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Biomedicines
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Antibiotic Combination Therapy: A Strategy to Overcome Bacterial Resistance
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Antibiotic Combination Therapy: A Strategy to Overcome Bacterial Resistance

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Drug Discovery, Development and Delivery".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 13021

Special Issue Editor

Dr. Israa M.S. Al-Kadmy

E-Mail Website
Guest Editor
Faculty of Science & Engineering, University of Plymouth, Plymouth, UK
Interests: nanotechnology; antimicrobial resistance; molecular microbiology; enviromental mcrobiology; antibiotics resistance; biotechnology

Special Issue Information

Dear Colleagues,

The spread of antibiotic resistance has resulted in the increased interest in combination-based treatments. This has led to the development and spread of antibiotic resistance. Although this combination has been widely reported for its effects on bacterial growth, there is a lack of further studies that show the effect of antibiotics on long-term clearance. Additionally, it is important to discover new ways to reduce antimicrobial resistance. This Special Issue welcomes original research papers, reviews and short communications.

Dr. Israa M.S. Al-Kadmy
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Antimicrobial resistance
  • Spread of antibiotic resistance
  • MDR and XDR bacteria
  • Superbugs
  • Nanoparticules as antimicrobial
  • Nanoparticules as antifungal
  • Novel antimicrobials
  • Antimicrobial peptiides
  • Phage therapy to combat MDR bacteria
  • Qurum sensing
  • Natural antimicrobials

Published Papers (5 papers)

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Research

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16 pages, 2095 KiB  
Article
Sodium Alginate-Based MgO Nanoparticles Coupled Antibiotics as Safe and Effective Antimicrobial Candidates against Staphylococcus aureus of Houbara Bustard Birds
by Maheen Murtaza, Amjad Islam Aqib, Shanza Rauf Khan, Afshan Muneer, Muhammad Muddassir Ali, Ahmad Waseem, Tean Zaheer, Lamya Ahmed Al-Keridis, Nawaf Alshammari and Mohd Saeed
Biomedicines 2023, 11(7), 1959; https://doi.org/10.3390/biomedicines11071959 - 11 Jul 2023
Cited by 2 | Viewed by 1255
Abstract
Alternative and modified therapeutic approaches are key elements in culminating antibiotic resistance. To this end, an experimental trial was conducted to determine the cytotoxicity and antibacterial potential of composites of magnesium oxide (MgO) nanoparticles and antibiotics stabilized in sodium alginate gel against multi-drug-resistant [...] Read more.
Alternative and modified therapeutic approaches are key elements in culminating antibiotic resistance. To this end, an experimental trial was conducted to determine the cytotoxicity and antibacterial potential of composites of magnesium oxide (MgO) nanoparticles and antibiotics stabilized in sodium alginate gel against multi-drug-resistant Staphylococcus aureus isolated from a houbara bustard. The characterization of preparations was carried out using X-ray diffraction (XRD), scanning transmissible electron microscopy (STEM), and Fourier-transform infrared spectroscopy (FTIR). The preparations used in this trial consisted of gel-stabilized MgO nanoparticles (MG), gel-stabilized tylosin (GT), gel-stabilized ampicillin (GA), gel-stabilized cefoxitin (GC), gel-stabilized MgO and tylosin (GMT), gel-stabilized MgO and cefoxitin (GMC), and gel-stabilized MgO and ampicillin (GMA). The study presents composites that cause a lesser extent of damage to DNA while significantly enhancing mitotic indices/phases compared to the other single component preparations with respect to the positive control (methyl methanesulphonate). It was also noted that there was a non-significant difference (p > 0.05) between the concentrations of composites and the negative control in the toxicity trial. Studying in parallel trials showed an increased prevalence, potential risk factors, and antibiotic resistance in S. aureus. The composites in a well diffusion trial showed the highest percentage increase in the zone of inhibition in the case of GT (58.42%), followed by GMT (46.15%), GC (40.65%), GMC (40%), GMA (28.72%), and GA (21.75%) compared to the antibiotics alone. A broth microdilution assay showed the lowest minimum inhibitory concentration (MIC) in the case of GMA (9.766 ± 00 µg/mL), followed by that of GT (13.02 ± 5.64 µg/mL), GMC (19.53 ± 0.00 µg/mL), GA (26.04 ± 11.28 µg/mL), GMT (26.04 ± 11.28 µg/mL), MG (39.06 ± 0.00 µg/mL), and GC (39.06 ± 0.00 µg/mL). The study thus concludes the effective tackling of multiple-drug-resistant S. aureus with sodium-alginate-stabilized MgO nanoparticles and antibiotics, whereas toxicity proved to be negligible for these composites. Full article
(This article belongs to the Special Issue Antibiotic Combination Therapy: A Strategy to Overcome Bacterial Resistance)
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Review

