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      Nanomaterials for Fighting Multidrug-Resistant Biofilm Infections

      review-article
      BME Frontiers
      AAAS

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          Abstract

          Multidrug-resistant bacterial infections represent a dire threat to global health. The development of antibiotic resistance in bacteria coupled with the lack of development of new antibiotics is creating infections requiring antibiotics of last resort, and even some infections for which we have no available treatment. Biofilm-based infections present some of the most challenging targets for treatment. The biofilm matrix provides a physical barrier that can impede access of antibiotics and antimicrobials to resident bacteria. The phenotypic diversity found in biofilms further exacerbates the difficulty of eliminating infections, with quiescent “persister” cells evading therapeutics and re-initiating infections after treatment. Nanomaterials provide a tool for combatting these refractory biofilm infections. The distinctive size regime and physical properties of nanomaterials provide them with the capability to penetrate and disrupt biofilms. Nanomaterials can also access antimicrobial pathways inaccessible to conventional antimicrobials, providing a synergistic strategy for treating biofilm infections. This review will summarize key challenges presented by antibiotic resistance and biofilms when treating infection and provide selected examples of how nanomaterials are being used to address these challenges.

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          Most cited references74

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          Molecular mechanisms of antibiotic resistance.

          Antibiotic-resistant bacteria that are difficult or impossible to treat are becoming increasingly common and are causing a global health crisis. Antibiotic resistance is encoded by several genes, many of which can transfer between bacteria. New resistance mechanisms are constantly being described, and new genes and vectors of transmission are identified on a regular basis. This article reviews recent advances in our understanding of the mechanisms by which bacteria are either intrinsically resistant or acquire resistance to antibiotics, including the prevention of access to drug targets, changes in the structure and protection of antibiotic targets and the direct modification or inactivation of antibiotics.
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            Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem.

            Antimicrobial resistance is a global public health challenge, which has accelerated by the overuse of antibiotics worldwide. Increased antimicrobial resistance is the cause of severe infections, complications, longer hospital stays and increased mortality. Overprescribing of antibiotics is associated with an increased risk of adverse effects, more frequent re-attendance and increased medicalization of self-limiting conditions. Antibiotic overprescribing is a particular problem in primary care, where viruses cause most infections. About 90% of all antibiotic prescriptions are issued by general practitioners, and respiratory tract infections are the leading reason for prescribing. Multifaceted interventions to reduce overuse of antibiotics have been found to be effective and better than single initiatives. Interventions should encompass the enforcement of the policy of prohibiting the over-the-counter sale of antibiotics, the use of antimicrobial stewardship programmes, the active participation of clinicians in audits, the utilization of valid rapid point-of-care tests, the promotion of delayed antibiotic prescribing strategies, the enhancement of communication skills with patients with the aid of information brochures and the performance of more pragmatic studies in primary care with outcomes that are of clinicians' interest, such as complications and clinical outcomes.
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              Metal nanoparticles: understanding the mechanisms behind antibacterial activity

              As the field of nanomedicine emerges, there is a lag in research surrounding the topic of nanoparticle (NP) toxicity, particularly concerned with mechanisms of action. The continuous emergence of bacterial resistance has challenged the research community to develop novel antibiotic agents. Metal NPs are among the most promising of these because show strong antibacterial activity. This review summarizes and discusses proposed mechanisms of antibacterial action of different metal NPs. These mechanisms of bacterial killing include the production of reactive oxygen species, cation release, biomolecule damages, ATP depletion, and membrane interaction. Finally, a comprehensive analysis of the effects of NPs on the regulation of genes and proteins (transcriptomic and proteomic) profiles is discussed.
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                Author and article information

                Journal
                BME Front
                BME Front
                BMEF
                BME Frontiers
                AAAS
                2765-8031
                24 April 2023
                2023
                : 4
                : 0017
                Affiliations
                [1]Department of Chemistry, University of Massachusetts Amherst , 710 North Pleasant Street, Amherst, MA 01003, USA.
                Author notes
                [*] [ ]Address correspondence to: rotello@ 123456chem.umass.edu
                Article
                0017
                10.34133/bmef.0017
                10521699
                37849666
                e641a0b4-3eed-4153-b847-6e06503ef70d
                Copyright © 2023 Vincent M. Rotello

                Exclusive licensee Suzhou Institute of Biomedical Engineering and Technology, CAS. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution License 4.0 (CC BY 4.0).

                History
                : 30 January 2023
                : 28 March 2023
                Page count
                Figures: 9, Tables: 0, References: 77, Pages: 11
                Funding
                Funded by: Foundation for the National Institutes of Health, FundRef http://dx.doi.org/10.13039/100000009;
                Award ID: AI134770
                Award Recipient : Vincent Rotello
                Categories
                Review Article

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