Alternative Approaches to Treating Antimicrobial Resistant Infections

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

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 78549

Special Issue Editors

Department of Life Sciences, University of Roehampton, London, UK
Interests: metabolic evolution; opportunistic pathogens; cystic fibrosis; Pseudomonas aeruginosa; Staphylococcus aureus
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue will focus on alternative approaches to treating antimicrobial resistant infections. The discovery of antibiotics revolutionized the clinical treatment of bacterial infections. However, this fundamental pillar of modern medicine is now crumbling. The development of novel antimicrobials has slowed down in recent years and major pharmaceutical firms have withdrawn from the anti-infective research area due to its low profitability.

As a consequence, many infections are now difficult to treat, which is raising the mortality and healthcare-associated costs due to difficulties in accomplishing total remission. Antimicrobial resistance is now considered one of the greatest risks to humanity. Common surgical procedures and treatments that could lead to immunosuppression may soon be considered high-risk due to the antibiotic crisis (e.g. cancer chemotherapy or organ transplants).

We are therefore inviting both reviews and original articles on the latest developments on novel antibacterial strategies to treat infections caused by antimicrobial resistant pathogens. Topics include the development of novel combinatorial therapies based on the repurposing of anti-infectives, host-targeted therapies, bacteriophages, the use of predatory bacteria, bacteriocins, antimicrobial peptides, nanoparticles, natural compounds, immunotherapeutics, probiotics used for competitive exclusion of pathogens, and the development of novel antibacterial compounds.

Dr. Michal Letek
Dr. Volker Behrends
Guest Editors

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Keywords

  • Repurposing, anti-infectives
  • host-targeted therapies
  • bacteriophages
  • predatory bacteria
  • bacteriocins
  • antimicrobial peptides
  • nanoparticles
  • natural compounds
  • immunotherapy
  • probiotics
  • antibiotics

Published Papers (12 papers)

