Strategies to combat antimicrobial resistance: anti-plasmid and plasmid curing

Area of Science:

• Microbiology
• Genetics
• Molecular Biology

Background:

• Antimicrobial resistance (AMR) is a significant global health threat, compromising modern medicine.
• Antimicrobial resistance genes (ARGs) are often located on transmissible plasmids, facilitating their spread.
• Effective strategies are needed to reduce ARG prevalence and restore antibiotic efficacy.

Purpose of the Study:

• To review current and novel strategies for combating antimicrobial resistance through plasmid targeting.
• To highlight the potential of plasmid curing and anti-plasmid approaches.
• To identify the critical need for in vivo plasmid curing methods.

Main Methods:

• Discussion of various plasmid curing agents used in laboratory settings (chemicals, drugs, plant compounds).
• Examination of novel anti-plasmid strategies including conjugation inhibitors, plasmid incompatibility systems, phages, and CRISPR/Cas approaches.
• Review of existing literature on plasmid curing and anti-plasmid technologies.

Main Results:

• A wide range of laboratory-based plasmid curing agents have been identified.
• Emerging strategies like conjugation inhibitors and CRISPR/Cas offer new avenues for anti-plasmid interventions.
• There is a significant lack of effective in vivo plasmid curing options.

Conclusions:

• Plasmid curing and anti-plasmid strategies hold promise for reducing ARG prevalence and sensitizing bacteria to antibiotics.
• Filling the gap in in vivo curing methods could provide a powerful tool against AMR in clinical and veterinary settings.
• Even ex vivo plasmid curing methods can contribute to reducing the environmental burden of ARGs.