Investigating forthcoming strategies to tackle deadly superbugs: current status and future vision

ABSTRACT

Introduction

Superbugs are microorganisms that cause disease and have increased resistance to the treatments typically used against infections. Recently, antibiotic resistance development has been more rapid than the pace at which antibiotics are manufactured, leading to refractory infections. Scientists are concerned that a particularly virulent and lethal ‘superbug’ will one day join the ranks of existing bacteria that cause incurable diseases, resulting in a global health disaster on the scale of the Black Death.

Areas covered

This study highlights the current developments in the management of antibiotic-resistant bacteria and recommends strategies for further regulating antibiotic-resistant microorganisms associated with the healthcare system. This review also addresses the origins, prevalence, and pathogenicity of superbugs, and the design of antibacterial against these growing multidrug-resistant organisms from a medical perspective.

Expert opinion

It is recommended that antimicrobial resistance should be addressed by limiting human-to-human transmission of resistant strains, lowering the use of broad-spectrum antibiotics, and developing novel antimicrobials. Using the risk-factor domains framework from this study would assure that not only clinical but also community and hospital-specific factors are covered, lowering the chance of confounders. Extensive subjective research is necessary to fully understand the underlying factors and uncover previously unexplored areas.

KEYWORDS:

• Superbugs
• antibiotic resistance
• priority pathogens
• prevalence
• antibiotic development

Article highlights

• Highlights the current innovations to control antibiotic-resistant bacteria.

• Suggests ways to control antibiotic-resistant bacteria associated with the healthcare system.

• Discusses the origin, prevalence, and pathogenicity of superbugs.

• From a medical standpoint, this study also discusses the development of antibacterials against these growing multidrug-resistant pathogens.

Abbreviations

ABSSSIs, acute bacterial skin and skin structure infections AMP, Antimicrobial peptideAMR, Antimicrobial resistanceARG, antibiotic resistance geneARMs, antibiotic-resistant microorganismsARTI, acute respiratory tract infectionATP, adenosine triphosphateAu-NCs, gold nanoclustersAu-NPs, gold nanoparticlesBDS, Bachelor of Dental SurgeryBLIs, β-lactamase inhibitorsBSM, Bensulfuron-methyl CA-MRSA, community-associated MRSACCCP, carbonyl cyanide m-chlorophenylhydrazoneCDC, Centers for Disease Control and PreventionCDI, Clostridium difficile infectionCDs, cyclodextrinsCFR, chloramphenicol–florfenicol resistanceCPEs, carbapenemase-producing EnterobacteriaceaeCRAB, Carbapenem-resistant A. baumanniiCREs, carbapenem-resistant EnterobacteralesDALYs, disability-adjusted life yearsDCT, double-carbapenem therapyDNA, Deoxyribonucleic acidEOs, essential oilEPI, Efflux pump inhibitorESAPAR, European Strategic Action Plan on Antibiotic ResistanceESBL, extended-spectrum β-lactamase ESKAPE, Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and EnterobacterFAMHP, Federal Agency for Medicines and Health ProductsFDA, Food and Drug AdministrationFMT, Fecal microbiota transplantationFQs, FluoroquinolonesGRAS, Generally Recognized as SafeHA-MRSA, Hospital- or healthcare-associated MRSAHIV, human immumodeficiency virusIDSA, Infectious Diseases Society of AmericaIF-2, translation initiation factor 2IMP, imipenemaseKPC, K. pneumoniae carbapenemaseMBLs, metallo-β-lactamases MDR, multidrug-resistant MDS, Master of Dental SurgeryMIC, minimum inhibitory concentrationMOSs, Mannan-oligosaccharides MRSA, Methicillin-resistant S. aureusMSSA, methicillin-susceptible S. aureusNDM-1, New Delhi metallo-β-lactamase-1NMP, 1-(1-naphthylmethyl)-piperazine NTCD, Nontoxigenic Clostridium difficileOATs, Organic anion transportersOXA, oxacillinasePAN, phenyl arginine-napthalmide PC, phosphatidylcholinePD, PharmacodynamicP-gp, P-glycoproteinPK, PharmacokineticPrAMPs, proline-rich AMPsR&D, research and developmentREMS, Risk Evaluation and Mitigation StrategyRNA, Ribonucleic acidROS, reactive oxygen speciesSEA, South-East AsiaSNP, Single nucleotide polymorphismsSSSIs, skin structure infectionsTATFAR, Transatlantic Taskforce on Antimicrobial ResistanceTB, tuberculosisTMP-SMX, trimethoprim-sulfamethoxazole UK, United KingdomURAT1, urate transporter 1US, United StatesUTIs, urinary tract infectionsVIM, Verona integrin-encoded MBLVRE, vancomycin-resistant enterococciVRSA, vancomycin-resistant Staphylococcus aureusWHO, World Health OrganizationXDR, extensively-drug-resistant XOSs, xylo-oligosaccharides

Author contributions

Conceptualization, S.M. and T.B.E.; validation, S.M., F.I., R.D., F.N., S.S., K.C., F.A.A., T.B.E., and J.S-G.; formal analysis, S.M., S.A.S., S.R.P., T.M.U., K.C., F.A.A., and T.B.E.; investigation, S.M., S.A.S., S.R.P., and T.B.E.; resources, S.M., S.R.P., and S.A.S.; data curation, S.M. and S.A.S.; writing—original draft preparation, S.M., S.A.S., S.R.P., and T.M.U.; writing—review and editing, S.M., F.N., and J.S-G.; visualization, F.I., and T.B.E.; supervision, T.B.E. and J.S-G.; and project administration, T.B.E. and J.S-G.; funding acquisition, T.B.E. and J.S-G. All authors have read and agreed to the published version of the manuscript.

Data Availability Statement

Available data are presented in the manuscript.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or mending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

Funding for open access charge: Universidade de Vigo/CISUG.