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Research

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12 pages, 396 KiB  
Article
Facing the Increased Prevalence of Antibiotic-Resistant M. tuberculosis: Exploring the Feasibility of Realising Koch’s Aspiration of Immunotherapy of Tuberculosis
by Peter A. Bretscher
Antibiotics 2022, 11(3), 371; https://doi.org/10.3390/antibiotics11030371 - 10 Mar 2022
Cited by 3 | Viewed by 1596
Abstract
Koch attempted to treat tuberculosis in the late 1800s by administering an antigenic extract derived from the pathogen to patients. He hoped to bolster the patient’s protective immunity. The treatment had diverse results. In some, it improved the patient’s condition and in others [...] Read more.
Koch attempted to treat tuberculosis in the late 1800s by administering an antigenic extract derived from the pathogen to patients. He hoped to bolster the patient’s protective immunity. The treatment had diverse results. In some, it improved the patient’s condition and in others led to a worsening state and even to death. Koch stopped giving his experimental treatment. I consider here three issues pertinent to realizing Koch’s vision. Rational immunotherapy requires a knowledge of what constitutes protective immunity; secondly, how on-going immune responses are regulated, so the patient’s immunity can be modulated to become optimally protective; thirdly, a simple methodology by which treatment might be realized. I deliberately cast my account in simple terms to transcend barriers due to specialization. The proposed immunotherapeutic treatment, if realizable, would significantly contribute to overcoming problems of treatment posed by antibiotic resistance of the pathogen. Full article
(This article belongs to the Special Issue Alternative Approaches to Treating Antimicrobial Resistant Infections)
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8 pages, 1260 KiB  
Article
Antibacterial Activity of the Novel Drug Gepotidacin against Stenotrophomonas maltophilia—An In Vitro and In Vivo Study
by Maike Isabell Sanders, Eyhab Ali, Jan Buer, Joerg Steinmann, Peter-Michael Rath, Hedda Luise Verhasselt and Lisa Kirchhoff
Antibiotics 2022, 11(2), 192; https://doi.org/10.3390/antibiotics11020192 - 01 Feb 2022
Cited by 2 | Viewed by 2805
Abstract
Stenotrophomonas maltophilia is increasingly recognized as a nosocomial bacterial pathogen with a multi-drug resistance profile. In this study, the novel drug gepotidacin, the first compound of the novel triazaacenaphthylene topoisomerase inhibitor antibiotics class, was evaluated on its activity against clinical S. maltophilia isolates. [...] Read more.
Stenotrophomonas maltophilia is increasingly recognized as a nosocomial bacterial pathogen with a multi-drug resistance profile. In this study, the novel drug gepotidacin, the first compound of the novel triazaacenaphthylene topoisomerase inhibitor antibiotics class, was evaluated on its activity against clinical S. maltophilia isolates. Ninety-nine S. maltophilia isolates plus reference strain K279a (N = 100) were tested on their susceptibility towards gepotidacin in a broth microdilution. Additional susceptibility testing was performed towards the commonly applied combination trimethoprim/sulfamethoxazole (TMP/SXT), moxifloxacin, and levofloxacin. The time–kill kinetic of gepotidacin was observed in a time–kill assay. The greater wax moth Galleria mellonella was used to determine the activity of gepotidacin against S. maltophilia in vivo. Gepotidacin showed minimum inhibitory concentrations (MICs) between 0.25 and 16 mg/L (MIC50: 2 mg/L; MIC90: 8 mg/L), independently of its susceptibility towards TMP/SXT. The five TMP/SXT resistant strains exhibited gepotidacin MICs from 1 to 4 mg/L. The S. maltophilia strains resistant to the assessed fluoroquinolones showed in parts high MICs of gepotidacin. The time–kill assay revealed a time- and strain-dependent killing effect of gepotidacin. In vivo, injection of gepotidacin increased the survival rate of the larvae from 61 % to 90 % after 2 days. This study showed antimicrobial effects of gepotidacin towards S. maltophilia. Full article
(This article belongs to the Special Issue Alternative Approaches to Treating Antimicrobial Resistant Infections)
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10 pages, 1495 KiB  
Article
Predicting the Effects of Carbapenem/Carbapenemase Inhibitor Combinations against KPC-Producing Klebsiella pneumoniae in Time-Kill Experiments: Alternative versus Traditional Approaches to MIC Determination
by Alla V. Filimonova, Maria V. Golikova, Elena N. Strukova, Yury A. Portnoy, Anastasiya A. Kuznetsova and Stephen H. Zinner
