Cross-resistance and associated resistance in <Emphasis Type="Italic">Escherichia coli</Emphasis> isolates from nosocomial urinary tract infections between 2004–2006 in a Turkish Hospital

In this study, antimicrobial resistance profiles were determined for 748 isolates of Escherichia coli from patients with acute nosocomial urinary tract infections (UTIs) at a Turkish Training Hospital. Thirteen antibiotics were included. Resistance to ampicillin alone (45.1%) and ciprofloxacin alone (20.6%) were the most commonly identified ‘single resistances’. Multiple resistance was found in 49.7% of the strains. The most common multiple antibiotic resistance profiles included ampicillin-sulbactam/amoxycilline-clavulonate (4.0%) and ampicillin-sulbactam/trimethoprim-sulfamethoxazole/amoxycilline-clavulonate (2.8%). From 2004 to 2006, ampicillin, trimethoprim-sulfamethoxazole and ciprofloxacin resistant strains increased to 76% from 57%, 53% from 43% and 55% from 41%, respectively. The percentage of extended-spectrum β-lactamase (ESBL) producing strains was 7.8% and imipenem resistance was seen in 5.2% of ESBL positive strains. We conclude that clinically important E.coli strains have now emerged with broader multidrug resistance. Periodical evaluation of laboratory results and clinical surveillance are crucially important for optimal antibiotic management of UTIs and infection control policies.     

Antimicrobial susceptibility of Listeria monocytogenes isolated from meningoencephalitis in sheep

The antimicrobial susceptibility to different antimicrobial agents of 41 Listeria monocytogenes strains isolated from sheep with meningoencephalitis and from feedstuff was tested by both microdilution and disk diffusion methods. Both sets of isolates of L. monocytogenes were susceptible to penicillin G, amoxicillin, cephalothin, erythromycin, vancomycin, rifampicin, gentamicin, kanamycin, trimethoprim, sulfisoxazole, chloramphenicol and ciprofloxacin, but resistant to tetracycline and doxycycline (7.3 and 4.9%, respectively). Tetracycline was the most frequent resistance trait in L. monocytogenes strains of animal origin. Four strains (9.8%) also exhibited reduced susceptibility (MIC 4 mg/l) to doxycycline suggesting the need of surveillance studies to monitor the antimicrobial resistance of Listeria strains of animal origin.     

A 1-year study of antibiotic resistance among paediatric pneumococcal isolates in 1995 from four regions of France

The main object of this study was to describe the features of antibiotic resistance in pneumococci from children in four regions of France in 1995. Despite the high prevalence (40%) of pneumococci with diminished susceptibilty to penicillin (PDSP), resistance to amoxycillin (0.8%) and cefotaxime (0.4%) was rare; 16% of pneumococci were resistant to penicillin G (PRP, MIC > 1 mg/l). PDSP showed the expected resistance to macrolides (67%) and cotrimoxazole (57%) and were predominantly serotypes 23F, 14, 9 and 6. This study by the Regional Pneumococcal Observatories confirms the high prevalence and the main characteristics of antibiotic resistance among pneumococci isolated from children. Nevertheless, the resistance to all antibiotics was lower than that found in French multicentre, nationwide surveys, possibly because of differences in the mode of strain collection and geographic origin.     

Antimicrobials: modes of action and mechanisms of resistance

After six decades of widespread antibiotic use, bacterial pathogens of human and animal origin are becoming increasingly resistant to many antimicrobial agents. Antimicrobial resistance develops through a limited number of mechanisms: (a). permeability changes in the bacterial cell wall/membrane, which restrict antimicrobial access to target sites; (b). active efflux of the antimicrobial from the cell; (c). mutation in the target site; (d). enzymatic modification or degradation of the antimicrobial; and (e). acquisition of alternative metabolic pathways to those inhibited by the drug. Numerous bacterial antimicrobial resistance phenotypes result from the acquisition of external genes that may provide resistance to an entire class of antimicrobials. These genes are frequently associated with large transferable extrachromosomal DNA elements called plasmids, on which may be other mobile DNA elements such as transposons and integrons. An array of different resistance genes may accumulate on a single mobile element, presenting a situation in which multiple antibiotic resistance can be acquired via a single genetic event. The versatility of bacterial populations in adapting to toxic environments, along with their facility in exchanging DNA, signifies that antibiotic resistance is an inevitable biological phenomenon that will likely continue to be a chronic medical problem. Successful management of current antimicrobials, and the continued development of new ones, is vital to protecting human and animal health against bacterial pathogens.     

