Abstract
Antibiotic resistance has increased markedly in Gram-negative bacteria, causing severe infections intractable with traditional drugs and amplifying mortality and healthcare costs. Consequently, to find novel antimicrobial compounds, active on multidrug resistant bacteria, is mandatory. In this regard, cationic antimicrobial peptides (CAMPs)—able to kill pathogens on contact—could represent an appealing solution. However, low selectivity, hemolytic toxicity and cost of manufacturing, hamper their massive clinical application. In the recent years—starting from CAMPs as template molecules—less toxic and lower-cost synthetic mimics of CAMPs, including cationic peptides, polymers and dendrimers, have been developed. Although the pending issue of hemolytic toxicity and biodegradability is still left not completely solved, cationic antimicrobial polymers (CAPs), compared to small drug molecules, thanks to their high molecular weight, own appreciable selectivity, reduced toxicity toward eukaryotic cells, more long-term activity, stability and non-volatility. With this background, an updated overview concerning the main manufactured types of CAPs, active on Gram-negative bacteria, is herein reported, including synthetic procedure and action’s mechanism. Information about their structures, antibacterial activity, advantages and drawbacks, was reported in the form of tables, which allow faster consultation and quicker learning concerning current CAPs state of the art, in order not to retrace reviews already available.
Highlights
Gram-negative bacteria over Gram-positive is evident in all the priority groups identified in the report, such as the “other priority pathogens” group, the “high priority” group and the “medium priority” group
Since the scope of this work is to review cationic antimicrobial polymers (CAPs) active on Gram-negative bacteria, a list of the some representatives of this class was reported in Table 2, while a brief description of the cell wall of Gram-negative bacteria was provided in the subsequent Section
Concerning Gram-negative bacteria, the results of investigations carried with different experimental methods in the last decades, supported the hypothesis that antimicrobial polymers bearing cationic charges on the quaternary ammonium/phosphonium groups, kill bacteria by electrostatic interaction with the outer membrane (OM) and cytoplasmic membrane (CM), followed by their damage, cell lysis with release of crucial ions such as potassium [65]
Summary
The increasing replacement of antibiotic-susceptible bacteria (ASB) with antibiotic-resistant bacteria (ARB) is one of the most concern of microbiologists and over the last two decades, antibiotic resistance has increased markedly in Gram-negative bacteria and has determined an improvement of mortality and of healthcare costs [1,2]. In order not to re-propose a simple update ofbyother reviews already Gram‐negative available, the most part hand to how the concern for the dangers represented multidrug‐resistant bacteria of was provided in the form of tables, a more “readers-friendly” tool, which allows faster hasinformation grown On this and background, in this work, the mostcharacteristics important achievements in antimicrobial the field of cationic discussed. An updated information concerning the different types of the industrialized CAPs active on Gram‐negative bacteria that are highly critical for human Cationic health, their structures, the supposed mechanism of action and their or field of of applications, Antimicrobial Devices were reported. Recognized for long time asserts that concerning Gram-negative bacteria, thanks to their cationic
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