Coping with the ESKAPE pathogens: Evolving strategies, challenges and future prospects

Area of Science:

• Microbiology
• Infectious Diseases
• Pharmacology

Background:

• ESKAPE pathogens are a major cause of hospital-acquired infections globally.
• These multidrug-resistant bacteria pose significant health and economic challenges worldwide.
• Existing treatments are becoming less effective due to widespread antimicrobial resistance.

Purpose of the Study:

• To review emerging alternative therapeutic strategies for treating ESKAPE pathogens.
• To analyze the merits, limitations, and future prospects of these novel therapies.
• To highlight the importance of understanding resistance mechanisms for treatment development.

Main Methods:

• This narrative review examines combination antibiotics, antimicrobial peptides (AMPs), bacteriophage therapy, and photodynamic therapy.
• The review analyzes mechanisms of drug resistance employed by ESKAPE pathogens.
• It discusses the benefits and drawbacks of alternative therapeutic approaches.

Main Results:

• ESKAPE pathogens utilize diverse resistance mechanisms, including drug inactivation, altered drug-binding sites, reduced permeability, increased efflux, and biofilm formation.
• Novel strategies like AMPs and phage therapy offer benefits but face limitations such as instability, toxicity, and host immune responses.
• Significant scientific interest exists in these alternative therapies despite their challenges.

Conclusions:

• Comprehending bacterial resistance mechanisms is crucial for refining and developing new therapeutic strategies.
• Overcoming resistance barriers is essential to address the global health challenges posed by ESKAPE pathogens.
• Continued research into alternative therapies and resistance mechanisms is vital for future treatment success.