Antibiotics 2021, 10(12), 1520; https://doi.org/10.3390/antibiotics10121520 - 11 Dec 2021
Cited by 2 | Viewed by 2398
Abstract
Traditionally, the antibacterial activity of β-lactam antibiotics in the presence of β-lactamase inhibitors is determined at the fixed inhibitor concentration. This traditional approach does not consider the ratio of antibiotic-to-inhibitor concentrations achieved in humans. To explore whether an alternative pharmacokinetically based approach to [...] Read more.
Traditionally, the antibacterial activity of β-lactam antibiotics in the presence of β-lactamase inhibitors is determined at the fixed inhibitor concentration. This traditional approach does not consider the ratio of antibiotic-to-inhibitor concentrations achieved in humans. To explore whether an alternative pharmacokinetically based approach to estimate MICs in combinations is predictive of antimicrobial efficacy, the effects of imipenem and doripenem alone and in combination with relebactam were studied in time-kill experiments against carbapenemase-producing Klebsiella pneumoniae. The carbapenem-to-relebactam concentration ratios in time-kill assays were equal to the therapeutic 24-h area under the concentration-time curve (AUC) ratios of the drugs (1.5/1). The simulated levels of carbapenem and relebactam were equal to their concentrations achieved in humans. When effects of combined regimens were plotted against respective C/MICs, a sigmoid relationship was obtained only with MICs determined by pharmacokinetically based method. The effectiveness of both carbapenems in the presence of relebactam was comparable by the results of time-kill experiments. These findings suggest that (1) antibiotic/inhibitor MICs determined at a pharmacokinetically based concentration ratio allow an adequate assessment of carbapenem susceptibility in carbapenemase-producing K. pneumoniae strains and can be used to predict antibacterial effects; (2) in time-kill experiments, the effects of imipenem and doripenem in the presence of relebactam are comparable. Full article
(This article belongs to the Special Issue Alternative Approaches to Treating Antimicrobial Resistant Infections)
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11 pages, 725 KiB  
Article
Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant Acinetobacter baumannii Pneumonia
by Jae-Min Park, Kyung-Sook Yang, You-Seung Chung, Ki-Byung Lee, Jeong-Yeon Kim, Sun-Bean Kim, Jang-Wook Sohn and Young-Kyung Yoon
Antibiotics 2021, 10(8), 903; https://doi.org/10.3390/antibiotics10080903 - 23 Jul 2021
Cited by 6 | Viewed by 2710
Abstract
This study compared the clinical outcomes and safety of meropenem–colistin versus meropenem–tigecycline in the treatment of adult patients with carbapenem-resistant Acinetobacter baumannii (CRAB) pneumonia. A retrospective observational study of patients with CRAB pneumonia was performed at a 1048-bed university-affiliated hospital in the Republic [...] Read more.
This study compared the clinical outcomes and safety of meropenem–colistin versus meropenem–tigecycline in the treatment of adult patients with carbapenem-resistant Acinetobacter baumannii (CRAB) pneumonia. A retrospective observational study of patients with CRAB pneumonia was performed at a 1048-bed university-affiliated hospital in the Republic of Korea between June 2013 and January 2020. All adult patients initially treated with meropenem–colistin were compared with those treated with meropenem–tigecycline to evaluate in-hospital mortality and adverse events. Altogether, 66 patients prescribed meropenem–colistin and 24 patients prescribed meropenem–tigecycline were included. All patients had nosocomial pneumonia, and 31.1% had ventilator-associated pneumonia. The minimum inhibitory concentrations of meropenem ≤ 8 μg/mL and tigecycline ≤ 2 μg/mL were 20.0% and 81.1%, respectively. The in-hospital and 28-day mortality rates were 40% and 32%, respectively. In the Cox proportional hazard regression analysis, predictors associated with in-hospital mortality included procalcitonin ≥ 1 ng/mL (adjusted hazard ratio (aHR), 3.39; 95% confidence interval (CI) 1.40–8.19; p = 0.007) and meropenem–colistin combination therapy (aHR, 2.58; 95% CI, 1.07–6.23; p = 0.036). Episodes of nephrotoxicity were significantly more common in the meropenem–colistin group than in the meropenem–tigecycline group (51.5% vs. 12.5%, p = 0.001). Meropenem–tigecycline combination therapy might be a valuable treatment option for patients with CRAB pneumonia. Full article
(This article belongs to the Special Issue Alternative Approaches to Treating Antimicrobial Resistant Infections)
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Review

