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Antimicrobial Resistance: Is There a 'Light' at the End of the Tunnel?
Leon G Leanse1,2, Sanjay Marasini3, Carolina Dos Anjos2
1Health and Sports Sciences Hub, University of Gibraltar, Europa Point Campus, Gibraltar GX11 1AA, Gibraltar.
Abstract:
In recent years, with the increases in microorganisms that express a multitude of antimicrobial resistance (AMR) mechanisms, the threat of antimicrobial resistance in the global population has reached critical levels. The introduction of the COVID-19 pandemic has further contributed to the influx of infections caused by multidrug-resistant organisms (MDROs), which has placed significant pressure on healthcare systems. For over a century, the potential for light-based approaches targeted at combatting both cancer and infectious diseases has been proposed. They offer effective killing of microbial pathogens, regardless of AMR status, and have not typically been associated with high propensities of resistance development. To that end, the goal of this review is to describe the different mechanisms that drive AMR, including intrinsic, phenotypic, and acquired resistance mechanisms. Additionally, the different light-based approaches, including antimicrobial photodynamic therapy (aPDT), antimicrobial blue light (aBL), and ultraviolet (UV) light, will be discussed as potential alternatives or adjunct therapies with conventional antimicrobials. Lastly, we will evaluate the feasibility and requirements associated with integration of light-based approaches into the clinical pipeline.
Insights
Antimicrobial resistance (AMR) is a growing global threat. Light-based therapies like antimicrobial photodynamic therapy (aPDT) show promise in combating drug-resistant infections with minimal resistance development.
Area of Science:
- Microbiology and Infectious Diseases
- Biomedical Engineering
- Photomedicine
Background:
- Rising antimicrobial resistance (AMR) poses a critical global health threat, exacerbated by multidrug-resistant organisms (MDROs).
- The COVID-19 pandemic has intensified the challenge of MDRO infections, straining healthcare systems worldwide.
- Light-based therapeutic approaches have a long history of investigation for treating both cancer and infectious diseases.
Purpose of the Study:
- To elucidate the diverse mechanisms underlying antimicrobial resistance (AMR), encompassing intrinsic, phenotypic, and acquired resistance.
- To review various light-based therapeutic modalities, including antimicrobial photodynamic therapy (aPDT), antimicrobial blue light (aBL), and ultraviolet (UV) light.
- To assess the clinical feasibility and integration requirements for light-based therapies as alternatives or adjuncts to conventional antimicrobials.
Main Methods:
- Comprehensive literature review of antimicrobial resistance mechanisms.
- Analysis of existing research on light-based therapies (aPDT, aBL, UV light) for antimicrobial applications.
- Evaluation of clinical translation challenges and requirements for light-based interventions.
Main Results:
- Light-based approaches demonstrate effective pathogen killing irrespective of AMR status.
- These therapies are associated with a low propensity for resistance development compared to conventional antibiotics.
- Various light-based methods offer potential as standalone or complementary treatments against resistant microbes.
Conclusions:
- Light-based therapies represent a promising strategy to combat the escalating crisis of antimicrobial resistance.
- Further research and clinical evaluation are necessary to facilitate the integration of aPDT, aBL, and UV light into standard medical practice.
- These modalities offer a viable path to overcome infections caused by multidrug-resistant organisms (MDROs).
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