Recent Advances in Strategies to Combat Bacterial Drug Resistance: Antimicrobial Materials and Drug Delivery Systems
Bacterial infection is a common clinical disease. Antibiotics have saved countless lives since their discovery and are a powerful weapon in the fight against bacteria. However, with the widespread use of antibiotics, the problem of drug resistance now poses a great threat to human health. In recent years, studies have investigated approaches to combat bacterial resistance. Several antimicrobial materials and drug delivery systems have emerged as promising strategies. Nano-drug delivery systems for antibiotics can reduce the resistance to antibiotics and extend the lifespan of novel antibiotics, and they allow targeting drug delivery compared to conventional antibiotics.
This review highlights the mechanistic insights of using different strategies to combat drug-resistant bacteria and summarizes the recent advancements in antimicrobial materials and drug delivery systems for different carriers. Furthermore, the fundamental properties of combating antimicrobial resistance are discussed, and the current challenges and future perspectives in this field are proposed.
Bacterial infection is a common clinical disease that can affect a number of organs and tissues in the human body. Antibiotics are used clinically to combat pathogenic bacteria, which in turn have gradually developed resistance to more antibiotics. Simultaneously, vancomycin, polymyxin, and other antibiotics known as the “last line of defense” have also produced multidrug-resistant (MDR) bacteria. The accumulation of bacterial genetic mutations will lead to the emergence of “superbugs” and superbug infections that are almost incurable. This has made the treatment of clinical trauma infections extremely difficult, and scientists have speculated that mankind will soon enter the “post-antibiotic era” in response to the current situation.
Medical researchers have pointed out that about 50% of the world’s antibiotics are misused each year, and over 80,000 people in China currently die indirectly or directly from antibiotic misuse in China each year. The new Global Antimicrobial Resistance Surveillance System (GLASS) of the World Health Organization (WHO) has revealed widespread antibiotic resistance among 500,000 suspected bacterial infections in 22 countries. In 2017, the WHO released the 12 most resistant “superbugs” that pose the greatest threat to human health, including carbapenem-resistant Acinetobacter baumannii (A. baumannii), Pseudomonas aeruginosa (P. aeruginosa), and Escherichia coli (E. coli), which are classified as “urgent” level and had the highest urgency for new antibiotics. For example, P. aeruginosa displays an exceptional level of resistance to antibiotics and has the remarkable ability to develop antibiotic resistance in hospitalized patients.
The number of deaths directly caused by antibiotic resistance in 2019 is equal to the number of deaths caused by AIDS and malaria combined, and antibiotic resistance-related deaths are the third leading cause of death globally after ischemic heart disease and stroke. According to a recent survey by the Centers for Disease Control and Prevention (CDC), antibiotic resistance causes millions of infections around the world each year. The study estimated that by 2050, 10 million people worldwide each year will die due to bacterial resistance; this equates to one death every three seconds, which is higher than the current number of deaths from cancer.
Over the course of the global fight against the COVID-19 pandemic, there were increasing reports of bacterial infections that may have been common or secondary to respiratory infections in patients with COVID-19. In recent years, bacteria and other organisms have been detected in the microenvironment of various tumors, and studies have found that these bacteria are actually the “accomplices” of the tumors. It was found that most solid tumors, including breast cancer, lung cancer, melanoma, and pancreatic cancer, contain bacteria, mostly tumor-specific intracellular bacteria. Cai’s team at Westlake University reported that a variety of unique “intracellular bacteria” present in breast cancer tissues played an important role in the metastatic colonization process.
Bacteria have been constantly invading people, which means that we are facing a public health crisis of unimaginable proportions, and there is an urgent need for researchers to investigate new strategies and fight antimicrobial resistance (AMR) with new agents with lower drug resistance. In this review, we summarize the types of traditional antibiotics and their mechanisms of action and resistance.
As conventional antibiotics are commonly used clinically and have been summarized in the relevant literature, we provide a brief overview of conventional antibiotics and instead focus on various other strategies to combat drug-resistant bacteria. In particular, strategies to combat the pressing bacterial resistance problem, including various antimicrobial materials and different drug delivery systems, are summarized and highlighted. Finally, we discuss the potential challenges of bacterial drug resistance and explore the development trends.
In 1928, British bacteriologist Alexander Fleming stumbled upon penicillin, the first antibiotic to be discovered by humans. This discovery led to a revolution in the medical world, and humans were no longer helpless in the face of bacterial infections. Subsequently, antibiotics, representing natural and chemically synthesized entities, have become powerful tools in the fight against infectious diseases. Antibiotics are commonly used in the treatment and prevention of infections and are classified according to their chemical structure.
Antibiotics have saved countless lives since their discovery, making them a powerful weapon in the fight against bacteria. However, antibiotics are not omnipotent. With the widespread use of antibiotics, the problem of drug resistance has gradually become serious. Antibiotic resistance mechanisms are generated corresponding to their mechanism of action. The mechanisms of action and resistance of different types of antibiotics are summarized in the following sections.
Antibiotic-mediated cell death is a complex process that involves physical interactions between drug molecules and specific targets in bacteria and thus alters the state at the biochemical, molecular, and ultrastructural levels in the affected bacteria. The mechanisms of action mainly include inhibition of the bacterial cell wall, protein, and nucleic acid synthesis; changes to the cell membrane permeability; and inhibition of bacterial metabolic pathways.
Inhibition of bacterial cell wall synthesis is the main action mechanism of β-lactam and glycopeptide antibiotics. The β-lactam antibiotics work by binding through the β-lactam ring to the bacterial penicillin-binding protein (PBP), which acts to synthesize and remodel bacterial peptidoglycans, thus inhibiting the transpeptidation effect. The mechanism of action of vancomycin, a representative drug of glycopeptide antibiotics, is to form a hydrogen bond compound with the terminal dipeptide D-alanine-D-alanine region of the precursor lipid II of the peptidoglycan chain of the bacterial cell wall, interfering with the peptidoglycan layer maturation process and thereby preventing cell wall synthesis.
Medications that have been suggested by doctors worldwide are available on the link below
https://mygenericpharmacy.com/category/antibiotics