The increase of antibiotic resistance (AR) is a global concern for patients with acute infections as well as chronic illnesses, such as cystic fibrosis. Few antibiotics are effective, in particular against Gram-negative bacteria, due to their inherent cell membrane impermeability and high number of efflux pumps. Consequently, there is a dire need for innovative strategies to understand the underlying causes of low drug uptake and high efflux in bacteria. Electrochemistry has attracted immense attention over the past decade, because its methods are cost efficient and sensitive. This presentation highlights bioelectrochemical approaches to recognize and quantify antibiotic resistance. Following the characterization of antibacterials, the monitoring of drug efflux, the detection of antibiotic resistance through cell metabolites and the measurement of drug retention in bacteria are possible strategies to quantify antibiotic resistance in pathogens. The presented research forms the basis for the future development of a point-of-care biosensor to identify antibiotic resistance in patient samples. Such technology would advance clinical treatment from the current trial-and-error approach to the prescription of evidence based personalized drug regimens and benefit patients around the world.
Antibiotic resistance has developed into one of the major threats to public health in the 21st century. Approximately 700,000 people around the world die each year as a consequence of drug-resistance in bacterial infections. If no action is taken, 10 million deaths due to drug-resistance are predicted by 2050. The permeability of the bacterial cell membrane is strongly connected to antibiotic resistance. A decrease in membrane permeability reduces antibiotic uptake and antibiotic efflux via efflux transporters is especially pronounced in Gram-negative bacteria Understanding membrane transport of antibiotics in bacteria is essential to identify new diagnostic and treatment strategies for antibiotic resistance. Pseudomonas aeruginosa is a Gram-negative anaerobic bacterium and is listed on the World Health Organization priority list. Commonly prescribed antibiotics to treat P. aeruginosa infections are ciprofloxacin (CIP) and tobramycin (TOB). However, P. aeruginosa often exhibit resistance to both compounds. The presented work investigates the transport of CIP and TOB across the P. aeruginosa cell membrane, employing electroanalytical methods, such as voltammetry and scanning electrochemical microscopy (SECM). Studying the influx and efflux mechanisms in P. aeruginosa will provide a quantitative measure for drug susceptibility.
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