Discerning the role of polymicrobial biofilms in the ascent, prevalence, and extent of heteroresistance in clinical practice
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/1822/70787 |
Resumo: | Antimicrobial therapy is facing a worrisome and underappreciated challenge, the phenomenon of heteroresistance (HR). HR has been gradually documented in clinically relevant pathogens (e.g. Pseudomonas aeruginosa, Staphylococcus aureus, Burkholderia spp., Acinetobacter baumannii, Klebsiella pneumoniae, Candida spp.) towards several drugs and is believed to complicate the clinical picture of chronic infections. This type of infections are typically mediated by polymicrobial biofilms, wherein microorganisms inherently display a wide range of physiological states, distinct metabolic pathways, diverging refractory levels of stress responses, and a complex network of chemical signals exchange. This review aims to provide an overview on the relevance, prevalence, and implications of HR in clinical settings. Firstly, related terminologies (e.g. resistance, tolerance, persistence), sometimes misunderstood and overlapped, were clarified. Factors generating misleading HR definitions were also uncovered. Secondly, the recent HR incidences reported in clinically relevant pathogens towards different antimicrobials were annotated. The potential mechanisms underlying such occurrences were further elucidated. Finally, the link between HR and biofilms was discussed. The focus was to recognize the presence of heterogeneous levels of resistance within most biofilms, as well as the relevance of polymicrobial biofilms in chronic infectious diseases and their role in resistance spreading. These topics were subject of a critical appraisal, gaining insights into the ascending clinical implications of HR in antimicrobial resistance spreading, which could ultimately help designing effective therapeutic options. |
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Discerning the role of polymicrobial biofilms in the ascent, prevalence, and extent of heteroresistance in clinical practiceAntimicrobialBiofilmClinical failureHeteroresistanceInterspecies interactionsScience & TechnologyAntimicrobial therapy is facing a worrisome and underappreciated challenge, the phenomenon of heteroresistance (HR). HR has been gradually documented in clinically relevant pathogens (e.g. Pseudomonas aeruginosa, Staphylococcus aureus, Burkholderia spp., Acinetobacter baumannii, Klebsiella pneumoniae, Candida spp.) towards several drugs and is believed to complicate the clinical picture of chronic infections. This type of infections are typically mediated by polymicrobial biofilms, wherein microorganisms inherently display a wide range of physiological states, distinct metabolic pathways, diverging refractory levels of stress responses, and a complex network of chemical signals exchange. This review aims to provide an overview on the relevance, prevalence, and implications of HR in clinical settings. Firstly, related terminologies (e.g. resistance, tolerance, persistence), sometimes misunderstood and overlapped, were clarified. Factors generating misleading HR definitions were also uncovered. Secondly, the recent HR incidences reported in clinically relevant pathogens towards different antimicrobials were annotated. The potential mechanisms underlying such occurrences were further elucidated. Finally, the link between HR and biofilms was discussed. The focus was to recognize the presence of heterogeneous levels of resistance within most biofilms, as well as the relevance of polymicrobial biofilms in chronic infectious diseases and their role in resistance spreading. These topics were subject of a critical appraisal, gaining insights into the ascending clinical implications of HR in antimicrobial resistance spreading, which could ultimately help designing effective therapeutic options.This work was supported by the Portuguese Foundation for Science Technology (FCT) under the scope of the strategic funding of UID/BIO/04469/2020 unit BioTecNorte operation [NORTE-01-0145-FEDER-000004] funded by the European Regional Development Fund under the scope of Norte2020–Programa Operacional Regional do Norte. The authors also acknowledge COMPETE2020 FCT for the project POCI-01-0145-FEDER-029,841 and for the Scientific Employment Stimulus 2017 grant [CEECIND/01507/2017] (A. M. Sousa).info:eu-repo/semantics/publishedVersionTaylor and FrancisUniversidade do MinhoLopes, Susana PatríciaJorge, Paula Alexandra SilvaSousa, Ana MargaridaPereira, Maria Olívia2021-02-022021-02-02T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/1822/70787engLopes, Susana P.; Jorge, Paula; Sousa, Ana Margarida; Pereira, Maria Olívia, Discerning the role of polymicrobial biofilms in the ascent, prevalence, and extent of heteroresistance in clinical practice. Critical Reviews in Microbiology, 47(2), 162-191, 20211040-841X1549-782810.1080/1040841X.2020.186332933527850http://informahealthcare.com/journal/mbyinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-21T11:54:48Zoai:repositorium.sdum.uminho.pt:1822/70787Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T18:44:16.783244Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Discerning the role of polymicrobial biofilms in the ascent, prevalence, and extent of heteroresistance in clinical practice |