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22 pages, 4983 KiB  
Review
Extended-Spectrum β-Lactamases (ESBL): Challenges and Opportunities
by Asmaul Husna, Md. Masudur Rahman, A. T. M. Badruzzaman, Mahmudul Hasan Sikder, Mohammad Rafiqul Islam, Md. Tanvir Rahman, Jahangir Alam and Hossam M. Ashour
Biomedicines 2023, 11(11), 2937; https://doi.org/10.3390/biomedicines11112937 - 30 Oct 2023
Cited by 3 | Viewed by 4058
Abstract
The rise of antimicrobial resistance, particularly from extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E), poses a significant global health challenge as it frequently causes the failure of empirical antibiotic therapy, leading to morbidity and mortality. The E. coli- and K. pneumoniae-derived CTX-M genotype [...] Read more.
The rise of antimicrobial resistance, particularly from extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E), poses a significant global health challenge as it frequently causes the failure of empirical antibiotic therapy, leading to morbidity and mortality. The E. coli- and K. pneumoniae-derived CTX-M genotype is one of the major types of ESBL. Mobile genetic elements (MGEs) are involved in spreading ESBL genes among the bacterial population. Due to the rapidly evolving nature of ESBL-E, there is a lack of specific standard examination methods. Carbapenem has been considered the drug of first choice against ESBL-E. However, carbapenem-sparing strategies and alternative treatment options are needed due to the emergence of carbapenem resistance. In South Asian countries, the irrational use of antibiotics might have played a significant role in aggravating the problem of ESBL-induced AMR. Superbugs showing resistance to last-resort antibiotics carbapenem and colistin have been reported in South Asian regions, indicating a future bleak picture if no urgent action is taken. To counteract the crisis, we need rapid diagnostic tools along with efficient treatment options. Detailed studies on ESBL and the implementation of the One Health approach including systematic surveillance across the public and animal health sectors are strongly recommended. This review provides an overview of the background, associated risk factors, transmission, and therapy of ESBL with a focus on the current situation and future threat in the developing countries of the South Asian region and beyond. Full article
(This article belongs to the Special Issue Antibiotic Combination Therapy: A Strategy to Overcome Bacterial Resistance)
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20 pages, 1852 KiB  
Review
Phage Therapy, a Salvage Treatment for Multidrug-Resistant Bacteria Causing Infective Endocarditis
by Helal F. Hetta, Zainab I. Rashed, Yasmin N. Ramadan, Israa M. S. Al-Kadmy, Soheir M. Kassem, Hesham S. Ata and Wedad M. Nageeb
Biomedicines 2023, 11(10), 2860; https://doi.org/10.3390/biomedicines11102860 - 22 Oct 2023
Cited by 2 | Viewed by 2504
Abstract
Infective endocarditis (IE) is defined as an infection of the endocardium, or inner surface of the heart, most frequently affecting the heart valves or implanted cardiac devices. Despite its rarity, it has a high rate of morbidity and mortality. IE generally occurs when [...] Read more.
Infective endocarditis (IE) is defined as an infection of the endocardium, or inner surface of the heart, most frequently affecting the heart valves or implanted cardiac devices. Despite its rarity, it has a high rate of morbidity and mortality. IE generally occurs when bacteria, fungi, or other germs from another part of the body, such as the mouth, spread through the bloodstream and attach to damaged areas in the heart. The epidemiology of IE has changed as a consequence of aging and the usage of implantable cardiac devices and heart valves. The right therapeutic routes must be assessed to lower complication and fatality rates, so this requires early clinical suspicion and a fast diagnosis. It is urgently necessary to create new and efficient medicines to combat multidrug-resistant bacterial (MDR) infections because of the increasing threat of antibiotic resistance on a worldwide scale. MDR bacteria that cause IE can be treated using phages rather than antibiotics to combat MDR bacterial strains. This review will illustrate how phage therapy began and how it is considered a powerful potential candidate for the treatment of MDR bacteria that cause IE. Furthermore, it gives a brief about all reported clinical trials that demonstrated the promising effect of phage therapy in combating resistant bacterial strains that cause IE and how it will become a hope in future medicine. Full article
(This article belongs to the Special Issue Antibiotic Combination Therapy: A Strategy to Overcome Bacterial Resistance)
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30 pages, 1816 KiB  
Review
Potential of Selected African Medicinal Plants as Alternative Therapeutics against Multi-Drug-Resistant Bacteria
