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Antimicrobial Resistance: Tackling This Pressing Global Health Challenge

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (30 September 2020) | Viewed by 20011

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Guest Editor
Egas Moniz School of Health and Science, Caparica, Portugal
Interests: antimicrobial resistance; bacterial biofilms; antimicrobial susceptibility testing; strategies to fight multidrug-resistant isolates
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Special Issue Information

Dear colleagues,

Everyone recognizes the crucial role microbiology plays in our society. One of the biggest global issues that is putting modern medicine at stake and threating global health, food security, and development today is antimicrobial resistance. The emergence of ‘superbugs’ harboring multidrug resistance is spurring the research, discovery, and development of new antibiotics and/or strategies, which are urgently needed. It is paramount to address fundamental gaps in basic scientific research that are hampering new antimicrobial drug discovery. On that basis, the research in this field advances in a variety of approaches, including bacteriophage therapy, fecal microbiota transplantation, antimicrobial peptides (AMPs), immunotherapies, quorum sensing inhibitors, and nanotechnology. At the same time, attention must be given to the traditional screening of new molecules from natural products. Other strategies to tackle the problem of antibiotic resistance include i) the combination of antibiotics with different modes of action or the combination of antibiotics with non-antibiotic compounds that can restore the activity of existing antibiotics and ii) targeting biofilm formation mechanisms and developing antibiofilm agents. Papers addressing these topics are welcome in this Special Issue, especially those providing innovative approaches for new solutions to combat antimicrobial resistance. New research papers, reviews, case reports, methodological papers, and brief reports are invited.

Dr. Lucinda J. Bessa
Guest Editor

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Keywords

  • Antimicrobial resistance
  • Multidrug-resistant clinical and environmental isolates
  • Mechanisms of antibiotic resistance
  • Environmental microbiology
  • Bacterial biofilms
  • Infection control
  • Antimicrobial peptides
  • Antimicrobial nanoparticles
  • Innovative antibacterial strategies

Published Papers (6 papers)

