Shariati Aref, Kashi Milad, Chegini Zahra, Hosseini Seyed Mostafa
Infectious Diseases Research Center (IDRC), Arak University of Medical Sciences, Arak, Iran.
Student research committee, Arak University of Medical Sciences, Arak, Iran.
Front Pharmacol. 2024 Sep 17;15:1467086. doi: 10.3389/fphar.2024.1467086. eCollection 2024.
Carbapenem-resistant (CR) Gram-negative bacteria have become a significant public health problem in the last decade. In recent years, the prevalence of CR bacteria has increased. The resistance to carbapenems could result from different mechanisms such as loss of porin, penicillin-binding protein alteration, carbapenemase, efflux pump, and biofilm community. Additionally, genetic variations like insertion, deletion, mutation, and post-transcriptional modification of corresponding coding genes could decrease the susceptibility of bacteria to carbapenems. In this regard, scientists are looking for new approaches to inhibit CR bacteria. Using bacteriophages, natural products, nanoparticles, disulfiram, N-acetylcysteine, and antimicrobial peptides showed promising inhibitory effects against CR bacteria. Additionally, the mentioned compounds could destroy the biofilm community of CR bacteria. Using them in combination with conventional antibiotics increases the efficacy of antibiotics, decreases their dosage and toxicity, and resensitizes CR bacteria to antibiotics. Therefore, in the present review article, we have discussed different aspects of non-antibiotic approaches for managing and inhibiting the CR bacteria and various methods and procedures used as an alternative for carbapenems against these bacteria.
耐碳青霉烯革兰氏阴性菌在过去十年中已成为一个重大的公共卫生问题。近年来，耐碳青霉烯细菌的流行率有所上升。对碳青霉烯类药物的耐药性可能由不同机制引起，如孔蛋白丢失、青霉素结合蛋白改变、碳青霉烯酶、外排泵和生物膜群落。此外，相应编码基因的插入、缺失、突变和转录后修饰等基因变异可能会降低细菌对碳青霉烯类药物的敏感性。在这方面，科学家们正在寻找抑制耐碳青霉烯细菌的新方法。使用噬菌体、天然产物、纳米颗粒、双硫仑、N-乙酰半胱氨酸和抗菌肽对耐碳青霉烯细菌显示出有前景的抑制作用。此外，上述化合物可以破坏耐碳青霉烯细菌的生物膜群落。将它们与传统抗生素联合使用可提高抗生素的疗效，降低其剂量和毒性，并使耐碳青霉烯细菌重新对抗生素敏感。因此，在本综述文章中，我们讨论了管理和抑制耐碳青霉烯细菌的非抗生素方法的不同方面，以及用作碳青霉烯类药物替代物对抗这些细菌的各种方法和程序。