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14 pages, 671 KiB  
Review
Understanding microRNAs in the Context of Infection to Find New Treatments against Human Bacterial Pathogens
by Álvaro Mourenza, Blanca Lorente-Torres, Elena Durante, Jesús Llano-Verdeja, Jesús F. Aparicio, Arsenio Fernández-López, José A. Gil, Luis M. Mateos and Michal Letek
Antibiotics 2022, 11(3), 356; https://doi.org/10.3390/antibiotics11030356 - 08 Mar 2022
Cited by 6 | Viewed by 3633
Abstract
The development of RNA-based anti-infectives has gained interest with the successful application of mRNA-based vaccines. Small RNAs are molecules of RNA of <200 nucleotides in length that may control the expression of specific genes. Small RNAs include small interference RNAs (siRNAs), Piwi-interacting RNAs [...] Read more.
The development of RNA-based anti-infectives has gained interest with the successful application of mRNA-based vaccines. Small RNAs are molecules of RNA of <200 nucleotides in length that may control the expression of specific genes. Small RNAs include small interference RNAs (siRNAs), Piwi-interacting RNAs (piRNAs), or microRNAs (miRNAs). Notably, the role of miRNAs on the post-transcriptional regulation of gene expression has been studied in detail in the context of cancer and many other genetic diseases. However, it is also becoming apparent that some human miRNAs possess important antimicrobial roles by silencing host genes essential for the progress of bacterial or viral infections. Therefore, their potential use as novel antimicrobial therapies has gained interest during the last decade. The challenges of the transport and delivery of miRNAs to target cells are important, but recent research with exosomes is overcoming the limitations in RNA-cellular uptake, avoiding their degradation. Therefore, in this review, we have summarised the latest developments in the exosomal delivery of miRNA-based therapies, which may soon be another complementary treatment to pathogen-targeted antibiotics that could help solve the problem caused by multidrug-resistant bacteria. Full article
(This article belongs to the Special Issue Alternative Approaches to Treating Antimicrobial Resistant Infections)
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37 pages, 1556 KiB  
Review
Progress in Alternative Strategies to Combat Antimicrobial Resistance: Focus on Antibiotics
by Jayaseelan Murugaiyan, P. Anand Kumar, G. Srinivasa Rao, Katia Iskandar, Stephen Hawser, John P. Hays, Yara Mohsen, Saranya Adukkadukkam, Wireko Andrew Awuah, Ruiz Alvarez Maria Jose, Nanono Sylvia, Esther Patience Nansubuga, Bruno Tilocca, Paola Roncada, Natalia Roson-Calero, Javier Moreno-Morales, Rohul Amin, Ballamoole Krishna Kumar, Abishek Kumar, Abdul-Rahman Toufik, Thaint Nadi Zaw, Oluwatosin O. Akinwotu, Maneesh Paul Satyaseela and Maarten B. M. van Dongenadd Show full author list remove Hide full author list
Antibiotics 2022, 11(2), 200; https://doi.org/10.3390/antibiotics11020200 - 04 Feb 2022
Cited by 92 | Viewed by 20898
Abstract
Antibiotic resistance, and, in a broader perspective, antimicrobial resistance (AMR), continues to evolve and spread beyond all boundaries. As a result, infectious diseases have become more challenging or even impossible to treat, leading to an increase in morbidity and mortality. Despite the failure [...] Read more.
Antibiotic resistance, and, in a broader perspective, antimicrobial resistance (AMR), continues to evolve and spread beyond all boundaries. As a result, infectious diseases have become more challenging or even impossible to treat, leading to an increase in morbidity and mortality. Despite the failure of conventional, traditional antimicrobial therapy, in the past two decades, no novel class of antibiotics has been introduced. Consequently, several novel alternative strategies to combat these (multi-) drug-resistant infectious microorganisms have been identified. The purpose of this review is to gather and consider the strategies that are being applied or proposed as potential alternatives to traditional antibiotics. These strategies include combination therapy, techniques that target the enzymes or proteins responsible for antimicrobial resistance, resistant bacteria, drug delivery systems, physicochemical methods, and unconventional techniques, including the CRISPR-Cas system. These alternative strategies may have the potential to change the treatment of multi-drug-resistant pathogens in human clinical settings. Full article
(This article belongs to the Special Issue Alternative Approaches to Treating Antimicrobial Resistant Infections)
