Recent Strategies to Combat Multidrug Resistance

Microbial Biofilms: Applications, Clinical Consequences, and Alternative Therapies

“…According to the WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS 2022) report, about 4.95 million deaths were associated with AMR (antimicrobial resistance) in 2019, and AMR may involve up to 3.8% of the GDP (GLASS, 2022). Multidrug resistance is increasing and presents itself as a major global threat to the life of all plants and animals, including humans [ 119 ]. MDR naturally develops in pathogenic agents in order to enhance their fitness and aid in survival, and it is increasing at a tremendous pace [ 119 ].…”

“…Multidrug resistance is increasing and presents itself as a major global threat to the life of all plants and animals, including humans [ 119 ]. MDR naturally develops in pathogenic agents in order to enhance their fitness and aid in survival, and it is increasing at a tremendous pace [ 119 ]. Besides the exploitation and misuse of antimicrobials, which is the primary driver, the World Health Organisation (WHO) identifies a lack of cleanliness and sanitation, no proper access to clean water, and a lack of disease control and prevention as contributors to the increasing levels of antimicrobial resistance and tolerance [ 120 ].…”

“…Besides the exploitation and misuse of antimicrobials, which is the primary driver, the World Health Organisation (WHO) identifies a lack of cleanliness and sanitation, no proper access to clean water, and a lack of disease control and prevention as contributors to the increasing levels of antimicrobial resistance and tolerance [ 120 ]. The enormous spread of resistance traits has resulted in a loss of effectiveness of antibiotics and other antimicrobials [ 119 ]. Plasmids are found to be the culprits in the spread of resistance traits against last-resort antibiotics as they aid in horizontal gene transfer for evolution [ 121 ].…”

“…It can be used synergistically with other methods for immunocompromised patients, where the immune system does not possess enough capability to remove the pathogenic bacteria at all. It is known that the QS system is responsible for the expression of virulence factors; hence, inhibiting the quorum sensing can prevent the expression of several genes that are involved in biofilm production [ 119 , 163 ]. To interrupt the biofilm formation, quorum quenching enzymes or quorum sensing inhibitors can be utilised.…”

“…They function by decreasing the activity of AHL synthase, inactivating the AHL molecules, or activating them and creating antagonists that can compete with signal molecules [ 164 ]. Different steps of biofilm formation can be targeted using various approaches, such as decreasing the QS signalling, and preventing the synthesis of EPS by blocking e-DNA, protein, and polysaccharide formation [ 119 ]. Several plant-derived substances, such as sulphur-containing compounds, monoterpenes and terpenoids, phenylpropanoids, benzoic acid derivatives, diarylheptanoids, coumarin, flavonoids, and tannins, have proven QS-inhibiting properties.…”