Bacterial Nosocomial Infections: Multidrug Resistance as a Trigger for the Development of Novel Antimicrobials

Abstract

Nosocomial bacterial infections are associated with high morbidity and mortality, posing a huge burden to healthcare systems worldwide. The ongoing COVID-19 pandemic, with the raised hospitalization of patients and the increased use of antimicrobial agents, boosted the emergence of difficult-to-treat multidrug-resistant (MDR) bacteria in hospital settings. Therefore, current available antibiotic treatments often have limited or no efficacy against nosocomial bacterial infections, and novel therapeutic approaches need to be considered. In this review, we analyze current antibacterial alternatives under investigation, focusing on metal-based complexes, antimicrobial peptides, and antisense antimicrobial therapeutics. The association of new compounds with older, commercially available antibiotics and the repurposing of existing drugs are also revised in this work.

Chemical Barrier Proteins in Human Body Fluids

“…Nosocomial infection, also known as a hospital-acquired infection, is contracted from the environment or staff of a healthcare facility affecting nearly 9% of patients according to the WHO [ 74 ]. The most common nosocomial infections are caused by common bacteria such as Pseudomonas aeruginosa , Staphylococcus aureus, Acinetobacter baumannii , and Enterococci species [ 75 , 76 , 77 ] usually leading to milder diseases. Bacterial infections are treated with antibiotics that kill or suppress the bacterial species sensitive to the antibiotic, while the resistant strains survive and may spread in the hospital [ 78 , 79 ].…”

“…AMPs are promising candidates due to their fast killing kinetics, pharmacodynamic properties, and mechanisms of killing that overcome the common resistance mechanisms of pathogens [ 75 ]. The biofilm-disrupting properties of AMPs may also confer efficacy against multidrug-resistant bacterial infections associated with wounds and/or medical implants [ 75 ]. While preclinical studies were promising for numerous AMPs, most of the investigated AMPs failed in clinical studies [ 80 , 81 , 82 ].…”

Molecular Identification of Biocide Resistant Quaternary Ammonium Compound (QAC) Genes in Multi-Drug Resistant Acinetobacter baumannii Isolated from ICU Patients in Erbil City

“…It has a considerable potential to colonize and persists for a prolonged period on inanimate hospital surfaces under disinfected environment. Moreover, due to its intrinsic multiple drug resistance this pathogen can easily cause nosocomial outbreaks (Sousa et al, 2021). The majority of hospital acquired A. baumannii isolates are resistant to different classes of antibiotic including penicillins, cephalosporins, carbapenems, aminoglycosides and fluoroquinolones.…”

Recent Advances in the Use of Molecular Methods for the Diagnosis of Bacterial Infections

“…[3]. These pathogens, together with Clostridioides difficile, Escherichia coli, Campylobacter spp., (C. jejuni and C. coli), Legionella spp., and Salmonella spp., are the most common causes of nosocomial infections [4,5]. These pathogens exhibit drug resistance through several mechanisms, including active site modification, drug inactivation, efflux pump overexpression, and biofilm formation (Figure 1) [6][7][8].…”

“…These pathogens exhibit drug resistance through several mechanisms, including active site modification, drug inactivation, efflux pump overexpression, and biofilm formation (Figure 1) [6][7][8]. As a result, these microorganisms are able to persist for long periods of time in hospital environments, becoming resistant to biocides or otherwise limiting their effects, spreading from person to person, and causing serious hospital infections [4,9,10]. The ability to produce enzymes such as ESBLs and carbapenemases, which can inactivate antibiotics of last resort, have contributed greatly to the rapid spread of the Gram-negative members of the ESKAPE group, especially in intensive care units (ICUs) [11,12].…”