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Research

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12 pages, 4697 KiB  
Article
Silver Nanostars-Coated Surfaces with Potent Biocidal Properties
by Lucinda J. Bessa, Miguel Peixoto de Almeida, Peter Eaton, Eulália Pereira and Paula Gameiro
Int. J. Environ. Res. Public Health 2020, 17(21), 7891; https://doi.org/10.3390/ijerph17217891 - 28 Oct 2020
Cited by 6 | Viewed by 1797
Abstract
Bacterial proliferation on certain surfaces is of concern as it tends to lead to infectious health problems. Nanotechnology is offering new options for engineering antimicrobial surfaces. Herein, the antibiofilm and biocidal properties of star-shaped silver nanoparticles (AgNSs) in suspension and as coating surfaces [...] Read more.
Bacterial proliferation on certain surfaces is of concern as it tends to lead to infectious health problems. Nanotechnology is offering new options for engineering antimicrobial surfaces. Herein, the antibiofilm and biocidal properties of star-shaped silver nanoparticles (AgNSs) in suspension and as coating surfaces were studied. AgNSs and spherical silver nanoparticles (AgNPs) (used for comparison purposes) were synthesized using reported methods. Glass disks (9 mm diameter) were covered with AgNSs using deposition by centrifugation. Minimum inhibitory concentrations (MICs) of AgNSs and AgNPs were determined against several reference strains and multidrug-resistant isolates and their antibiofilm activity was assessed against preformed biofilms of Pseudomonas aeruginosa and Staphylococcus aureus by both Live/Dead staining and atomic force microscopy (AFM). The antimicrobial properties of AgNSs-coated surfaces were evaluated by the “touch test” method on agar, and also Live/Dead staining and AFM. The MIC values of the AgNSs were 2–4 times lower than those of the AgNPs. Biofilms treated with AgNSs at a concentration equal to the MIC were not significantly affected, although they exhibited more dead cells than the non-treated biofilms. The biocidal activity of AgNSs-coated surfaces was attested, since no growth on agar nor viable cells were observed after contact of the inoculated bacteria with the coated surface for 6 and 24 h. Thus, AgNSs show greater potential as a surface coating with biocidal effects than used as suspension for antimicrobial purposes. Full article
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14 pages, 408 KiB  
Article
Hospital Wastewater—Important Source of Multidrug Resistant Coliform Bacteria with ESBL-Production
by Kristína Lépesová, Petra Olejníková, Tomáš Mackuľak, Klára Cverenkárová, Monika Krahulcová and Lucia Bírošová
Int. J. Environ. Res. Public Health 2020, 17(21), 7827; https://doi.org/10.3390/ijerph17217827 - 26 Oct 2020
Cited by 20 | Viewed by 4157
Abstract
This work compares the prevalence of antibiotic resistant coliform bacteria in hospital wastewater effluents in Slovak (SR) and Czech Republic (ČR). It also describes selected antibiotic resistant isolates in view of resistance mechanism and virulence factor. The highest number of multidrug resistant bacteria [...] Read more.
This work compares the prevalence of antibiotic resistant coliform bacteria in hospital wastewater effluents in Slovak (SR) and Czech Republic (ČR). It also describes selected antibiotic resistant isolates in view of resistance mechanism and virulence factor. The highest number of multidrug resistant bacteria was detected in samples from the hospital in Valašské Meziříčí (ČR). More than half of resistant isolates showed multidrug resistance phenotype as well as strong ability to form biofilm. In 42% of isolates efflux pump overproduction was detected together with tetA and tetE genes. The production of extended-spectrum β-lactamases in coliform isolates was encoded mainly by blaTEM, blaCTX-M-2 and blaCTX-M-8/25 genes. About 62% of resistants contained a combination of two or more extended spectrum beta-lactamases (ESBL) genes. Our results strengthen the fact that hospital effluents are a source of multidrug resistant bacteria which can spread their resistance genes to other bacteria in wastewater treatment plants (WWTPs). Accordingly, hospital wastewater should be better treated before it enters urban sewerage. Full article
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14 pages, 2347 KiB  
Article
Phylloseptin-1 is Leishmanicidal for Amastigotes of Leishmania amazonensis Inside Infected Macrophages
by Selma A. S. Kückelhaus, Daniela Sant’Ana de Aquino, Tatiana K. Borges, Daniel C. Moreira, Luciana de Magalhães Leite, Maria Imaculada Muniz-Junqueira, Carlos S. Kückelhaus, Gustavo A. Sierra Romero, Maura V. Prates, Carlos Bloch, Jr. and José Roberto S. A. Leite
Int. J. Environ. Res. Public Health 2020, 17(13), 4856; https://doi.org/10.3390/ijerph17134856 - 06 Jul 2020
Cited by 8 | Viewed by 2166
Abstract
Leishmania protozoans are the causal agents of neglected diseases that represent an important public health issue worldwide. The growing occurrence of drug-resistant strains of Leishmania and severe side effects of available treatments represent an important challenge for the leishmaniases treatment. We have previously [...] Read more.
Leishmania protozoans are the causal agents of neglected diseases that represent an important public health issue worldwide. The growing occurrence of drug-resistant strains of Leishmania and severe side effects of available treatments represent an important challenge for the leishmaniases treatment. We have previously reported the leishmanicidal activity of phylloseptin-1 (PSN-1), a peptide found in the skin secretion of Phyllomedusa azurea (=Pithecopus azureus), against Leishmania amazonensis promastigotes. However, its impact on the amastigote form of L. amazonensis and its impact on infected macrophages are unknown. In this work, we evaluated the effects of PSN-1 on amastigotes of L. amazonensis inside macrophages infected in vitro. We assessed the production of hydrogen peroxide and nitric oxide, as well as the levels of inflammatory and immunomodulatory markers (TGF-β, TNF-α and IL-12), in infected and non-infected macrophages treated with PSN-1. Treatment with PSN-1 decreased the number of infected cells and the number of ingested amastigotes per cell when compared with the untreated cells. At 32 µM (64 µg/mL), PSN-1 reduced hydrogen peroxide levels in both infected and uninfected macrophages, whereas it had little effect on NO production or TGF-β release. The effect of PSN-1 on IL-12 and TNF-α secretion depended on its concentration, but, in general, their levels tended to increase as PSN-1 concentration increased. Further in vitro and in vivo studies are needed to clarify the mechanisms of action of PSN-1 and its interaction with the immune system aiming to develop pharmacological applications. Full article
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17 pages, 1160 KiB  
Article
Fluoroquinolone Metalloantibiotics: A Promising Approach against Methicillin-Resistant Staphylococcus aureus
by Mariana Ferreira, Lucinda J. Bessa, Carla F. Sousa, Peter Eaton, Dafne Bongiorno, Stefania Stefani, Floriana Campanile and Paula Gameiro
Int. J. Environ. Res. Public Health 2020, 17(9), 3127; https://doi.org/10.3390/ijerph17093127 - 30 Apr 2020
Cited by 10 | Viewed by 3219
Abstract
Fluoroquinolones (FQs) are antibiotics commonly used in clinical practice, although nowadays they are becoming ineffective due to the emergence of several mechanisms of resistance in most bacteria. The complexation of FQs with divalent metal ions and phenanthroline (phen) is a possible approach to [...] Read more.
Fluoroquinolones (FQs) are antibiotics commonly used in clinical practice, although nowadays they are becoming ineffective due to the emergence of several mechanisms of resistance in most bacteria. The complexation of FQs with divalent metal ions and phenanthroline (phen) is a possible approach to circumvent antimicrobial resistance, since it forms very stable complexes known as metalloantibiotics. This work is aimed at determining the antimicrobial activity of metalloantibiotics of Cu(II)FQphen against a panel of multidrug-resistant (MDR) clinical isolates and to clarify their mechanism of action. Minimum inhibitory concentrations (MICs) were determined against MDR isolates of Escherichia coli, Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA). Metalloantibiotics showed improved antimicrobial activity against several clinical isolates, especially MRSA. Synergistic activity was evaluated in combination with ciprofloxacin and ampicillin by the disk diffusion and checkerboard methods. Synergistic and additive effects were shown against MRSA isolates. The mechanism of action was studied though enzymatic assays and atomic force microscopy (AFM) experiments. The results indicate a similar mechanism of action for FQs and metalloantibiotics. In summary, metalloantibiotics seem to be an effective alternative to pure FQs against MRSA. The results obtained in this work open the way to the screening of metalloantibiotics against other Gram-positive bacteria. Full article
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9 pages, 1355 KiB  
Article
Environmental Contamination Prevalence, Antimicrobial Resistance and Molecular Characteristics of Methicillin-Resistant Staphylococcus Aureus and Staphylococcus Epidermidis Isolated from Secondary Schools in Guangzhou, China
by Yingying Wang, Jialing Lin, Ting Zhang, Suiping He, Ying Li, Wencui Zhang, Xiaohua Ye and Zhenjiang Yao
Int. J. Environ. Res. Public Health 2020, 17(2), 623; https://doi.org/10.3390/ijerph17020623 - 18 Jan 2020
Cited by 9 | Viewed by 4034
Abstract
Background: Methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE), the most prevalent causes of hospital-associated and community-associated infections, could exist on frequently touched surfaces. This study aims to determine the contamination prevalence and the characteristics of MRSA and MRSE isolated from secondary [...] Read more.
Background: Methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE), the most prevalent causes of hospital-associated and community-associated infections, could exist on frequently touched surfaces. This study aims to determine the contamination prevalence and the characteristics of MRSA and MRSE isolated from secondary school environments. Methods: We collected environmental samples from ten secondary schools in Guangzhou city between October 2016 and January 2017. The samples were confirmed for MRSA and MRSE isolates by using biochemical tests and polymerase chain reactions. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion method. Staphylococcal cassette chromosome mec (SCCmec) typing, toxin gene screening, and multilocus sequence typing (MLST) were performed to further characterize the isolates. Data were analyzed by two-sample proportion tests. Results: A total of 1830 environmental samples were collected. The prevalence of MRSA and MRSE contamination were 1.86% (34/1830) and 5.14% (94/1830), respectively. The proportions of multidrug resistance in both MRSA (58.82%) and MRSE (63.83%) isolates were high. Seven clonal complexes (CC) and 12 sequence types (ST) were identified, with the CC5 (35.29%) and ST45 (25.53%) being the most prevalent. We found that 44.12% of the MRSA isolates were community-acquired and the main type was ST45-SCCmec IV. We found that 5.88% and 32.35% of MRSA isolates were positive to Panton-Valentine leukocidin (PVL) and toxic shock syndrome toxin-1 (tst) gene, respectively. No MRSE isolate was positive to the toxin genes. Conclusion: Our findings raise potential public health concerns for environmental contamination of MRSA and MRSE in school environments. Surfaces of school environments may potentially provide a source for cross-contamination with these bacteria into the wider community. Full article
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Review

