Challenges and Emerging Strategies to Tackle the Global Burden of Antimicrobial Resistance

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 8176

Special Issue Editor


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Guest Editor
1. University Centre Varaždin, University North, Varazdin, Croatia
2. Institute for Health Metrics and Evaluation (IHME), University of Washington, Seatle, WA, USA
3. Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle, WA, USA
Interests: global burden of AMR; AMR surveillance; diagnostics; treatment; multi-resistant microorganisms; AMR policy; antibiotic stewardship; public health; global health
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Special Issue Information

Dear Colleagues,

Antimicrobial resistance (AMR) poses a significant global health threat, with far-reaching implications for health systems and society. Despite the immense disease burden due to resistant microorganisms and urgent need for effective strategies to tackle them, there remains a clear lack of practical clinical research to inform much-needed advances in this field. The emergence of multidrug-resistant pathogens compromises the effectiveness of standard antibiotic treatment regimens, jeopardising in turn medical progress and patient outcomes worldwide.

Therefore, prompt and effective action is essential to address the challenges posed by AMR and develop strategies to mitigate its impact. This Special Issue of the journal "Antibiotics" aims to address this critical issue by focusing on articles covering a range of topics related to AMR. These include novel approaches to AMR diagnostics, surveillance strategies and antimicrobial treatment strategies, but also cover novel approaches to antibiotic stewardship and local/global policy perspectives.

I am pleased to invite submissions of high-quality research-based or review papers addressing the challenges and emerging strategies to tackle the global burden of antimicrobial resistance. The end-goal is to create a timely and highly relevant collection of articles aimed at addressing this pressing topic, which is currently one of the biggest global health concerns the humanity has faced.

Dr. Tomislav Meštrović
Guest Editor

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Keywords

  • antimicrobial resistance (AMR)
  • global burden of AMR
  • AMR in the context of public and global health
  • diagnostic and treatment of AMR
  • new approaches to AMR surveillance
  • antibiotic stewardship
  • local and global policy initiatives on AMR
  • prevention of AMR

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Published Papers (3 papers)

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Research

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8 pages, 770 KiB  
Article
Ciprofloxacin Concentrations 100-Fold Lower than the MIC Can Select for Ciprofloxacin Resistance in Neisseria subflava: An In Vitro Study
by Zina Gestels, Saïd Abdellati, Chris Kenyon and Sheeba Santhini Manoharan-Basil
Antibiotics 2024, 13(6), 560; https://doi.org/10.3390/antibiotics13060560 - 14 Jun 2024
Cited by 2 | Viewed by 1496
Abstract
Neisseria gonorrhoeae can acquire antimicrobial resistance (AMR) through horizontal gene transfer (HGT) from other Neisseria spp. such as commensals like Neisseria subflava. Low doses of antimicrobials in food could select for AMR in N. subflava, which could then be transferred to N. [...] Read more.
Neisseria gonorrhoeae can acquire antimicrobial resistance (AMR) through horizontal gene transfer (HGT) from other Neisseria spp. such as commensals like Neisseria subflava. Low doses of antimicrobials in food could select for AMR in N. subflava, which could then be transferred to N. gonorrhoeae. In this study, we aimed to determine the lowest concentration of ciprofloxacin that can induce ciprofloxacin resistance (minimum selection concentration—MSC) in a N. subflava isolate (ID-Co000790/2, a clinical isolate collected from a previous community study conducted at ITM). In this study, Neisseria subflava was serially passaged on gonococcal (GC) medium agar plates containing ciprofloxacin concentrations ranging from 1:100 to 1:10,000 below its ciprofloxacin MIC (0.006 µg/mL) for 6 days. After 6 days of serial passaging at ciprofloxacin concentrations of 1/100th of the MIC, 24 colonies emerged on the plate containing 0.06 µg/mL ciprofloxacin, which corresponds to the EUCAST breakpoint for N. gonorrhoeae. Their ciprofloxacin MICs were between 0.19 to 0.25 µg/mL, and whole genome sequencing revealed a missense mutation T91I in the gyrA gene, which has previously been found to cause reduced susceptibility to fluoroquinolones. The N. subflava MSCde novo was determined to be 0.06 ng/mL (0.00006 µg/mL), which is 100×-fold lower than the ciprofloxacin MIC. The implications of this finding are that the low concentrations of fluoroquinolones found in certain environmental samples, such as soil, river water, and even the food we eat, may be able to select for ciprofloxacin resistance in N. subflava. Full article
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Review