2018年内蒙古包头市细菌耐药性监测

目的 了解2018年内蒙古包头市11所参加全国细菌耐药监测网医院临床分离株的构成及耐药情况,为本地区临床合理化用药提供理论依据。方法 各成员医院按监测方案,采用纸片扩散法或自动化仪器检测法进行药敏试验,按美国临床实验室标准化研究协会(CLSI) 2017年版标准判读药敏结果,采用WHONET 5.6软件进行数据分析。结果 共收集上述医院非重复临床分离菌7773株,其中革兰阳性菌2138株,占27.5%,革兰阴性菌5635株,占72.5%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的平均检出率分别为12.2%和66.9%,MRSA和MRCNS对大多数抗菌药物的耐药率均显著高于甲氧西林敏感株(MSSA和MSCNS),未发现利奈唑胺、万古霉素和替考拉宁耐药菌株。屎肠球菌对大多数抗菌药物的耐药率均显著高于粪肠球菌,粪肠球菌中发现有3株利奈唑胺、1株万古霉素和1株替考拉宁耐药菌株。非脑脊液标本分离的肺炎链球菌对青霉素的耐药率为2.0%。大肠埃希菌和克雷伯菌属中产ESBL菌株的平均检出率分别为48.3%和20.6%,产ESBL菌株对所测抗菌药物的耐药率均高于非产ESBL菌株。肠杆菌科细菌中CRE的检出率为1.2%,CRKP菌株对阿米卡星的耐药率为64.3%。铜绿假单胞菌对碳青霉烯类、氨基糖苷类、喹诺酮类、头孢他啶、头孢吡肟、头孢哌酮/舒巴坦和哌拉西林/三唑巴坦的耐药率均低于15.0%。不动杆菌属对包括碳青霉烯类在内的大多数抗菌药物的耐药率超过38.0%,其中亚胺培南和美罗培南的耐药率分别为42.3%和43.5%。结论 我市细菌耐药情况较全国水平低,但仍呈缓慢增长趋势,应继续做好细菌耐药性监测工作,加强抗菌药物临床应用管理措施,以合理化使用抗菌药物。     

2018年内蒙古包头市细菌耐药性监测

目的 了解2018年内蒙古包头市11所参加全国细菌耐药监测网医院临床分离株的构成及耐药情况,为本地区临床合理化用药提供理论依据。方法 各成员医院按监测方案,采用纸片扩散法或自动化仪器检测法进行药敏试验,按美国临床实验室标准化研究协会(CLSI) 2017年版标准判读药敏结果,采用WHONET 5.6软件进行数据分析。结果 共收集上述医院非重复临床分离菌7773株,其中革兰阳性菌2138株,占27.5%,革兰阴性菌5635株,占72.5%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的平均检出率分别为12.2%和66.9%,MRSA和MRCNS对大多数抗菌药物的耐药率均显著高于甲氧西林敏感株(MSSA和MSCNS),未发现利奈唑胺、万古霉素和替考拉宁耐药菌株。屎肠球菌对大多数抗菌药物的耐药率均显著高于粪肠球菌,粪肠球菌中发现有3株利奈唑胺、1株万古霉素和1株替考拉宁耐药菌株。非脑脊液标本分离的肺炎链球菌对青霉素的耐药率为2.0%。大肠埃希菌和克雷伯菌属中产ESBL菌株的平均检出率分别为48.3%和20.6%,产ESBL菌株对所测抗菌药物的耐药率均高于非产ESBL菌株。肠杆菌科细菌中CRE的检出率为1.2%,CRKP菌株对阿米卡星的耐药率为64.3%。铜绿假单胞菌对碳青霉烯类、氨基糖苷类、喹诺酮类、头孢他啶、头孢吡肟、头孢哌酮/舒巴坦和哌拉西林/三唑巴坦的耐药率均低于15.0%。不动杆菌属对包括碳青霉烯类在内的大多数抗菌药物的耐药率超过38.0%,其中亚胺培南和美罗培南的耐药率分别为42.3%和43.5%。结论     