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61 pages, 4920 KiB  
Review
Nanotechnology as a Novel Approach in Combating Microbes Providing an Alternative to Antibiotics
by Bismillah Mubeen, Aunza Nayab Ansar, Rabia Rasool, Inam Ullah, Syed Sarim Imam, Sultan Alshehri, Mohammed M. Ghoneim, Sami I. Alzarea, Muhammad Shahid Nadeem and Imran Kazmi
Antibiotics 2021, 10(12), 1473; https://doi.org/10.3390/antibiotics10121473 - 30 Nov 2021
Cited by 74 | Viewed by 11699
Abstract
The emergence of infectious diseases promises to be one of the leading mortality factors in the healthcare sector. Although several drugs are available on the market, newly found microorganisms carrying multidrug resistance (MDR) against which existing drugs cannot function effectively, giving rise to [...] Read more.
The emergence of infectious diseases promises to be one of the leading mortality factors in the healthcare sector. Although several drugs are available on the market, newly found microorganisms carrying multidrug resistance (MDR) against which existing drugs cannot function effectively, giving rise to escalated antibiotic dosage therapies and the need to develop novel drugs, which require time, money, and manpower. Thus, the exploitation of antimicrobials has led to the production of MDR bacteria, and their prevalence and growth are a major concern. Novel approaches to prevent antimicrobial drug resistance are in practice. Nanotechnology-based innovation provides physicians and patients the opportunity to overcome the crisis of drug resistance. Nanoparticles have promising potential in the healthcare sector. Recently, nanoparticles have been designed to address pathogenic microorganisms. A multitude of processes that can vary with various traits, including size, morphology, electrical charge, and surface coatings, allow researchers to develop novel composite antimicrobial substances for use in different applications performing antimicrobial activities. The antimicrobial activity of inorganic and carbon-based nanoparticles can be applied to various research, medical, and industrial uses in the future and offer a solution to the crisis of antimicrobial resistance to traditional approaches. Metal-based nanoparticles have also been extensively studied for many biomedical applications. In addition to reduced size and selectivity for bacteria, metal-based nanoparticles have proven effective against pathogens listed as a priority, according to the World Health Organization (WHO). Moreover, antimicrobial studies of nanoparticles were carried out not only in vitro but in vivo as well in order to investigate their efficacy. In addition, nanomaterials provide numerous opportunities for infection prevention, diagnosis, treatment, and biofilm control. This study emphasizes the antimicrobial effects of nanoparticles and contrasts nanoparticles’ with antibiotics’ role in the fight against pathogenic microorganisms. Future prospects revolve around developing new strategies and products to prevent, control, and treat microbial infections in humans and other animals, including viral infections seen in the current pandemic scenarios. Full article
(This article belongs to the Special Issue Alternative Approaches to Treating Antimicrobial Resistant Infections)
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39 pages, 12755 KiB  
Review
Sub-Inhibitory Antibiotic Exposure and Virulence in Pseudomonas aeruginosa
by Charlotte Nolan and Volker Behrends
Antibiotics 2021, 10(11), 1393; https://doi.org/10.3390/antibiotics10111393 - 13 Nov 2021
Cited by 9 | Viewed by 3699
Abstract
Pseudomonas aeruginosa is a prime opportunistic pathogen, one of the most important causes of hospital-acquired infections and the major cause of morbidity and mortality in cystic fibrosis lung infections. One reason for the bacterium’s pathogenic success is the large array of virulence factors [...] Read more.
Pseudomonas aeruginosa is a prime opportunistic pathogen, one of the most important causes of hospital-acquired infections and the major cause of morbidity and mortality in cystic fibrosis lung infections. One reason for the bacterium’s pathogenic success is the large array of virulence factors that it can employ. Another is its high degree of intrinsic and acquired resistance to antibiotics. In this review, we first summarise the current knowledge about the regulation of virulence factor expression and production. We then look at the impact of sub-MIC antibiotic exposure and find that the virulence–antibiotic interaction for P. aeruginosa is antibiotic-specific, multifaceted, and complex. Most studies undertaken to date have been in vitro assays in batch culture systems, involving short-term (<24 h) antibiotic exposure. Therefore, we discuss the importance of long-term, in vivo-mimicking models for future work, particularly highlighting the need to account for bacterial physiology, which by extension governs both virulence factor expression and antibiotic tolerance/resistance. Full article
