Beating the Bio-Terror Threat with Rapid Antimicrobial Susceptibility Testing

Abstract

A bioterror event using an infectious bacterium may lead to catastrophic outcomes involving morbidity and mortality as well as social and psychological stress. Moreover, a bioterror event using an antibiotic resistance engineered bacterial agent may raise additional concerns. Thus, preparedness is essential to preclude and control the dissemination of the bacterial agent as well as to appropriately and promptly treat potentially exposed individuals or patients. Rates of morbidity, death, and social anxiety can be drastically reduced if the rapid delivery of antimicrobial agents for post-exposure prophylaxis and treatment is initiated as soon as possible. Availability of rapid antibiotic susceptibility tests that may provide key recommendations to targeted antibiotic treatment is mandatory, yet, such tests are only at the development stage. In this review, we describe the recently published rapid antibiotic susceptibility tests implemented on bioterror bacterial agents and discuss their assimilation in clinical and environmental samples.

Phage therapy potentiates second-line antibiotic treatment against pneumonic plague

“…Although natural plague outbreaks are rare, plague is considered a reemerging disease [3,4]. A recent large outbreak occurred in Madagascar in 2017, where many patients presented with the pneumonic form of the disease [5,6].…”

“…However, several strains isolated from rodents or from plague patients have demonstrated antibiotic resistance against first-line antibiotics such as streptomycin [3,[8][9][10][11]. Moreover, a major concern exists regarding the possibility of the generation and usage of antibiotic-resistant Y. pestis strains in a bioterror event [3,4,7]. Currently, no licensed plague vaccine is available in Western countries [4,12], thus emphasizing the importance of developing alternative treatments such as bacteriophage (phage) therapy.…”

“…Yersinia pestis , a gram-negative bacterium and the etiological agent of plague, is a lethal pathogen that has led to three world pandemics throughout human history [1,2]. Although natural plague outbreaks are rare, plague is considered a reemerging disease [3,4]. A recent large outbreak occurred in Madagascar in 2017, where many patients presented with the pneumonic form of the disease [5,6].…”

“…Moreover, a major concern exists regarding the possibility of the generation and usage of antibiotic-resistant Y. pestis strains in a bioterror event [3,4,7]. Currently, no licensed plague vaccine is available in Western countries [4,12], thus emphasizing the importance of developing alternative treatments such as bacteriophage (phage) therapy.…”