A Comprehensive Review on Mechanism, Clinical Impact, Alternative Treatment and Challenges in drug Development of Multidrug Resistance Bacteria

Abstract

Antibiotic resistant bacteria and resistance genes have become more prevalent in the
environment due to unchecked use, despite the fact that antibiotics are widely used to
prevent and treat infections in both humans and animals. Multidrug-resistant (MDR)
bacteria can survive in harsh environments and are found in reservoirs created by
wastewater and untreated sewage from hospitals, industries, and agricultural operations.
Drinking water, soil, wastewater, groundwater, and surface water have all been found to
contain resistant bacteria. Mycobacterium tuberculosis, Enterococcus faecium,
Klebsiella pneumoniae, Staphylococcus aureus, Acinetobacter baumannii, and
Pseudomonas aeruginosa are MDR pathogens that are significant worldwide.
Salmonella, Vibrio cholerae, and Shigella are examples of MDR enteric pathogens that
present additional risks to public health in developing nations. Because of the
production of carbapenemase, resistance to carbapenems, which are frequently the last
line of treatment for MDR Gram-negative bacteria like K. pneumoniae and E. coli, has
become especially concerning. MDR bacteria use a variety of strategies, such as efflux
pumps, antibiotic degradation or modification, target site mutation, decreased
membrane permeability, biofilm formation, and horizontal gene transfer through
conjugation, transduction, and transformation. Hospital-acquired resistance has gotten
worse due to the spread of β-lactamases, ESBLs, and carbapenemases via plasmids.
According to clinical research, infections brought on by MDR organisms are associated
with longer hospital stays, higher treatment expenses, and higher mortality rates,
especially in intensive care units and patients with compromised immune systems.
Synergistic antibiotic combinations, efflux pump inhibitors, engineered endolysins
(artilysins), and tactics aimed at outer membrane permeability are among the novel
approaches being investigated to treat MDR infections. Control efforts are made more
difficult by the spread of resistance genes via clonal outbreaks and mobile genetic
elements. MDR bacteria continue to be a significant global clinical and public health
concern because no single antibiotic is effective against all pathogens