SASPI Ltd.
Systematic review/Scoping review with large effect size
Metal-Based Approaches for the Fight against Antimicrobial Resistance: Mechanisms, Opportunities, and Challenges.
DOI:- 10.1021/jacs.4c16035
Authors: Wang C et al
Abstract
The rapid emergency and spread of antimicrobial-resistant (AMR) bacteria and the lack of new antibiotics being developed pose serious threats to the global healthcare system. Therefore, the development of more effective therapies to overcome AMR is highly desirable. Metal ions have a long history of serving as antimicrobial agents, and metal-based compounds are now attracting more interest from scientific communities in the fight against AMR owing to their unique mechanism. Moreover, they may also serve as antibiotic adjuvants to enhance the efficacy of clinically used antibiotics. In this perspective, the authors highlight important showcase studies in the last 10 years on the development of metal-based strategies to overcome the AMR crisis. Specifically, they categorize these metallo-antimicrobials into five classes based on their modes of action (i.e., metallo-enzymes and metal-binding enzyme inhibitors, membrane perturbants, uptake/efflux system inhibitors/regulators, persisters inhibitors, and oxidative stress inducers). The significant advantages of metallo-antimicrobials over traditional antibiotics lie in their multitargeted mechanisms, which render less likelihood to generate resistance. However, it is also noticed that such modes of action of metallo-antimicrobials may also raise concern over their potential side effects owing to the low selectivity toward pathogens and host, which appears to be the biggest obstacle for downstream translational research. It is anticipated that combination therapy through repurposing (metallo)drugs with antibiotics and the optimization of their absorption route through formulation to achieve a target-oriented delivery will be a powerful way to combat AMR. Despite significant challenges, metallo-antimicrobials hold great opportunities for the therapeutic intervention of infection by resistant bacteria.
Systematic review/Scoping review with large effect size
Insights of SEDRIC, the Surveillance and Epidemiology of Drug-Resistant Infections Consortium.
Authors: Feasey N et al
Abstract
The increasing threat from infection with drug-resistant pathogens is among the most serious public health challenges of our time. Formed by Wellcome in 2018, the Surveillance and Epidemiology of Drug-Resistant Infections Consortium (SEDRIC) is an international think tank whose aim is to inform policy and change the way countries track, share, and analyse data relating to drug-resistant infections, by defining knowledge gaps and identifying barriers to the delivery of global surveillance. SEDRIC delivers its aims through discussions and analyses by world-leading scientists that result in recommendations and advocacy to Wellcome and others. As a result, SEDRIC has made key contributions in furthering global and national actions. Here, we look back at the work of the consortium between 2018-2024, highlighting notable successes. We provide specific examples where technical analyses and recommendations have helped to inform policy and funding priorities that will have real-world impact on the surveillance and epidemiology of infections with drug-resistant pathogens.
Systematic review/Scoping review with large effect size
Adherence to Antibiotic Prescriptions Among Dental Patients in Saudi Arabia: A Cross-Sectional Study.
Authors: Alamri H et al
Abstract
Background: Antimicrobial resistance (AMR) is an increasing worldwide health concern, and non-adherence to antibiotic medication is a crucial factor in its growth. The objective of this research was to assess the adherence of dental patients in Saudi Arabia to oral antibiotic therapy, their knowledge of AMR, and their precise antibiotic prescription.
Methodology: From February 2023 to July 2023, a descriptive quantitative study was conducted among 450 outpatient dental patients who had obtained antibiotic prescriptions from dentists in the previous year. The questionnaire included three elements: knowledge of AMR, antibiotic usage behavior, and demographic information.
Results: During the study, it was found that only 3.6% of participants showed complete adherence to antibiotic therapy; 34% showed adherence to antibiotic therapy to a moderate extent, while 62.3% exhibited low adherence. Statistically significant relationships were established between age and income, and patients’ adherence levels, with considerably lower adherence among the younger and the patients with lower income. Despite 72.5% admitting the importance of appropriate use of antibiotics, 68.8% said they had stopped taking the antibiotic medication once they started to feel better, and 35.3% used lower prescribed doses.
Conclusion: The results of the study suggest that the level of adherence to antibiotic prescription among dental patients in Saudi Arabia is low, and this is of great concern to AMR. It is hereby imperative to tackle the elements that lead to nonadherence to maintain the efficacy of antibiotics and protect public health. Healthcare stakeholders can achieve AMR reduction and optimal patient outcomes by implementing focused interventions and public health efforts.
Systematic review/Scoping review with large effect size
Threats across boundaries: the spread of ESBL-positive Enterobacteriaceae bacteria and its challenge to the “one health” concept.
Authors: Zhang S et al
Abstract
β-lactam antibiotics are essential medications for treating human diseases. The spread of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) exists globally in multiple reservoirs and the natural environment and poses an immense threat to public health. Plasmid incompatibility groups, such as IncFIA, IncI1, IncY, IncFIB, IncN, IncFIC, IncX4, IncB/O/K/Z, IncHI1/2, and IncA/C, which exist in humans, animals, and the environment, carrying bla CTX-M, bla TEM, and bla SHV genes. The ISEcp1 upstream and orf477 downstream of bla CTX-M genes, as well as other mobile genetic elements (MGEs) such as IS903 and IS26, are involved in capturing and mobilizing antibiotic-resistant genes (ARGs). The bla CTX-M-15 gene is the most common among all discussed reservoirs. The environmental reservoir and propagation mode of ESBL-PE are increasing and difficult to control. The reasons include but are not limited to bacterial adaptability and horizontal gene transfer (HGT) mediated by MGEs and plasmids. Conjugation is a pathway of HGT that is almost uncontrollable. MGEs and plasmids such as Tn3, IS1380 families, IncI1, IncK, and IncN are facilitating HGT of bla CTX-M genes. This review highlights the need to monitor trends in antimicrobial resistance (AMR) in the natural environment. Therefore, policies such as antibiotic management plans, training for healthcare providers and/or patients, cautious use of antibiotics, the need for epidemiological networks, pre-travel consultations, World Health Organization (WHO) infection control and biosafety guidelines, and other intervention measures are considered desirable.