Resistance to antimicrobials and particularly multidrug resistance is one of the greatest challenges in the health system nowadays. The continual increase in the rates of antimicrobial resistance worldwide boosted by the ongoing COVID-19 pandemic poses a major public health threat. Different approaches have been employed to minimize the effect of resistance and control this threat, but the question still lingers as to their safety and efficiency. In this context, new anti-infectious approaches against multidrug resistance are being examined. Use of new antibiotics and their combination with new β-lactamase inhibitors, phage therapy, antimicrobial peptides, nanoparticles, and antisense antimicrobial therapeutics are considered as one such promising approach for overcoming bacterial resistance. In this review, we provide insights into these emerging alternative therapies that are currently being evaluated and which may be developed in the future to break the progression of antimicrobial resistance. We focus on their advantages and limitations and potential application in medicine. We further highlight the importance of the combination therapy approach, wherein two or more therapies are used in combination in order to more effectively combat infectious disease and increasing access to quality healthcare. These advances could give an alternate solution to overcome antimicrobial drug resistance. We eventually hope to provide useful information for clinicians who are seeking solutions to the problems caused by antimicrobial resistance.

This comparative study assessed hepatitis A virus (HAV) contamination in shellfish harvesting areas in Morocco, and the correlations between viral contamination and rainfall. To this aim, HAV contamination was evaluated in 156 shellfish samples collected at three Moroccan coastal areas (52 samples/area): Dakhla (class A), Oualidia (class B), and Moulay Bousselham (class C). Samples were collected monthly between March 2018 and March 2019, and included oysters from different farms at the Oualidia and Dakhla coastal areas, and wild mussels at the Moulay Bousselham lagoon. HAV was detected by RT-qPCR in 24/156 (15.38%) samples: 16/145 (11.03%) mussel (Mytillus galloprovincialis) and 8/156 (5.13%) oyster (Crassostea gigas) samples. The 16 mussel-positive samples (16/52) were collected at Moulay Bousselham, and the eight oyster-positive samples (8/52) were collected at Oualidia, and none at Dakhla (class A). The highest HAV contamination rate was recorded at Moulay Bousselham lagoon (class C) (30.77%), while it did not exceed 8% at Oualidia (class A). A nonsignificant, positive correlation between HAV-positive samples and mean rainfall was observed. The important HAV presence in bivalve mollusks from the Oualidia and Moulay Bousselham lagoons indicate the need of viral surveillance of bivalve mollusks and of improving wastewater quality to enhance shellfish safety.

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