Abstract:
The emergence of antimicrobial resistance raises the fear of untreatable diseases. Antimicrobial resistance is a multifaceted and dynamic phenomenon that is the cumulative result of different factors. While Gram-positive pathogens, such as methicillin-resistant Staphylococcus aureus and Clostridium difficile, were previously the most concerning issues in the field of public health, Gram-negative pathogens are now of prime importance. The World Health Organization\'s priority list of pathogens mostly includes multidrug-resistant Gram-negative organisms particularly carbapenem-resistant Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa, and extensively drug-resistant Acinetobacter baumannii. The spread of Gram-negative bacterial resistance is a global issue, involving a variety of mechanisms. Several strategies have been proposed to control resistant Gram-negative bacteria, such as the development of antimicrobial auxiliary agents and research into chemical compounds with new modes of action. Another emerging trend is the development of naturally derived antibacterial compounds that aim for targets novel areas, including engineered bacteriophages, probiotics, metal-based antibacterial agents, odilorhabdins, quorum sensing inhibitors, and microbiome-modifying agents. This review focuses on the current status of alternative treatment regimens against multidrug-resistant Gram-negative bacteria, aiming to provide a snapshot of the situation and some information on the broader context.
摘要:
抗菌素耐药性的出现增加了对无法治愈的疾病的恐惧。抗菌素耐药性是一个多方面的动态现象,是不同因素的累积结果。而革兰氏阳性病原体,如耐甲氧西林金黄色葡萄球菌和艰难梭菌,以前是公共卫生领域最令人担忧的问题,革兰氏阴性病原体现在是最重要的。世界卫生组织的病原体优先清单主要包括耐多药革兰氏阴性菌,特别是耐碳青霉烯类肠杆菌,耐碳青霉烯类铜绿假单胞菌,和广泛耐药的鲍曼不动杆菌。革兰氏阴性细菌耐药性的传播是一个全球性问题,涉及多种机制。已经提出了几种策略来控制耐药革兰氏阴性菌,例如开发抗菌助剂和研究具有新作用模式的化合物。另一个新兴趋势是开发天然来源的抗菌化合物,旨在针对新领域,包括工程噬菌体,益生菌,金属基抗菌剂,地利兰,群体感应抑制剂,和微生物组修饰剂。这篇综述的重点是针对多药耐药革兰氏阴性菌的替代治疗方案的现状。旨在提供情况的快照和更广泛背景的一些信息。