Overcoming Multidrug Resistance in Bacteria Through Antibiotics Delivery in Surface-Engineered Nano-Cargos: Recent Developments for Future Nano-Antibiotics

Abstract

In the recent few decades, the increase in multidrug-resistant (MDR) bacteria has reached an alarming rate and caused serious health problems. The incidence of infections due to MDR bacteria has been accompanied by morbidity and mortality; therefore, tackling bacterial resistance has become an urgent and unmet challenge to be properly addressed. The field of nanomedicine has the potential to design and develop efficient antimicrobials for MDR bacteria using its innovative and alternative approaches. The uniquely constructed nano-sized antimicrobials have a predominance over traditional antibiotics because their small size helps them in better interaction with bacterial cells. Moreover, surface engineering of nanocarriers offers significant advantages of targeting and modulating various resistance mechanisms, thus owe superior qualities for overcoming bacterial resistance. This review covers different mechanisms of antibiotic resistance, application of nanocarrier systems in drug delivery, functionalization of nanocarriers, application of functionalized nanocarriers for overcoming bacterial resistance, possible limitations of nanocarrier-based approach for antibacterial delivery, and future of surface-functionalized antimicrobial delivery systems.

Microbial resistance to nanotechnologies: An important but understudied consideration using antimicrobial nanotechnologies in orthopaedic implants

“…To address this, external stimuli-responsive agents have been incorporated into the nano delivery systems to improve the release kinetics of antibiotics, enabling controlled and sustained release upon triggered by environmental changes, such as light, pH, temperature, magnetic field, or ultrasonic power [ 153 ]. With these highly localized, precise, and controlled nano delivery modalities, bacterial resistance progression can be largely impeded; yet the uncertainty of their long-term stability in the physiological environment and ADME (absorption, distribution, metabolism and excretion) profile in vivo requires future investigation in order to fully verify their practicality for hospital use [ 154 ].…”

Advances in Nanostructures for Antimicrobial Therapy

“…Moreover, by encapsulating antimicrobial compounds of natural origin into suitable NCs, “green therapeutics” can be prepared. For example, recent progress and strategies to overcome bacterial resistance by encapsulating phytochemical oils showing antibacterial activity was presented by Gafur et al [ 80 ] The limitations of conventional antibiotics applied in therapies against bacterial infections can be overcome by the use of surface-modified antibacterial NCs able to enhance delivery, bioavailability and effectiveness of encapsulated drugs [ 81 , 82 ]. For example, the use of bacteriophages in the treatment of bacterial infections using nanotechnologies to overcome pharmacological barriers is very interesting [ 83 ].…”

Multidrug-Resistant Microbial Therapy Using Antimicrobial Peptides and the CRISPR/Cas9 System

“…Antibiotics are the most important discovery in the history of mankind that saves countless lives of animals and humans, but the effectiveness of antibiotics diminished through time led to the emergence and spread of multidrug-resistant microbes. 17 , 18 Several factors can be considered for the current rise in antimicrobial resistance in hospitals and communities. Indiscriminate use of antibiotics in human and veterinary medicine, lack of proper regulatory mechanisms, and a decline in novel antimicrobial discovery and poor sanitation practices are the major factors responsible for the widespread multidrug-resistant microbes.…”