The potential impact of coinfection on antimicrobial chemotherapy and drug resistance

Abstract

Across a range of pathogens, resistance to chemotherapy is a growing problem in both public health and animal health. Despite the ubiquity of coinfection, and its potential effects on within-host biology, the role played by coinfecting pathogens on the evolution of resistance and efficacy of antimicrobial chemotherapy is rarely considered. In this review, we provide an overview of the mechanisms of interaction of coinfecting pathogens, ranging from immune modulation and resource modulation, to drug interactions. We discuss their potential implications for the evolution of resistance, providing evidence in the rare cases where it is available. Overall, our review indicates that the impact of coinfection has the potential to be considerable, suggesting that this should be taken into account when designing antimicrobial drug treatments.

Clinical potential of engineered cationic antimicrobial peptides against drug resistant biofilms

“…The majority of nosocomial infections are caused by biofilm colonization of medical implants, for which removal of the colonized implant is often the only effective treatment[3]. Additionally, biofilms are often polymicrobial[4], making treatment more complex as well as possibly further modulating antimicrobial susceptibility[5]. …”

“…Furthermore, AMPs have been shown to neutralize fungi, parasites, and even viruses[10], potentially also via membrane interactions. Polymicrobial infections can modulate antimicrobial resistance[5], and viral bacterial co-infections of the respiratory tract have been shown to increase bacterial resistance to frontline traditional antibiotics[20]. However, we have recently used eCAPs to concurrently disrupt extraordinarily resistant Pseudomonas aeruginosa biofilms and inactivate respiratory syncytial virus[13], revealing the potential for eCAPs to simultaneously treat infections with pathogens from multiple kingdoms even when the infection displays synergistic antimicrobial resistance.…”

Biology and management of methicillin resistantStaphylococcus aureusin cystic fibrosis

“…Therefore, any bacterial growth mode associated with decreased growth and metabolic activity will decrease effectiveness of antibiotics . Further, interactions between different pathogens in the lung may influence antibiotic susceptibility . Such factors may explain lower response rates to therapy of chronic MRSA and relapsing symptoms shortly after therapy as occurs in some patients.…”

Identification of Broad‐Spectrum Dengue/Zika Virus Replication Inhibitors by Functionalization of Quinoline and 2,6‐Diaminopurine Scaffolds

“…BSAs may allow the immediate initiation of a prophylactic or therapeutic treatment in an outbreak setting of unknown, yet suspected, etiology for which a specific antiviral drug is still unavailable. In addition, BSAs may offer better treatment options for multi‐species co‐infections, which is one of the greatest challenges to global health, creating confusion and delay in diagnosis and treatment, and leading to additive or synergistic morbidities . Co‐infection with arboviruses (e.g., DENV, ZIKV, chikungunya virus) co‐circulating within the same vector creates significant difficulties in diagnosing, controlling, and treating infected individuals and leads to complicated immune responses toward other viruses or host proteins (Guillain–Barré syndrome) …”