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20 pages, 1510 KiB  
Review
Treatment Processes for Microbial Resistance Mitigation: The Technological Contribution to Tackle the Problem of Antibiotic Resistance
by Gabriela Bairán, Georgette Rebollar-Pérez, Edith Chávez-Bravo and Eduardo Torres
Int. J. Environ. Res. Public Health 2020, 17(23), 8866; https://doi.org/10.3390/ijerph17238866 - 28 Nov 2020
Cited by 24 | Viewed by 3903
Abstract
Advances generated in medicine, science, and technology have contributed to a better quality of life in recent years; however, antimicrobial resistance has also benefited from these advances, creating various environmental and health problems. Several determinants may explain the problem of antimicrobial resistance, such [...] Read more.
Advances generated in medicine, science, and technology have contributed to a better quality of life in recent years; however, antimicrobial resistance has also benefited from these advances, creating various environmental and health problems. Several determinants may explain the problem of antimicrobial resistance, such as wastewater treatment plants that represent a powerful agent for the promotion of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARG), and are an important factor in mitigating the problem. This article focuses on reviewing current technologies for ARB and ARG removal treatments, which include disinfection, constructed wetlands, advanced oxidation processes (AOP), anaerobic, aerobic, or combined treatments, and nanomaterial-based treatments. Some of these technologies are highly intensive, such as AOP; however, other technologies require long treatment times or high doses of oxidizing agents. From this review, it can be concluded that treatment technologies must be significantly enhanced before the environmental and heath problems associated with antimicrobial resistance can be effectively solved. In either case, it is necessary to achieve total removal of bacteria and genes to avoid the possibility of regrowth given by the favorable environmental conditions at treatment plant facilities. Full article
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