Antibiotic Resistance: Present Knowledge and Future Challenges

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Antimicrobial Agents and Resistance".

Deadline for manuscript submissions: closed (15 April 2024) | Viewed by 10482

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Guest Editor
INIAV—National Institute for Agrarian and Veterinarian Research/cE3c—Centre for Ecology, Evolution and Environmental Changes, University of Lisbon, Lisbon, Portugal
Interests: microbial genomics; metagenomics; evolution; one health; antibiotic resistance
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Special Issue Information

Dear Colleagues,

Antibiotic resistance constitutes a worldwide problem that implicates humans, animals and environmental health and today it is among the greatest challenges for public health this century. The emergence and rapid spread of antibiotic resistance has significantly limited the effective prevention and treatment of various infections caused by bacteria, viruses, fungi and parasites. This phenomenon not only endangers human and animal health but also threatens to impose significant economic costs. Humans urgently need to take a variety of effective measures in order to control antibiotic resistance at the same time and rationally control the use of various antibiotics to minimize the occurrence and spread of antibiotic resistance, thereby prolonging the effective time of antibiotics, which remains a long-term challenge for human beings.

This Special Issue will focus on the most recent advances in the field of antibiotic resistance, including present knowledge and future challenges. The Issue will cover a variety of topics, such as the epidemiology and clinical implications of antibiotic resistance, the mechanisms underlying resistance development and antimicrobial therapy approaches.

Dr. Teresa Nogueira
Guest Editor

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Keywords

  • antibiotic resistance
  • bacterial tolerance to antibiotics
  • genomics
  • multidrug-resistant
  • bacterial infection

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Published Papers (5 papers)

