Selection of resistance by antimicrobial coatings in the healthcare setting

Pietsch, Franziska; O’Neill, Alex J.; Ivask, Angela; Jenssen, Håvard; Inkinen, Jenni; Kahru, Anne; Ahonen, Merja; Schreiber, Frank

doi:10.1016/j.jhin.2020.06.006

Cited by 63 publications

(52 citation statements)

References 139 publications

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“…Interestingly, the team also found that the total abundance of MRGs (including sil genes) were highest in the SBRs treated with NAg, suggesting that the nanoparticle has the most potential for ARG co-selection compared to Ag + (Ma et al, 2016). There is also evidence to show that the formation of biofilms functions as a mechanism for co-selecting antibiotic and metal resistance (Baker-Austin et al, 2006;Pietsch et al, 2020). The EPS matrix of biofilms acts as a sequestering barrier to heavy metals and antibiotics, and alarmingly, studies have found that exposure of metals on biofilms can encourage EPS synthesis, improving the biofilms adhesive, structural, and protective integrity (Yang and Alvarez, 2015;Song et al, 2016).…”

Section: Silver and Other Metals As Drivers Of Antibiotic Resistancementioning

confidence: 99%

“…Silver nanoparticle has also been shown to promote the co-emergence of antibiotic resistance in bacteria (Ma et al, 2016;Chen et al, 2019b;Pietsch et al, 2020). A study by Ma et al (2016) found that treatment of waste water with NAg (and Ag + ) using lab-scale sequencing batch reactors (SBRs), resulted in an increased shift in various ARGs among isolated Burkholderia spp., Streptomyces spp., and Gemmatimonas spp.…”

Section: Silver and Other Metals As Drivers Of Antibiotic Resistancementioning

confidence: 99%

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Emerging Concern for Silver Nanoparticle Resistance in Acinetobacter baumannii and Other Bacteria

et al. 2021

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The misuse of antibiotics combined with a lack of newly developed ones is the main contributors to the current antibiotic resistance crisis. There is a dire need for new and alternative antibacterial options and nanotechnology could be a solution. Metal-based nanoparticles, particularly silver nanoparticles (NAg), have garnered widespread popularity due to their unique physicochemical properties and broad-spectrum antibacterial activity. Consequently, NAg has seen extensive incorporation in many types of products across the healthcare and consumer market. Despite clear evidence of the strong antibacterial efficacy of NAg, studies have raised concerns over the development of silver-resistant bacteria. Resistance to cationic silver (Ag+) has been recognised for many years, but it has recently been found that bacterial resistance to NAg is also possible. It is also understood that exposure of bacteria to toxic heavy metals like silver can induce the emergence of antibiotic resistance through the process of co-selection. Acinetobacter baumannii is a Gram-negative coccobacillus and opportunistic nosocomial bacterial pathogen. It was recently listed as the “number one” critical level priority pathogen because of the significant rise of antibiotic resistance in this species. NAg has proven bactericidal activity towards A. baumannii, even against strains that display multi-drug resistance. However, despite ample evidence of heavy metal (including silver; Ag+) resistance in this bacterium, combined with reports of heavy metal-driven co-selection of antibiotic resistance, little research has been dedicated to assessing the potential for NAg resistance development in A. baumannii. This is worrisome, as the increasingly indiscriminate use of NAg could promote the development of silver resistance in this species, like what has occurred with antibiotics.

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Section: Silver and Other Metals As Drivers Of Antibiotic Resistancementioning

confidence: 99%

Section: Silver and Other Metals As Drivers Of Antibiotic Resistancementioning

confidence: 99%

Emerging Concern for Silver Nanoparticle Resistance in Acinetobacter baumannii and Other Bacteria

et al. 2021

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“…However, the precise mechanism(s) leading to this increased survival could not be determined by proteomic and genomic analyses [70]. Upregulation of copper efflux systems such as Cus system in E. coli or transmission of plasmids harboring copper-resistance genes by Horizontal Gene Transfer (HGT) have been proposed to explain copper-tolerance in some strains [71]. Also, in A. baumannii, the presence of copRS in strains was recently linked with coppertolerance [72].…”

Section: Vegetative Formsmentioning

confidence: 99%

“…The likelihood of a widespread emergence of bacterial strains resistant to copper-induced contact killing and its possible contribution to overall antibiotic-resistance can be evaluated as low on the basis of the following considerations: (i) copper and copper alloys have been used for a very long time without enabling the rise of complete resistance to copper-induced contact killing, (ii) contact killing is a rapid process, especially in dry conditions, and does not leave bacterial cells the time to divide, and (iii) DNA damages, which are part of the contactkilling process, also target plasmidic DNA [16]. However, a point of concern is the possible contribution of these surfaces in the selection of strains already resistant to antibiotics and also carrying copper-tolerance/resistance genes through co-selection [71,73,74].…”

Section: Vegetative Formsmentioning

confidence: 99%

Brass Alloys: Copper-Bottomed Solutions against Hospital-Acquired Infections?

Dauvergne

Mullié

2021

Antibiotics

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Copper has been used for its antimicrobial properties since Antiquity. Nowadays, touch surfaces made of copper-based alloys such as brasses are used in healthcare settings in an attempt to reduce the bioburden and limit environmental transmission of nosocomial pathogens. After a brief history of brass uses, the various mechanisms that are thought to be at the basis of brass antimicrobial action will be described. Evidence shows that direct contact with the surface as well as cupric and cuprous ions arising from brass surfaces are instrumental in the antimicrobial effectiveness. These copper ions can lead to oxidative stress, membrane alterations, protein malfunctions, and/or DNA damages. Laboratory studies back up a broad spectrum of activity of brass surfaces on bacteria with the possible exception of bacteria in their sporulated form. Various parameters influencing the antimicrobial activity such as relative humidity, temperature, wet/dry inoculation or wear have been identified, making it mandatory to standardize antibacterial testing. Field trials using brass and copper surfaces consistently report reductions in the bacterial bioburden but, evidence is still sparse as to a significant impact on hospital acquired infections. Further work is also needed to assess the long-term effects of chemical/physical wear on their antimicrobial effectiveness.

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“…If a determinant for copper resistance, for example, was carried on a plasmid carrying multiple resistance genes specific for different classes of drug, a copper-containing antimicrobial surface has potential to drive the plasmid (and hence multidrug resistance) through a population. A recent article by Pietsch and colleagues [ 57 ] reviews studies that indicate a risk of antimicrobial surfaces promoting AMR and considers the evidence in the context of healthcare-related environments.…”

Section: The Potential Impact On Amrmentioning

confidence: 99%