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Heliyon
Oct, 2023;9 (10): e20561.

The burden of hospital acquired infections and antimicrobial resistance.

Molly Kukua Abban, Eunice Ampadubea Ayerakwa, Lydia Mosi, Abiola Isawumi
Author Information
  1. Molly Kukua Abban: West African Centre for Cell Biology of Infectious Pathogens, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, Ghana.
  2. Eunice Ampadubea Ayerakwa: West African Centre for Cell Biology of Infectious Pathogens, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, Ghana.
  3. Lydia Mosi: West African Centre for Cell Biology of Infectious Pathogens, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, Ghana.
  4. Abiola Isawumi: West African Centre for Cell Biology of Infectious Pathogens, P.O. Box LG 54, Volta Road, University of Ghana, Legon, Accra, Ghana.
PMID: 37818001 DOI: 10.1016/j.heliyon.2023.e20561

Abstract

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 - (, , , , and 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.

Keywords

AMR mechanisms Antimicrobial resistance ESKAPE pathogens Hospital care-associated infections Nosocomial infections Polymyxins

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