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Research

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13 pages, 9832 KiB  
Article
Identification of a Novel KPC Variant, KPC-204, Conferring Resistance to Both Carbapenems and Ceftazidime–Avibactam in an ST11 Klebsiella pneumoniae Strain
by Yanqiao Gong, Yu Feng and Xiaoju Lv
Microorganisms 2024, 12(6), 1193; https://doi.org/10.3390/microorganisms12061193 - 13 Jun 2024
Viewed by 810
Abstract
This study describes KPC-204, a novel variant of Klebsiella pneumoniae carbapenemase, characterized by a Lys-Asp-Asp (KDD) amino acid insertion at Ambler position 269 deviates from KPC-2. This variant was identified in an ST11-type clinical isolate of carbapenem-resistant Klebsiella pneumoniae from China. Notably, KPC-204 [...] Read more.
This study describes KPC-204, a novel variant of Klebsiella pneumoniae carbapenemase, characterized by a Lys-Asp-Asp (KDD) amino acid insertion at Ambler position 269 deviates from KPC-2. This variant was identified in an ST11-type clinical isolate of carbapenem-resistant Klebsiella pneumoniae from China. Notably, KPC-204 exhibits resistance to both ceftazidime-avibactam and carbapenems. Genetic analysis revealed that blaKPC-204 was located on a highly mobile IncFII/IncR plasmid within a complex genetic structure that facilitates its spread. Functional analysis, achieved through cloning into E. coli DH5α, validates KPC-204’s contribution to increased resistance to ceftazidime-avibactam. The kinetic parameters showed that KPC-204 exhibited similar affinity to KPC-2 toward ceftazidime and reduced sensitivity to avibactam. Docking simulations revealed a weaker interaction between KPC-204 and avibactam compared to KPC-2. Mating experiments demonstrated the resistance’s transmissibility. This investigation underscores the evolving diversity of KPC variants affecting ceftazidime-avibactam resistance, highlighting the necessity for continuous monitoring. Full article
(This article belongs to the Special Issue Antibiotic Resistance: Present Knowledge and Future Challenges)
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14 pages, 3885 KiB  
Article
Characteristics, Performance and Microbial Response of Aerobic Granular Sludge for Treating Tetracycline Hypersaline Pharmaceutical Wastewater
by Bichen Lou, Zhonghui Yang, Shengyan Zheng, Dong Ou, Wanpeng Hu and Ning Ai
Microorganisms 2024, 12(6), 1173; https://doi.org/10.3390/microorganisms12061173 - 9 Jun 2024
Cited by 2 | Viewed by 1315
Abstract
Salt-tolerant aerobic granular sludge(AGS) was successfully cultivated under the dual stress of tetracycline and 2.5% salinity, resulting in an average particle size of 435.0 ± 0.5 and exhibiting a chemical oxygen demand(COD) removal rate exceeding 80%, as well as excellent sedimentation performance. The [...] Read more.
Salt-tolerant aerobic granular sludge(AGS) was successfully cultivated under the dual stress of tetracycline and 2.5% salinity, resulting in an average particle size of 435.0 ± 0.5 and exhibiting a chemical oxygen demand(COD) removal rate exceeding 80%, as well as excellent sedimentation performance. The analysis of metagenomics technology revealed a significant pattern of succession in the development of AGS. The proportion of Oleiagrimonas, a type of salt-tolerant bacteria, exhibited a gradual increase and reached 38.07% after 42 days, which indicated that an AGS system based on moderate halophilic bacteria was successfully constructed. The expression levels of targeted genes were found to be reduced across the entire AGS process and formation, as evidenced by qPCR analysis. The presence of int1 (7.67 log10 gene copies g−1 in 0 d sludge sample) enabled microbes to horizontally transfer ARGs genes along the AGS formation under the double pressure of TC and 2.5% salinity. These findings will enhance our understanding of ARG profiles and the development in AGS under tetracycline pressure, providing a foundation for guiding the use of AGS to treat hypersaline pharmaceutical wastewater. Full article
(This article belongs to the Special Issue Antibiotic Resistance: Present Knowledge and Future Challenges)
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19 pages, 5074 KiB  
Article
Freshwater and Marine Environments in California Are a Reservoir of Carbapenem-Resistant Bacteria
by Ashley McCarley, Manuel Luis Espejo, Dana E. Harmon and Cristian Ruiz
Microorganisms 2024, 12(4), 802; https://doi.org/10.3390/microorganisms12040802 - 16 Apr 2024
Cited by 2 | Viewed by 1101
Abstract
Carbapenems are last-resort antibiotics used to treat multidrug-resistant bacterial infections. Resistance to carbapenems has been designated as an urgent threat and is increasing in healthcare settings. However, little is still known about the distribution and characteristics of carbapenem-resistant bacteria (CRB) outside of healthcare [...] Read more.
Carbapenems are last-resort antibiotics used to treat multidrug-resistant bacterial infections. Resistance to carbapenems has been designated as an urgent threat and is increasing in healthcare settings. However, little is still known about the distribution and characteristics of carbapenem-resistant bacteria (CRB) outside of healthcare settings. Here, we surveyed the distribution of CRB in ten diverse freshwater and seawater environments in California, U.S., ranging from San Luis Obispo County to San Bernardino County, combining both direct isolation and enrichment approaches to increase the diversity of isolated CRB. From the locations surveyed, we selected 30 CRB for further characterization. These isolates were identified as members of the genera Aeromonas, Enterobacter, Enterococcus, Paenibacillus, Pseudomonas, Sphingobacterium, and Stenotrophomonas. These isolates were resistant to carbapenems, other β-lactams, and often to other antibiotics (tetracycline, gentamicin, or ciprofloxacin). We also found that nine isolates belonging to the genera Aeromonas, Enterobacter (blaIMI-2), and Stenotrophomonas (blaL1) produced carbapenemases. Overall, our findings indicate that sampling different types of aquatic environments and combining different isolation approaches increase the diversity of the environmental CRB obtained. Moreover, our study supports the increasingly recognized role of natural water systems as an underappreciated reservoir of bacteria resistant to carbapenems and other antibiotics, including bacteria carrying carbapenemase genes. Full article
