Innovative Approaches to address antimicrobial resistance in ESKAPE Pathogens: A global health perspective

Abstract

Antimicrobial resistance (AMR) has become a critical global health crisis, driven by the misuse of antibiotics, self-medication, and inadequate healthcare practices, particularly in low-resource settings. These factors have accelerated the rise of Multidrug-Resistant (MDR) pathogens, with the ESKAPE group Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. posing the greatest threat due to their ability to evade most existing antibiotics. These pathogens are responsible for a significant proportion of healthcare-associated infections and exhibit diverse resistance mechanisms, including antibiotic-degrading enzymes, efflux pumps, porin alterations, and robust biofilm formation. The World Health Organization warns that AMR could result in up to 10 million deaths annually by 2050, surpassing the global mortality of cancer. The escalating burden of AMR demands innovative solutions beyond conventional antibiotics. Promising alternatives include novel antimicrobials, antimicrobial peptides, synthetic peptoids, bacteriophage therapy, nanotechnology-based drug delivery systems, and anti-virulence approaches targeting quorum sensing, biofilm formation, toxins, and regulatory pathways. These emerging strategies offer targeted and potentially more effective means to combat MDR ESKAPE pathogens. However, challenges such as high development costs, limited clinical translation, and lack of standardized global policies persist. Coordinated international efforts in surveillance, stewardship, and research are essential to mitigate the AMR crisis and secure effective treatments for future generations.