The burden of hospital acquired infections and antimicrobial resistance

The burden of Hospital care-associated infections (HCAIs) is becoming a global concern. This is compounded by the emergence of virulent and high-risk bacterial strains such as “ESKAPE” pathogens – (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomon...

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Main Authors: Molly Kukua Abban, Eunice Ampadubea Ayerakwa, Lydia Mosi, Abiola Isawumi
Format: Article
Language:English
Published: Elsevier 2023-10-01
Series:Heliyon
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405844023077691
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author Molly Kukua Abban
Eunice Ampadubea Ayerakwa
Lydia Mosi
Abiola Isawumi
author_facet Molly Kukua Abban
Eunice Ampadubea Ayerakwa
Lydia Mosi
Abiola Isawumi
author_sort Molly Kukua Abban
collection DOAJ
description The burden of Hospital care-associated infections (HCAIs) is becoming a global concern. This is compounded by the emergence of virulent and high-risk bacterial strains such as “ESKAPE” pathogens – (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species), especially within Intensive care units (ICUs) that house high-risk and immunocompromised patients. In this review, we discuss the contributions of AMR pathogens to the increasing burden of HCAIs and provide insights into AMR mechanisms, with a particular focus on last-resort antibiotics like polymyxins. We extensively discuss how structural modifications of surface-membrane lipopolysaccharides and cationic interactions influence and inform AMR, and subsequent severity of HCAIs. We highlight some bacterial phenotypic survival mechanisms against polymyxins. Lastly, we discuss the emergence of plasmid-mediated resistance as a phenomenon making mitigation of AMR difficult, especially within the ICUs. This review provides a balanced perspective on the burden of HCAIs, associated pathogens, implication of AMR and factors influencing emerging AMR mechanisms.
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spelling doaj.art-6c7550a4be774275bf682e40a46624e02023-10-30T06:06:35ZengElsevierHeliyon2405-84402023-10-01910e20561The burden of hospital acquired infections and antimicrobial resistanceMolly Kukua Abban0Eunice Ampadubea Ayerakwa1Lydia Mosi2Abiola Isawumi3West African Centre for Cell Biology of Infectious Pathogens, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, Ghana; Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, GhanaWest African Centre for Cell Biology of Infectious Pathogens, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, Ghana; Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, GhanaWest African Centre for Cell Biology of Infectious Pathogens, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, Ghana; Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, GhanaWest African Centre for Cell Biology of Infectious Pathogens, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, Ghana; Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, Ghana; Corresponding author. West African Centre for Cell Biology of Infectious Pathogens, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, Ghana.The burden of Hospital care-associated infections (HCAIs) is becoming a global concern. This is compounded by the emergence of virulent and high-risk bacterial strains such as “ESKAPE” pathogens – (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species), especially within Intensive care units (ICUs) that house high-risk and immunocompromised patients. In this review, we discuss the contributions of AMR pathogens to the increasing burden of HCAIs and provide insights into AMR mechanisms, with a particular focus on last-resort antibiotics like polymyxins. We extensively discuss how structural modifications of surface-membrane lipopolysaccharides and cationic interactions influence and inform AMR, and subsequent severity of HCAIs. We highlight some bacterial phenotypic survival mechanisms against polymyxins. Lastly, we discuss the emergence of plasmid-mediated resistance as a phenomenon making mitigation of AMR difficult, especially within the ICUs. This review provides a balanced perspective on the burden of HCAIs, associated pathogens, implication of AMR and factors influencing emerging AMR mechanisms.http://www.sciencedirect.com/science/article/pii/S2405844023077691Hospital care-associated infectionsNosocomial infectionsAntimicrobial resistanceESKAPE pathogensAMR mechanismsPolymyxins
spellingShingle Molly Kukua Abban
Eunice Ampadubea Ayerakwa
Lydia Mosi
Abiola Isawumi
The burden of hospital acquired infections and antimicrobial resistance
Heliyon
Hospital care-associated infections
Nosocomial infections
Antimicrobial resistance
ESKAPE pathogens
AMR mechanisms
Polymyxins
title The burden of hospital acquired infections and antimicrobial resistance
title_full The burden of hospital acquired infections and antimicrobial resistance
title_fullStr The burden of hospital acquired infections and antimicrobial resistance
title_full_unstemmed The burden of hospital acquired infections and antimicrobial resistance
title_short The burden of hospital acquired infections and antimicrobial resistance
title_sort burden of hospital acquired infections and antimicrobial resistance
topic Hospital care-associated infections
Nosocomial infections
Antimicrobial resistance
ESKAPE pathogens
AMR mechanisms
Polymyxins
url http://www.sciencedirect.com/science/article/pii/S2405844023077691
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