Prevalence and mechanisms of fosfomycin resistance among KPC-producing Klebsiella pneumoniae clinical isolates in China

The threat of antibiotic resistance has increased dramatically in recent years. Fosfomycin, an old antibiotic agent, has been re-introduced to fight infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP). However, the trend of fosfomycin resistance among KPC-KP strains is increasing. In this study, 80 KPC-KP clinical isolates were collected from three teaching hospitals during 2014–2017 in China and were subjected to whole-genome sequencing (WGS). The fosfomycin resistance phenotype and resistance mechanisms were investigated by antimicrobial susceptibility testing and carbon source growth test, respectively. Among all KPC-KP strains, 80.0% (64/80) were resistant to fosfomycin and 36.3% (29/80) were positive for the mobile fosfomycin resistance gene fosA3. Among the 63 strains that were unable to grow in M9 basic medium with glycerol-3-phosphate (G3P) as the sole carbon source (mediated by mutation of the target gene glpT), there was no significant difference regarding the MIC distribution of fosfomycin between fosA3-positive and fosA3-negative strains (P = 0.577). Among the 50 strains that were negative for fosA3 but positive for fosA, the fosfomycin MICs of strains unable to grow in M9 basic medium with G3P as the sole carbon source were significantly higher (P < 0.001) than in strains that were able to grow in M9 basic medium with G3P as the sole carbon source. Our findings indicate that fosfomycin resistance among KPC-KP in China is an emerging problem and the two major mechanisms of resistance identified were plasmid-mediated fosfomycin resistance gene fosA3 and mutation of the target gene glpT.     

The use and resistance to antibiotics in the community

The frequency of resistance to antibiotics among common community-acquired pathogens, and the number of drugs to which they are resistant have been increasing worldwide. The relationship between antibiotic usage and resistance is strongly supported by data from several studies. Countries with the highest per capita antibiotic consumption have the highest resistance. The emergence of penicillin-resistant Streptococcus pneumoniae is related to high consumption of antibiotics in general, as well as to increased use of aminopenicillins and/or probably to wider use of oral cephalosporins. Increased consumption of macrolides, especially the long-acting ones, correlates significantly with the level of macrolide resistance of group A streptococci and S. pneumoniae while increased use of oral cephalosporins might be associated with the increase of beta-lactamase-producing strains of Moraxella catarrhalis. Trimethoprim/sulphamethoxazole resistance is strongly associated with resistance to penicillin. A rise in consumption of fluoroquinolones is consonant with a higher rate of resistance to quinolones of S. pneumoniae, Escherichia coli and other Gram-negative bacteria. Paediatric bacterial isolates are more often resistant to various antimicrobial agents than isolates from adult patients; this higher resistance rate may be due to more frequent antimicrobial treatments in children, and extensive child to child transmission. Reliable data on antimicrobial consumption and resistance should form a basis for national policies devised to reduce the resistance of microorganisms to antibiotics.     

医院葡萄球菌感染的临床分析

目的了解我院葡萄球菌感染的临床分布及其耐药情况,指导临床合理应用抗生素,控制医院感染。方法药敏试验采用K-B纸片扩散法,同时进行耐苯唑西林葡萄球菌检测,并结合临床资料进行分析。结果 2006年6月至2009年5月共分离出葡萄球菌262株,其中金黄色葡萄球菌87株（33.1%）,占第一位;表皮葡萄球菌76株（29.0%）占第二位;其他如中间葡萄球菌、溶血葡萄球菌、腐生葡萄球菌等均占有一定比例。262株葡萄球菌中共检出耐苯唑西林葡萄球菌（MRS）185株占70.7%,苯唑西林敏感葡萄球菌（MSS）77株。MSS对青霉素和红霉素的耐药率高,分别为81.0%～84.4%和57.7%-61.9%。MRS对万古霉素、头孢西丁、替考拉宁、利福平、呋喃妥因等敏感性高,对其余多种抗生素耐药。结论临床分离菌中的葡萄球菌日益增多,加强葡萄球菌耐药性检测,对于正确合理选用抗菌药和控制葡萄球菌耐药性产生十分重要。     

人苍白杆菌的分离及耐药性分析

目的:了解人苍白杆菌在我院的分离情况及耐药性.方法:统计分析近4年分离到的83株人苍白杆菌耐药情况.结果:人苍白杆菌均分离自肝移植患者的血液标本,对β-内酰胺类抗生素均高度耐药,对哌拉西林/三唑巴坦、头孢哌酮/舒巴坦亦高度耐药,对其他抗菌药物有较好的敏感性,依次为环丙沙星(100%)、左旋氧氟沙星(100%)、亚胺培南(92.7%)、萘啶酸(92.0%)、奈替米星(91.7%)、妥布霉素(90.0%).结论:人苍白杆菌对β-内酰胺类抗生素耐药率高,治疗应首选喹诺酮类抗生素、亚胺培南.     

