Due to the severity of infections caused by P. aeruginosa and the limitations in treatment, it is necessary to find new therapeutic alternatives. Thus, the use of silver nanoparticles (AgNPs) is a viable alternative because of their potential actions in the combat of microorganisms, showing efficacy against Gram-positive and Gram-negative bacteria, including multidrug-resistant microorganisms (MDR). In this sense, the aim of this work was to conduct a literature review related to the antibacterial and antibiofilm activity of AgNPs against antibiotic-sensitive and multidrug-resistant Pseudomonas aeruginosa strains. The AgNPs are promising for future applications, which may match the clinical need for effective antibiotic therapy. The size of AgNPs is a crucial element to determine the therapeutic activity of nanoparticles, since smaller particles present a larger surface area of contact with the microorganism, affecting their vital functioning. AgNPs adhere to the cytoplasmic membrane and cell wall of microorganisms, causing disruption, penetrating the cell, interacting with cellular structures and biomolecules, and inducing the generation of reactive oxygen species and free radicals. Studies describe the antimicrobial activity of AgNPs at minimum inhibitory concentration (MIC) between 1 and 200 μg/mL against susceptible and MDR P. aeruginosa strains. These studies have also shown antibiofilm activity through disruption of biofilm structure, and oxidative stress, inhibiting biofilm growth at concentrations between 1 and 600 μg/mL of AgNPs. This study evidences the advance of AgNPs as an antibacterial and antibiofilm agent against Pseudomonas aeruginosa strains, demonstrating to be an extremely promising approach to the development of new antimicrobial systems.

Antimicrobial resistance (AMR) represents a critical obstacle to public health worldwide, due to the high incidence of strains resistant to available antibiotic therapies. In recent years, there has been a significant increase in the prevalence of resistant epidemic strains, associated with this, public health authorities have been alarmed about a possible scenario of uncontrolled dissemination of these microorganisms and the difficulty in interrupting their transmission, as nosocomial pathogens with resistance profiles previously considered sporadic. They become frequent bacteria in the community. In addition, therapy for infections caused by these pathogens is based on broad-spectrum antibiotic therapy, which favors an increase in the tolerance of remaining bacterial cells and is commonly associated with a poor prognosis. In this review, we present the current status of epidemic strains of methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococcus (VRE), MDR Mycobacterium tuberculosis , extended-spectrum β-lactamase-producing Enterobacterales (ESBL), Klebsiella pneumoniae carbapenemase (KPC), and—New Delhi Metallo-beta-lactamase-producing Pseudomonas aeruginosa (NDM).

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O tratamento de infecções causadas por enterobactérias produtoras de enzimas β-lactamases de espectro estendido (ESBLs) está cada vez mais desafiador, de forma que o uso indiscriminado e exacerbado de antibióticos promoveu a resistência e disseminação bacteriana destes patógenos, tornando o tratamento destas bactérias um desafio para a saúde pública. Levando em consideração que os aminoglicosídeos são os antibióticos indicados para o tratamento clínico de infecções causadas pelas enterobactérias, o objetivo dessa revisão foi descrever a utilização e eficácia dos aminoglicosídeos como estratégia terapêutica para combater as infecções causadas por enterobactérias produtoras de ESBLs.  Foi realizada uma revisão bibliográfica através de buscas nas bases PubMed, Scientific Eletronic Library On-line (SCIELO) e Scholar Google, selecionando artigos publicados entre 2011 a 2020, em inglês, com os seguintes descritores:  Bactérias gram-negativas, Resistência e Infecções. Os resultados mostraram que a plazomicina apresenta eficácia frente a cepas de Citrobacter spp., Klebsiella spp. e Enterobacter spp. produtoras de ESBLs, enquanto gentamicina, tobramicina e apramicina apresentam eficácia frente a E. coli, Burkholderia spp., Serratia spp., Citrobacter spp., Enterobacter spp. e Klebsiella spp. produtoras de ESBLs. Com relação à terapia combinada, pode-se observar que a combinação entre dois aminoglicosídeos ou entre aminoglicosídeos e outros antibióticos promoveram efeito sinérgico quando comparado com a monoterapia frente a E. coli, Enterobacter spp., Enterobacter cloacae e principalmente Klebsiella pneumonia produtoras de ESBLs. Portanto, os aminoglicosídeos vêm demonstrando grande potencial frente a esse grupo de bactérias as quais representam um grande desafio para a classe médica.