by Bertha N. Moiketsi, Katlego P. P. Makale, Gaolathe Rantong, Teddie O. Rahube and Abdullah Makhzoum
Biomedicines 2023, 11(10), 2605; https://doi.org/10.3390/biomedicines11102605 - 22 Sep 2023
Cited by 2 | Viewed by 1956
Abstract
Antimicrobial resistance is considered a “One-Health” problem, impacting humans, animals, and the environment. The problem of the rapid development and spread of bacteria resistant to multiple antibiotics is a rising global health threat affecting both rich and poor nations. Low- and middle-income countries [...] Read more.
Antimicrobial resistance is considered a “One-Health” problem, impacting humans, animals, and the environment. The problem of the rapid development and spread of bacteria resistant to multiple antibiotics is a rising global health threat affecting both rich and poor nations. Low- and middle-income countries are at highest risk, in part due to the lack of innovative research on the surveillance and discovery of novel therapeutic options. Fast and effective drug discovery is crucial towards combatting antimicrobial resistance and reducing the burden of infectious diseases. African medicinal plants have been used for millennia in folk medicine to cure many diseases and ailments. Over 10% of the Southern African vegetation is applied in traditional medicine, with over 15 species being partially or fully commercialized. These include the genera Euclea, Ficus, Aloe, Lippia. And Artemisia, amongst many others. Bioactive compounds from indigenous medicinal plants, alone or in combination with existing antimicrobials, offer promising solutions towards overcoming multi-drug resistance. Secondary metabolites have different mechanisms and modes of action against bacteria, such as the inhibition and disruption of cell wall synthesis; inhibition of DNA replication and ATP synthesis; inhibition of quorum sensing; inhibition of AHL or oligopeptide signal generation, broadcasting, and reception; inhibition of the formation of biofilm; disruption of pathogenicity activities; and generation of reactive oxygen species. The aim of this review is to highlight some promising traditional medicinal plants found in Africa and provide insights into their secondary metabolites as alternative options in antibiotic therapy against multi-drug-resistant bacteria. Additionally, synergism between plant secondary metabolites and antibiotics has been discussed. Full article
(This article belongs to the Special Issue Antibiotic Combination Therapy: A Strategy to Overcome Bacterial Resistance)
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19 pages, 1032 KiB  
Review
Mechanisms of Antibiotic and Biocide Resistance That Contribute to Pseudomonas aeruginosa Persistence in the Hospital Environment
by Cláudia Verdial, Isa Serrano, Luís Tavares, Solange Gil and Manuela Oliveira
Biomedicines 2023, 11(4), 1221; https://doi.org/10.3390/biomedicines11041221 - 19 Apr 2023
Cited by 9 | Viewed by 2380
Abstract
Pseudomonas aeruginosa is an opportunistic bacterial pathogen responsible for multiple hospital- and community-acquired infections, both in human and veterinary medicine. P. aeruginosa persistence in clinical settings is worrisome and is a result of its remarkable flexibility and adaptability. This species exhibits several characteristics [...] Read more.
Pseudomonas aeruginosa is an opportunistic bacterial pathogen responsible for multiple hospital- and community-acquired infections, both in human and veterinary medicine. P. aeruginosa persistence in clinical settings is worrisome and is a result of its remarkable flexibility and adaptability. This species exhibits several characteristics that allow it to thrive under different environmental conditions, including the ability to colonize inert materials such as medical equipment and hospital surfaces. P. aeruginosa presents several intrinsic mechanisms of defense that allow it to survive external aggressions, but it is also able to develop strategies and evolve into multiple phenotypes to persevere, which include antimicrobial-tolerant strains, persister cells, and biofilms. Currently, these emergent pathogenic strains are a worldwide problem and a major concern. Biocides are frequently used as a complementary/combination strategy to control the dissemination of P. aeruginosa-resistant strains; however, tolerance to commonly used biocides has also already been reported, representing an impediment to the effective elimination of this important pathogen from clinical settings. This review focuses on the characteristics of P. aeruginosa responsible for its persistence in hospital environments, including those associated with its antibiotic and biocide resistance ability. Full article
(This article belongs to the Special Issue Antibiotic Combination Therapy: A Strategy to Overcome Bacterial Resistance)
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