产超广谱β-内酰胺酶菌株在住院患儿中的分布及耐药性分析

目的探讨儿科住院患者产超广谱β-内酰胺酶(ESBLs)菌株的分布及耐药性情况。方法对深圳市妇幼保健院2008年至2011年儿科收治的住院患儿中ESBLs阳性菌感染情况进行回顾性分析,采用全自动细菌鉴定/药敏分析仪从标本中分离的大肠埃希菌和肺炎克雷伯杆菌进行检测。结果本组共检测出革兰阴性杆菌695株,共发现295株ESBLs阳性菌株,检出率为42.45%(295/695)。其中695株中大肠埃希菌230株,产ESBLs菌114株,占49.57%;肺炎克雷伯菌261株,产ESBLs菌181株,占69.35%。ESBLs阳性菌对不同抗生素耐药率及敏感率不同,差异有统计学意义(P<0.01,P<0.05)。结论 ES-BLs阳性菌已经成为儿科住院患儿中较为重要的耐药菌株,对抗菌药物的耐药性明显高于非产ESBLs菌,除亚胺培南外,产ESBLs菌对多种抗菌药物均出现不同程度的耐药性。对其治疗应依据药敏检测结果选择抗生素。     

In vitro evaluation of antimicrobial activity of fusafungine

Fusafungine is an antibiotic extracted from the fungus Fusarium laterium WR strain 437. The antimicrobial activity of fusafungine was determined on strains from laboratory collections and clinical isolates; since fusafungine is not soluble in the classical media, the usual techniques had to be modified. MICs for all the Gram-positive cocci and bacteria tested, aerobic, or anaerobic, were below 30 mcg/ml. The antimicrobial activity included Mycoplasma pneumoniae (MIC less than 18 mcg/ml) and Streptococcus mutans (MIC less than 30 mcg/ml). An antifungal activity was shown for most of the Candida albicans tested (MIC less than 32 mcg/ml) and for different Nocardia sp. (MIC less than 13 mcg/ml). Moreover, fusafungine induced neither acquired resistance nor cross-resistance towards the antibiotics classically used in therapy.     

铜绿假单胞菌与金黄色葡萄球菌耐药性分析

目的了解近年来铜绿假单胞菌和金黄色葡萄球菌医院感染的分布及耐药情况，为病原学调查及临床治疗提供依据。方法菌株按细菌检验常规方法培养与鉴定，采用纸片扩散法进行药敏实验。结果铜绿假单胞菌的耐药率依次为环丙沙星16.9%，阿米卡星20.0%，亚胺培南22.8%，哌拉西林30.9%，头孢曲松33.6%，头孢哌酮36.4%，庆大霉素64.8%。金黄色葡萄球菌耐药率为万古霉素11.0%，环丙沙星25.4%，阿莫西林/克拉维酸钾29.8%，苯唑西林47.9%，红霉素71.8%，青霉素78.9%。结论铜绿假单胞菌和金黄色葡萄球菌是医院感染主要病原菌，对多种抗生素呈耐药趋势。     