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19 pages, 1066 KiB  
Review
Current Knowledge on CRISPR Strategies Against Antimicrobial-Resistant Bacteria
by Carlos de la Fuente Tagarro, Diego Martín-González, Andrea De Lucas, Sergio Bordel and Fernando Santos-Beneit
Antibiotics 2024, 13(12), 1141; https://doi.org/10.3390/antibiotics13121141 - 27 Nov 2024
Cited by 1 | Viewed by 2261
Abstract
CRISPR/Cas systems have emerged as valuable tools to approach the problem of antimicrobial resistance by either sensitizing or lysing resistant bacteria or by aiding in antibiotic development, with successful applications across diverse organisms, including bacteria and fungi. CRISPR/Cas systems can target plasmids or [...] Read more.
CRISPR/Cas systems have emerged as valuable tools to approach the problem of antimicrobial resistance by either sensitizing or lysing resistant bacteria or by aiding in antibiotic development, with successful applications across diverse organisms, including bacteria and fungi. CRISPR/Cas systems can target plasmids or the bacterial chromosome of AMR-bacteria, and it is especially necessary to have an efficient entry into the target cells, which can be achieved through nanoparticles or bacteriophages. Regarding antibiotic development and production, though the use of CRISPR/Cas in this field is still modest, there is an untapped reservoir of bacterial and fungal natural products, with over 95% yet to be characterized. In Streptomyces, a key antibiotic-producing bacterial genus, CRISPR/Cas has been successfully used to activate silent biosynthetic gene clusters, leading to the discovery of new antibiotics. CRISPR/Cas is also applicable to non-model bacteria and different species of fungi, making it a versatile tool for natural products discovery. Moreover, CRISPR/Cas-based studies offer insights into metabolic regulation and biosynthetic pathways in both bacteria and fungi, highlighting its utility in understanding genetic regulation and improving industrial strains. In this work, we review ongoing innovations on ways to treat antimicrobial resistances and on antibiotic discovery using CRISPR/Cas platforms, highlighting the role of bacteria and fungi in these processes. Full article
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32 pages, 6288 KiB  
Review
A Decade of Antimicrobial Resistance in Human and Animal Campylobacter spp. Isolates
by Rita Barata, Maria José Saavedra and Gonçalo Almeida
Antibiotics 2024, 13(9), 904; https://doi.org/10.3390/antibiotics13090904 - 21 Sep 2024
Cited by 4 | Viewed by 3911
Abstract
Objectives: Campylobacter spp. remain a leading cause of bacterial gastroenteritis worldwide, with resistance to antibiotics posing significant challenges to treatment and public health. This study examines profiles in antimicrobial resistance (AMR) for Campylobacter isolates from human and animal sources over the past [...] Read more.
Objectives: Campylobacter spp. remain a leading cause of bacterial gastroenteritis worldwide, with resistance to antibiotics posing significant challenges to treatment and public health. This study examines profiles in antimicrobial resistance (AMR) for Campylobacter isolates from human and animal sources over the past decade. Methods: We conducted a comprehensive review of resistance data from studies spanning ten years, analyzing profiles in resistance to key antibiotics, ciprofloxacin (CIP), tetracycline (TET), erythromycin (ERY), chloramphenicol (CHL), and gentamicin (GEN). Data were collated from various regions to assess global and regional patterns of resistance. Results: The analysis reveals a concerning trend of increasing resistance patterns, particularly to CIP and TET, across multiple regions. While resistance to CHL and GEN remains relatively low, the high prevalence of CIP resistance has significantly compromised treatment options for campylobacteriosis. Discrepancies in resistance patterns were observed between human and animal isolates, with variations across different continents and countries. Notably, resistance to ERY and CHL showed regional variability, reflecting potential differences in antimicrobial usage and management practices. Conclusions: The findings underscore the ongoing challenge of AMR in Campylobacter, highlighting the need for continued surveillance and research. The rising resistance prevalence, coupled with discrepancies in resistance patterns between human and animal isolates, emphasize the importance of a One Health approach to address AMR. Enhanced monitoring, novel treatment strategies, and global cooperation are crucial for mitigating the impact of resistance and ensuring the effective management of Campylobacter-related infections. Full article
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