Antimicrobial Resistance: Global Burden, Molecular Mechanisms, Emerging Therapeutic Strategies and Future Perspectives

Author

Alisha Praveen ,Saloni Saini


Abstract

 AMR is now one of the greatest threats to global health, undermining the ability to prevent and treat infectious diseases, and is threatening many advances in medicine. Antimicrobial resistance (AMR) is the ability of microorganisms to survive after previously being sensitive to antimicrobial agents. While resistance is a natural evolutionary process, the use of inappropriate and excessive antimicrobials in humans, animals, agriculture and the environment has contributed to the emergence and spread of antimicrobial resistance.

The spread of bacterial AMR poses a special concern because resistance to the bacteria is linked to treatment failure, longer hospital stays, higher costs, disability, and death. According to a global analysis, in 2021 bacterial AMR was responsible for 4.71 million deaths, of which around 1.14 million were directly attributed to the disease. Without effective interventions, there will be a significant increase in the burden. AMR may have multiple molecular mechanisms such as, but not limited to, enzymatic antimicrobial inactivation, alteration/protection of antimicrobial target, decreased uptake/permeability, active efflux, metabolic adaptation, biofilm formation, and horizontal transfer of resistance determinants.

Alongside traditional antibiotic research, novel methods for antimicrobial drug discovery and development are gaining momentum, such as bacteriophage therapy, antimicrobial peptides, Cas9-based antimicrobial gene therapy, nanotechnology based antimicrobials, anti-biofilm agents, quorum-sensing inhibitors, monoclonal antibodies, microbiome-based therapies, host-directed therapies, and artificial intelligence (AI) assisted drug discovery. But better control of AMR will take more than new drugs. The importance of rapid diagnostics, antimicrobial stewardship, vaccination, genomic surveillance, environmental monitoring, infection prevention, equitable access to healthcare and a well-coordinated. The review covers the global burden of AMR, key molecular mechanisms of antimicrobial resistance, new therapeutic approaches, the challenges we face and future perspectives on a coordinated and precision-based response to AMR.


Keywords

Antimicrobial resistance/Antibiotic resistance; Multidrug resistant bacteria; Molecular mechanisms; Bacteriophage therapy; Antimicrobial peptides; CRISPR-Cas; Nanotechnology; Antimicrobial stewardship; One Health.



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References


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