卫生部全国细菌耐药监测网(Mohnarin)2007-2008年报告

目的 监测我国主要城市三级甲等医院住院患者的细菌耐药状况.方法 定点收集来自全国20家医院临床分离细菌,由中心实验室统一用平血二倍稀释法,测定抗菌药物MIC值.对2007年1月至2008年3月来自全国19座城市20家医院的5204株临床分离致病菌,进行了MIC测定.结果 革兰阳性菌1310株,占25.2%;革兰阴性菌3894株,占74.8%.MIC结果显示,对甲氧西林耐药葡萄球菌(MRSA)和对甲氧西林耐药表皮葡萄球菌(MRSE)检出率分别为73.6%和79.5%;未发现对万古霉素中介或耐药的葡萄球菌;凝固酶阴性葡萄球菌对替考拉宁有2.4%的中介率和1.2%的耐药率.粪肠球菌对青霉素的耐药率为23.7%;屎肠球菌则高达88.7%.在344株肠球菌中,发现2株对糖肽类耐药的VanA型屎肠球菌;5株对万古霉素中介的其他肠球菌.按口服青霉素V标准判断,对青霉素耐药肺炎链球菌(PRSP)和对青霉素中介肺炎链球菌(PISP)的检出率分别为17.3%和46.0%;非脑膜炎、非肠道系统给药的青霉素耐药率为0,中介率为0.8%.肠杆菌科细菌对碳青霉烯类抗生素,仍保持很高的敏感性,敏感率大于99%;此外,拉氧头孢、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦也具有很好抗菌活性,耐药率均在10%以下.非发酵革兰阴性菌中,铜绿假单胞菌和鲍曼不动杆菌,对亚安培南的耐药率分别为29.3%和29.2%,较2004-2005年的监测结果有明显增加,但仍属于对非发酵菌抗菌活性较好的药物.此外,酶抑制剂复方制剂、氟喹诺酮类药物及米诺环素等也有较强抗菌作用.比较不同病房来源菌株耐药率显示,ICU菌株耐药率高于NICU,但两者之间的差距在缩小.结论 MRSA检出率以及金黄色葡萄球菌、大肠埃希菌和鲍曼不动杆菌耐药率增高,较以往的监测结果明显上升.大环内酯类、喹诺酮及氨基糖苷类药物抗菌作用明显低于欧美及日本等监测报道;大肠埃希菌对多种抗菌药物的耐药率,明显高于国外报道.     

2008至2009年医院常见革兰氏阳性球菌的耐药现状

目的 通过对医院临床分离革兰阳性球菌的分布情况及耐药现状进行分析,从而为临床医生合理使用抗菌药物经验性治疗感染性疾病提供参考.方法 收集本院2008年1月-2009年12月临床各科送检标本,采用全自动微生物分析仪进行菌株鉴定与药敏测定.结果 共分离出G+球菌主要有凝固酶阴性葡萄球菌154株(12.3%)、肠球菌48株(...     

Perceptions,current practices,and interventions of community pharmacists regarding antimicrobial stewardship: A qualitative study

BackgroundCommunity health care accounts for the vast majority of antibiotic use in Europe. Given the threat of antimicrobial resistance (AMR), there is an urgent need to develop new antimicrobial stewardship (AMS) interventions in primary care that could involve different health care providers, including community pharmacists.ObjectivesThis study aimed to explore the perceptions, currents practices, and interventions of community pharmacists regarding AMS.MethodsSemistructured qualitative interviews were conducted with community pharmacists in France. Participants were recruited through a professional organization of community pharmacists combined with a snowballing technique. Interviews were audio recorded, transcribed, and analyzed using thematic analysis. The Consolidated Framework for Implementation Research was used while developing the interview guide and carrying out thematic analysis.ResultsSixteen community pharmacists participated. All the respondents had good awareness about antimicrobial resistance and believed that community pharmacists had an important role in tackling AMR. Some barriers to community pharmacists’ participation in AMS were identified such as difficult interactions with prescribers, lack of time, and lack of access to patient medical records and diagnosis. Increased patient education, audits and feedback of antibiotic prescribing, increased point-of-care testing, and delayed prescribing were interventions suggested by the pharmacists to improve antibiotic use in primary care. Strategies cited by participants to facilitate the implementation of such interventions are increased pharmacist–general practitioner collaboration, specialized training, clinical decision support tools, and financial incentives.ConclusionThis study suggests that community pharmacists could play a greater role in infection management and AMS interventions. Further interprofessional collaboration is needed to optimize antibiotic prescribing and utilization in community health care.     