(This article belongs to the Special Issue Alternative Approaches to Treating Antimicrobial Resistant Infections)
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14 pages, 335 KiB  
Review
Ethnobotany, Ethnopharmacology, and Phytochemistry of Medicinal Plants Used for Treating Human Diarrheal Cases in Rwanda: A Review
by Noel Gahamanyi, Emmanuel Munyaneza, Emmanuel Dukuzimana, Naasson Tuyiringire, Cheol-Ho Pan and Erick V. G. Komba
Antibiotics 2021, 10(10), 1231; https://doi.org/10.3390/antibiotics10101231 - 09 Oct 2021
Cited by 15 | Viewed by 3468
Abstract
Diarrhea, often caused by microorganisms, has been associated with high morbidity and mortality in Africa. Increased rates of antimicrobial-resistant pathogens have reignited the quest for alternative therapies. This review aimed at identifying medicinal plants used in the treatment of human diarrheal cases in [...] Read more.
Diarrhea, often caused by microorganisms, has been associated with high morbidity and mortality in Africa. Increased rates of antimicrobial-resistant pathogens have reignited the quest for alternative therapies. This review aimed at identifying medicinal plants used in the treatment of human diarrheal cases in Rwanda and analyzing their ethnobotany, ethnopharmacology, and phytochemistry. We searched PubMed/Medline, Google Scholar, ScienceDirect, and the Web of Science for published articles on medicinal plants used to treat diarrhea in Rwanda. Additionally, specialized herbarium documents of different institutes were reviewed. Articles were assessed for relevance, quality, and taxonomical accuracy before being included in this review. Overall, 63 species of medicinal plants belonging to 35 families were recorded. Asteraceae was the predominant family with six species, followed by Fabaceae and Lamiaceae, with five species each. The most reported species with anti-diarrheal properties were Vernonia amygdalina Delile, Tetradenia riparia (Hochst.) Codd, Clerodendrum myricoides R. Br. and Chenopodium ugandae (Aellen) Aellen. Leaves (66.7%) and roots (17.5%) were the commonly used plant parts in the preparation of medicine. Phytochemicals from medicinal plants with antidiarrheic activities were sesquiterpene lactones (V. amygdalina); terpene, sterols, saponosides, and flavonoids (C. ugandae); saponins and tannins (T. riparia); and tannins, flavonoids, and alkaloids (C. myricoides). Six studies tested the antimicrobial activities of the plants against bacteria and viruses known to cause diarrhea. Erythrina abyssinica, Euphorbia tirucalli, Dracaena afromontana, and Ficus thonningii are socio-culturally important. Further research on toxicity and posology is needed to ensure the safety of medicinal plants. Full article
(This article belongs to the Special Issue Alternative Approaches to Treating Antimicrobial Resistant Infections)
19 pages, 748 KiB  
Review
Phages for Africa: The Potential Benefit and Challenges of Phage Therapy for the Livestock Sector in Sub-Saharan Africa
by Angela Makumi, Amos Lucky Mhone, Josiah Odaba, Linda Guantai and Nicholas Svitek
Antibiotics 2021, 10(9), 1085; https://doi.org/10.3390/antibiotics10091085 - 08 Sep 2021
Cited by 11 | Viewed by 4841
Abstract
One of the world’s fastest-growing human populations is in Sub-Saharan Africa (SSA), accounting for more than 950 million people, which is approximately 13% of the global population. Livestock farming is vital to SSA as a source of food supply, employment, and income. With [...] Read more.
One of the world’s fastest-growing human populations is in Sub-Saharan Africa (SSA), accounting for more than 950 million people, which is approximately 13% of the global population. Livestock farming is vital to SSA as a source of food supply, employment, and income. With this population increase, meeting this demand and the choice for a greater income and dietary options come at a cost and lead to the spread of zoonotic diseases to humans. To control these diseases, farmers have opted to rely heavily on antibiotics more often to prevent disease than for treatment. The constant use of antibiotics causes a selective pressure to build resistant bacteria resulting in the emergence and spread of multi-drug resistant (MDR) organisms in the environment. This necessitates the use of alternatives such as bacteriophages in curbing zoonotic pathogens. This review covers the underlying problems of antibiotic use and resistance associated with livestock farming in SSA, bacteriophages as a suitable alternative, what attributes contribute to making bacteriophages potentially valuable for SSA and recent research on bacteriophages in Africa. Furthermore, other topics discussed include the creation of phage biobanks and the challenges facing this kind of advancement, and the regulatory aspects of phage development in SSA with a focus on Kenya. Full article