title |
Discerning the role of polymicrobial biofilms in the ascent, prevalence, and extent of heteroresistance in clinical practice |
spellingShingle |
Discerning the role of polymicrobial biofilms in the ascent, prevalence, and extent of heteroresistance in clinical practice Lopes, Susana Patrícia Antimicrobial Biofilm Clinical failure Heteroresistance Interspecies interactions Science & Technology |
title_short |
Discerning the role of polymicrobial biofilms in the ascent, prevalence, and extent of heteroresistance in clinical practice |
title_full |
Discerning the role of polymicrobial biofilms in the ascent, prevalence, and extent of heteroresistance in clinical practice |
title_fullStr |
Discerning the role of polymicrobial biofilms in the ascent, prevalence, and extent of heteroresistance in clinical practice |
title_full_unstemmed |
Discerning the role of polymicrobial biofilms in the ascent, prevalence, and extent of heteroresistance in clinical practice |
title_sort |
Discerning the role of polymicrobial biofilms in the ascent, prevalence, and extent of heteroresistance in clinical practice |
author |
Lopes, Susana Patrícia |
author_facet |
Lopes, Susana Patrícia Jorge, Paula Alexandra Silva Sousa, Ana Margarida Pereira, Maria Olívia |
author_role |
author |
author2 |
Jorge, Paula Alexandra Silva Sousa, Ana Margarida Pereira, Maria Olívia |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
Universidade do Minho |
dc.contributor.author.fl_str_mv |
Lopes, Susana Patrícia Jorge, Paula Alexandra Silva Sousa, Ana Margarida Pereira, Maria Olívia |
dc.subject.por.fl_str_mv |
Antimicrobial Biofilm Clinical failure Heteroresistance Interspecies interactions Science & Technology |
topic |
Antimicrobial Biofilm Clinical failure Heteroresistance Interspecies interactions Science & Technology |
description |
Antimicrobial therapy is facing a worrisome and underappreciated challenge, the phenomenon of heteroresistance (HR). HR has been gradually documented in clinically relevant pathogens (e.g. Pseudomonas aeruginosa, Staphylococcus aureus, Burkholderia spp., Acinetobacter baumannii, Klebsiella pneumoniae, Candida spp.) towards several drugs and is believed to complicate the clinical picture of chronic infections. This type of infections are typically mediated by polymicrobial biofilms, wherein microorganisms inherently display a wide range of physiological states, distinct metabolic pathways, diverging refractory levels of stress responses, and a complex network of chemical signals exchange. This review aims to provide an overview on the relevance, prevalence, and implications of HR in clinical settings. Firstly, related terminologies (e.g. resistance, tolerance, persistence), sometimes misunderstood and overlapped, were clarified. Factors generating misleading HR definitions were also uncovered. Secondly, the recent HR incidences reported in clinically relevant pathogens towards different antimicrobials were annotated. The potential mechanisms underlying such occurrences were further elucidated. Finally, the link between HR and biofilms was discussed. The focus was to recognize the presence of heterogeneous levels of resistance within most biofilms, as well as the relevance of polymicrobial biofilms in chronic infectious diseases and their role in resistance spreading. These topics were subject of a critical appraisal, gaining insights into the ascending clinical implications of HR in antimicrobial resistance spreading, which could ultimately help designing effective therapeutic options. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-02-02 2021-02-02T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1822/70787 |
url |
http://hdl.handle.net/1822/70787 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Lopes, Susana P.; Jorge, Paula; Sousa, Ana Margarida; Pereira, Maria Olívia, Discerning the role of polymicrobial biofilms in the ascent, prevalence, and extent of heteroresistance in clinical practice. Critical Reviews in Microbiology, 47(2), 162-191, 2021 1040-841X 1549-7828 10.1080/1040841X.2020.1863329 33527850 http://informahealthcare.com/journal/mby |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Taylor and Francis |
publisher.none.fl_str_mv |
Taylor and Francis |
dc.source.none.fl_str_mv |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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