How do Superbugs communicate to spread Antimicrobial Resistance?

Article by?Oshin J. Theodore

Over the years, by their way of adaptation, living beings have come to acclimatise themselves to shelters that give them protection and security. One such protective environment is biofilm formation. A biofilm comprises a large number of sessile microcolonies that shield its cells from environmental stress. The sessile microcolonies are capable of communication through a communication system known as quorum sensing. This mechanism could result in the synthesis of compounds needed for the development of antimicrobial resistance (AMR).

The ability of microbes to resist these antimicrobial agents may be naturally acquired or from other microbes. Factors that result in AMR may be unrestrained or overuse of antibiotics and improper prescription where a broad-spectrum drug is used. Microbes have well acquainted themselves with a variety of drugs due to repeated exposure. These drug resistant microbes may be categorised as multidrug-resistant (MDR) and extensively drug-resistant (XDR) also referred to as “Superbugs”.

AMR is the phenomenon of microbes developing resistance to drugs. This resistance can be exhibited through processes like inactivation of a drug or prevention of its uptake by going through cell wall modifications. Once a drug enters the microbe, it is pumped out through a special membrane pump. These pumps may be classified depending on the antimicrobial activity. The antimicrobial agents that we use, interfere with the cell wall synthesis and result in inhibition of metabolic pathways, protein and nucleic acid synthesis.?

Overdose of an antimicrobial agent may increase the patient’s risk of getting infected by the pathogen, showing sensitivity to the drug. ICU has been reported as a hotbed for superbugs resulting in high mortality due to Hospital-Acquired Infections (HAI) in ICU patients infected with superbugs. While the global burden of AMR and associated infections continue to be on the rise, it also has been identified as the leading cause of death.?

References

[1] Raju, Dantuluri Veerabhadra, et al. "Effect of bacterial quorum sensing and mechanism of antimicrobial resistance." Biocatalysis and Agricultural Biotechnology 43 (2022): 102409.

[2] Ma, Yanna, et al. "Stress tolerance of Staphylococcus aureus with different antibiotic resistance profiles." Microbial pathogenesis 133 (2019): 103549.

[3] Kalia, Vipin Chandra, et al. "Quorum sensing inhibitors as antipathogens: biotechnological applications." Biotechnology advances 37.1 (2019): 68-90.

[4] Haque, Shafiul, et al. "Quorum sensing pathways in Gram-positive and-negative bacteria: potential of their interruption in abating drug resistance." Journal of Chemotherapy 31.4 (2019): 161-187.

[5] Murray, Christopher JL, et al. "Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis." The Lancet 399.10325 (2022): 629-655.