Nisin resistance in Gram-positive bacteria and approaches to circumvent resistance for successful therapeutic use

Abstract

Antibiotic resistance among bacterial pathogens is one of the most worrying problems in health systems today. To solve this problem, bacteriocins from lactic acid bacteria, especially nisin, have been proposed as an alternative for controlling multidrug-resistant bacteria. Bacteriocins are antimicrobial peptides that have activity mainly against Gram-positive strains. Nisin is one of the most studied bacteriocins and is already approved for use in food preservation. Nisin is still not approved for human clinical use, but many in vitro studies have shown its therapeutic effectiveness, especially for the control of antibiotic-resistant strains. Results from in vitro studies show the emergence of nisin-resistant bacteria after exposure to nisin. Considering that nisin has shown promising results for clinical use, studies to elucidate nisin-resistant mechanisms and the development of approaches to circumvent nisin-resistance are important. Thus, the objectives of this review are to identify the Gram-positive bacterial strains that have shown resistance to nisin, describe their resistance mechanisms and propose ways to overcome the development of nisin-resistance for its successful clinical application.

Keywords:

• Staphylococcus aureus
• Listeria monocytogenes
• bioengineering
• combination therapy
• bacteriocins

Acknowledgments

The authors would like to thank Conselho de Desenvolvimento Cientıfico e Tecnologico (CNPq), Brasılia, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasılia, Brazil; and Fundação de Apoio a Pesquisa e a Inovação Tecnologica do Estado de Sergipe (FAPITEC), Sergipe, Brazil, for providing fellowships and financial support to the research on bacteriocins, essential oils, and antibiotic-resistant pathogens in our laboratory.

Disclosure statement

No potential conflict of interest was reported by the author(s).