as chitosane and other naturally derived polysaccharide [14] They can serve as drug delivery systems for antibiotics, metal nanoparticles [15], antimicrobial peptides [16] biological extracts [17], implant coating to prevent infection [18,19] and carriers for delivery of the CRISPR-Cas system for curing the plasmid encoding antimicrobial resistance [20,21]. Smart hydrogels targeting bacterial infections and responsive to the bacterial microenvironment, their ability to adjust the release of antibiotics and/or antimicrobial compounds according to the bacterial contamination, have been studied. These strategies limit the accumulation of drugs in healthy host tissues, minimizing the risks of toxicity and the selection of resistant bacteria [23]. The main application of hydrogels in antimicrobial resistance that will be discussed in this review is shown in (Figure 1)
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