Elshobary Mostafa E, Badawy Nadia K, Ashraf Yara, Zatioun Asmaa A, Masriya Hagar H, Ammar Mohamed M, Mohamed Nourhan A, Mourad Sohaila, Assy Abdelrahman M
Botany and Microbiology Department, Faculty of Science, Tanta University, Tanta 31527, Egypt.
Aquaculture Research, Alfred Wegener Institute (AWI)-Helmholtz Centre for Polar and Marine Research, Am Handelshafen, 27570 Bremerhaven, Germany.
Pharmaceuticals (Basel). 2025 Mar 12;18(3):402. doi: 10.3390/ph18030402.
The escalating global health crisis of antibiotic resistance, driven by the rapid emergence of multidrug-resistant (MDR) bacterial pathogens, necessitates urgent and innovative countermeasures. This review comprehensively examines the diverse mechanisms employed by bacteria to evade antibiotic action, including alterations in cell membrane permeability, efflux pump overexpression, biofilm formation, target site modifications, and the enzymatic degradation of antibiotics. Specific focus is given to membrane transport systems such as ATP-binding cassette (ABC) transporters, resistance-nodulation-division (RND) efflux pumps, major facilitator superfamily (MFS) transporters, multidrug and toxic compound extrusion (MATE) systems, small multidrug resistance (SMR) families, and proteobacterial antimicrobial compound efflux (PACE) families. Additionally, the review explores the global burden of MDR pathogens and evaluates emerging therapeutic strategies, including quorum quenching (QQ), probiotics, postbiotics, synbiotics, antimicrobial peptides (AMPs), stem cell applications, immunotherapy, antibacterial photodynamic therapy (aPDT), and bacteriophage. Furthermore, this review discusses novel antimicrobial agents, such as animal-venom-derived compounds and nanobiotics, as promising alternatives to conventional antibiotics. The interplay between clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated proteins (Cas) in bacterial adaptive immunity is analyzed, revealing opportunities for targeted genetic interventions. By synthesizing current advancements and emerging strategies, this review underscores the necessity of interdisciplinary collaboration among biomedical scientists, researchers, and the pharmaceutical industry to drive the development of novel antibacterial agents. Ultimately, this comprehensive analysis provides a roadmap for future research, emphasizing the urgent need for sustainable and cooperative approaches to combat antibiotic resistance and safeguard global health.
多重耐药(MDR)细菌病原体的迅速出现引发了全球抗生素耐药性这一日益严重的健康危机,因此迫切需要采取创新的应对措施。本综述全面研究了细菌用于逃避抗生素作用的多种机制,包括细胞膜通透性改变、外排泵过度表达、生物膜形成、靶位点修饰以及抗生素的酶促降解。特别关注了膜转运系统,如ATP结合盒(ABC)转运蛋白、耐药-固氮-分裂(RND)外排泵、主要易化子超家族(MFS)转运蛋白、多药和有毒化合物外排(MATE)系统、小多重耐药(SMR)家族以及变形菌抗菌化合物外排(PACE)家族。此外,该综述探讨了MDR病原体的全球负担,并评估了新兴的治疗策略,包括群体感应淬灭(QQ)、益生菌、后生元、合生元、抗菌肽(AMPs)、干细胞应用、免疫疗法﹑抗菌光动力疗法(aPDT)和噬菌体。此外,本综述还讨论了新型抗菌剂,如动物毒液衍生化合物和纳米生物制剂,作为传统抗生素的有前景的替代品。分析了成簇规律间隔短回文重复序列(CRISPR)与CRISPR相关蛋白(Cas)在细菌适应性免疫中的相互作用,揭示了靶向基因干预的机会。通过综合当前的进展和新兴策略,本综述强调了生物医学科学家、研究人员和制药行业之间跨学科合作以推动新型抗菌剂开发的必要性。最终,这一全面分析为未来研究提供了路线图,强调了采取可持续和合作方法来对抗抗生素耐药性并保障全球健康的迫切需求。