The burden of hospital acquired infections and antimicrobial resistance
Loading...
Date
2023
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Heliyon
Abstract
The burden of Hospital care-associated infections (HCAIs) is becoming a global concern. This is
compounded by the emergence of virulent and high-risk bacterial strains such as “ESKAPE”
pathogens – (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter
baumannii, Pseudomonas aeruginosa and Enterobacter species), especially within Intensive care
units (ICUs) that house high-risk and immunocompromised patients. In this review, we discuss
the contributions of AMR pathogens to the increasing burden of HCAIs and provide insights into
AMR mechanisms, with a particular focus on last-resort antibiotics like polymyxins. We exten sively discuss how structural modifications of surface-membrane lipopolysaccharides and cationic
interactions influence and inform AMR, and subsequent severity of HCAIs. We highlight some
bacterial phenotypic survival mechanisms against polymyxins. Lastly, we discuss the emergence
of plasmid-mediated resistance as a phenomenon making mitigation of AMR difficult, especially
within the ICUs. This review provides a balanced perspective on the burden of HCAIs, associated
pathogens, implication of AMR and factors influencing emerging AMR mechanisms.
Description
Research Article
Keywords
Hospital care-associated infections, Nosocomial infections, Antimicrobial resistance