(This article belongs to the Special Issue Antibiotic Resistance: Present Knowledge and Future Challenges)
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10 pages, 554 KiB  
Article
Supporting Clinical Decisions with Rapid Molecular Diagnostic Pneumonia Panel in Pediatric Intensive Care Unit: Single Center Experience in Turkiye
by Gurkan Bozan, Yalcin Kara, Eylem Kiral, Mahmut Can Kizil, Ebru Kacmaz, Tercan Us, Gul Durmaz, Omer Kilic and Ener Cagri Dinleyici
Microorganisms 2023, 11(10), 2391; https://doi.org/10.3390/microorganisms11102391 - 25 Sep 2023
Cited by 1 | Viewed by 1579
Abstract
Introduction: Lower respiratory tract infections are the leading cause of morbidity and mortality in children worldwide. It is crucial to promptly conduct diagnostic investigations in order to determine the microbiological cause of pneumonia, since this is necessary to ensure the appropriate delivery of [...] Read more.
Introduction: Lower respiratory tract infections are the leading cause of morbidity and mortality in children worldwide. It is crucial to promptly conduct diagnostic investigations in order to determine the microbiological cause of pneumonia, since this is necessary to ensure the appropriate delivery of antibiotic therapy to each individual patient. We evaluated the results of a rapid molecular diagnostic pneumonia panel in children with LRTI in a pediatric intensive care unit (PICU). Patients and Methods: Rapid molecular diagnostic pneumonia panel (BioFire®, FilmArray Pneumonia Panel plus; FA-PP) findings (71 results from 46 children) in a tertiary care PICU between 2019 and 2023 were retrospectively reviewed. Results: At least one bacterial pathogen was detected in 57 cases. A total of 77% of children had underlying conditions. A total of 70.4% of children needed invasive mechanical ventilation and 54.4% had ventilator-associated pneumonia. Pseudomonas aeruginosa (50.8%), Acinetobacter calcoaceticus baumannii complex (42%), and Klebsiella pneumoniae (38.6%) were the most common pathogens detected with the FA-PP. Of the 33 cases diagnosed with VAP, more than one pathogen was identified in 65.9% of cases, with the most commonly identified bacteria being K. pneumoniae (43.1%), P. aeruginosa (38.6%), and Acinetobacter calcoaceticus baumannii complex (31.8%). According to the FA-PP results, the same antibiotic therapy was continued in 39.4% of cases, escalated in 54.5%, and de-escalated in 6.1%. Conclusions: The utilization of the FA-PP has some beneficial effects, including more prompt delivery of findings compared to conventional approaches. Additionally, this approach enables the identification of resistance profiles in children diagnosed with pneumonia in the PICU. Consequently, these test results facilitate the organization of antibiotic treatment strategies, including escalation and de-escalation approaches. The detection of resistance patterns was exclusively determined via the implementation of molecular testing, prompting a reevaluation of the isolation technique in accordance with the obtained data. Full article
(This article belongs to the Special Issue Antibiotic Resistance: Present Knowledge and Future Challenges)
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9 pages, 641 KiB  
Opinion
Nanotechnology—A Light of Hope for Combating Antibiotic Resistance
by Ghazala Muteeb
Microorganisms 2023, 11(6), 1489; https://doi.org/10.3390/microorganisms11061489 - 3 Jun 2023
Cited by 25 | Viewed by 4962
Abstract
Antibiotic usage and resistance are major health concerns. Antibiotic resistance occurs when bacteria evolve to resist the effects of antibiotics, making it impossible to treat infections. The overuse and misuse of antibiotics are the main contributing factors, while environmental stress (such as heavy [...] Read more.
Antibiotic usage and resistance are major health concerns. Antibiotic resistance occurs when bacteria evolve to resist the effects of antibiotics, making it impossible to treat infections. The overuse and misuse of antibiotics are the main contributing factors, while environmental stress (such as heavy metals accumulation), unhygienic conditions, illiteracy, and unawareness also contribute to antibiotic resistance. The slow and costly development of new antibiotics has lagged behind the emergence of antibiotic-resistant bacteria, and the overuse of antibiotics leads to negative consequences. The current study used different literature resources to generate an opinion and find a possible solution to antibiotic barriers. Different scientific approaches have been reported to overcome antibiotic resistance. The most useful approach among these is nanotechnology. Nanoparticles can be engineered to disrupt bacterial cell walls or membranes, effectively eliminating resistant strains. Additionally, nanoscale devices enable the real-time monitoring of bacterial populations, allowing for the early detection of resistance emergence. Nanotechnology, along with evolutionary theory offers promising avenues in combating antibiotic resistance. Evolutionary theory helps us understand the mechanisms by which bacteria develop resistance, allowing us to anticipate and counteract their adaptive strategies. By studying the selective pressures that drive resistance, we can therefore design more effective interventions or traps. The synergy between the evolutionary theory and nanotechnology presents a powerful approach to combat antibiotic resistance, offering new avenues for the development of effective treatments and the preservation of our antibiotic arsenal. Full article
(This article belongs to the Special Issue Antibiotic Resistance: Present Knowledge and Future Challenges)
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