(This article belongs to the Special Issue Alternative Approaches to Treating Antimicrobial Resistant Infections)
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39 pages, 1012 KiB  
Review
Finding a Balance in the Vaginal Microbiome: How Do We Treat and Prevent the Occurrence of Bacterial Vaginosis?
by Rebecca Jane Joseph, Hooi-Leng Ser, Yi-He Kuai, Loh Teng-Hern Tan, Valliammai Jayanthi Thirunavuk Arasoo, Vengadesh Letchumanan, Lijing Wang, Priyia Pusparajah, Bey-Hing Goh, Nurul-Syakima Ab Mutalib, Kok-Gan Chan and Learn-Han Lee
Antibiotics 2021, 10(6), 719; https://doi.org/10.3390/antibiotics10060719 - 15 Jun 2021
Cited by 30 | Viewed by 15729
Abstract
Bacterial vaginosis (BV) has been reported in one-third of women worldwide at different life stages, due to the complex balance in the ecology of the vaginal microbiota. It is a common cause of abnormal vaginal discharge and is associated with other health issues. [...] Read more.
Bacterial vaginosis (BV) has been reported in one-third of women worldwide at different life stages, due to the complex balance in the ecology of the vaginal microbiota. It is a common cause of abnormal vaginal discharge and is associated with other health issues. Since the first description of anaerobic microbes associated with BV like Gardnerella vaginalis in the 1950s, researchers have stepped up the game by incorporating advanced molecular tools to monitor and evaluate the extent of dysbiosis within the vaginal microbiome, particularly on how specific microbial population changes compared to a healthy state. Moreover, treatment failure and BV recurrence rate remain high despite the standard antibiotic treatment. Consequently, researchers have been probing into alternative or adjunct treatments, including probiotics or even vaginal microbiota transplants, to ensure successful treatment outcomes and reduce the colonization by pathogenic microbes of the female reproductive tract. The current review summarizes the latest findings in probiotics use for BV and explores the potential of vaginal microbiota transplants in restoring vaginal health. Full article
(This article belongs to the Special Issue Alternative Approaches to Treating Antimicrobial Resistant Infections)
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12 pages, 725 KiB  
Review
Herbal Products and Their Active Constituents Used Alone and in Combination with Antifungal Drugs against Drug-Resistant Candida sp.
by Anna Herman and Andrzej Przemysław Herman
Antibiotics 2021, 10(6), 655; https://doi.org/10.3390/antibiotics10060655 - 31 May 2021
Cited by 11 | Viewed by 3181
Abstract
Clinical isolates of Candida yeast are the most common cause of opportunistic fungal infections resistant to certain antifungal drugs. Therefore, it is necessary to detect more effective antifungal agents that would be successful in overcoming such infections. Among them are some herbal products [...] Read more.
Clinical isolates of Candida yeast are the most common cause of opportunistic fungal infections resistant to certain antifungal drugs. Therefore, it is necessary to detect more effective antifungal agents that would be successful in overcoming such infections. Among them are some herbal products and their active constituents.The purpose of this review is to summarize the current state of knowledge onherbal products and their active constituents havingantifungal activity against drug-resistant Candida sp. used alone and in combination with antifungal drugs.The possible mechanisms of their action on drug-resistant Candida sp. including (1) inhibition of budding yeast transformation into hyphae; (2) inhibition of biofilm formation; (3) inhibition of cell wall or cytoplasmic membrane biosynthesis; (4) ROS production; and (5) over-expression of membrane transporters will be also described. Full article
(This article belongs to the Special Issue Alternative Approaches to Treating Antimicrobial Resistant Infections)
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