大肠埃希菌在泌尿系感染的筛查与耐药性分析

目的:了解泌尿系感染中大肠埃希菌对21种抗菌药物的耐药情况,为临床的合理用药提供参考。方法:用纸片扩散法(K-B法)对从门诊和住院泌尿系感染患者中分离的200株大肠埃希菌进行药物敏感试验分析,并用双纸片扩散法对产ESBLs菌株进行确证。结果:尿液标本中的大肠埃希菌对21种抗生素的耐药性检测结果显示,大肠埃希菌对舒普深、头孢西丁、亚胺培南、阿米卡星等单剂型药物的耐药性较低,其耐药率分别为8.7%、2.2%、2.2%、13.0%;对青霉素类和头孢菌素类抗生素的耐药率在60.0%以上;对复方磺胺的耐药率为91.3%;对四环素以及喹诺酮类抗生素的耐药率为65.2%～76.1%;对庆大霉素的耐药率为47.8%。对含ESBLs抑制剂的复合型抗生素的耐药率(阿莫西林/克拉维酸、哌拉西林/他唑巴坦为6.5%和2.2%)要明显低于单剂型同种抗生素。在46株大肠埃希菌中,产ESBLs菌株有20株,占43.5%,其对多种抗生素的耐药率显著高于不产ESBLs菌株。结论:引起泌尿系感染的大肠埃希菌耐药情况日趋严重,细菌耐药性监测对临床合理使用抗生素有指导意义。     

Antimicrobial resistance of Enterococci in Lebanon

There is little information on the types of Enterococcus spp and their antibiotic resistance patterns in Lebanon. One hundred and fifty-three consecutive clinical enterococcal isolates collected between 1998 and 1999 were tested against 11 antimicrobial agents using disk diffusion and the Etest. The isolates were identified by conventional methods and API-Strep and were found to consist of Enterococcus faecalis (72.5%), Enterococcus faecium (22.9%), Enterococcus avium (3.2%) and Enterococcus gallinarum (1.3%). The percent of resistant strains of E. faecalis and E. faecium respectively were, ampicillin 0.9 and 14%, erythromycin 59% and 40%, tetracycline 72% and 34%, chloramphenicol 32 and 11%, rifampin 36% and 57%, ciprofloxacin, 23% and 34%, norfloxacin 22 and 8%. High level aminoglycoside (HLA) resistance was found in 19% E. faecalis and 9% E. faecium for gentamicin and 36% and 26% for streptomycin. Excellent correlation was observed between the high level disk tests and the Etest in the detection of HLA resistance but not with the regular disks. None of the isolates showed resistance to vancomycin or teicoplanin except for one E. gallinarum isolate which showed intermediate resistance (MIC 16 mg/l) to vancomycin. These variable antimicrobial rates of resistance suggest a surveillance programme for antimicrobial resistance in this country would be helpful to help control infection, guide empirical antibiotic therapy and implement a policy of antibiotic usage.     

Antimicrobial profiles of Prevotella spp. and Fusobacterium nucleatum isolated from periodontal infections in a selected area of southern Italy

In view of the increasing antibiotic resistance of anaerobic Gram-negative bacteria, we determined the antimicrobial profile of 55 periodontal anaerobic Gram-negative bacteria correlated with human infections, comprising 16 strains of Fusobacterium nucleatum and 39 strains of Prevotella spp. isolated from periodontal pockets of 26 adults suffering from chronic periodontitis. All the strains of F. nucleatum were susceptible to amoxicillin/clavulanic acid, doxycycline, metronidazole, moxifloxacin and levofloxacin, whilst 2/16 strains were both resistant to amoxicillin and β-lactamase-positive and 11/16 were resistant to clarithromycin. All of the Prevotella strains were susceptible to amoxicillin/clavulanic acid, doxycycline and metronidazole, whereas 7/39 strains were β-lactamase-positive and resistant to amoxicillin, 5/39 were resistant to clarithromycin and 3/39 were resistant to both moxifloxacin and levofloxacin. Our findings confirm that there is an increasing need to encourage practitioners to use laboratory investigations to limit the risk of an incorrect therapeutic approach and to avoid the overuse of antimicrobial agents.     

Developments with investigating descriptors for antimicrobial AApeptides and their derivatives

Introduction: The development of multidrug-resistant strains of bacteria resulting from prolonged treatment with conventional antibiotics has necessitated the need for continuous research for better antibiotic strategies. One of these alternatives is evolutionary antimicrobial peptides also known as host-defense peptides (HDPs). HDPs are an integral part of the innate defense system in multicellular eukaryotes. Although HDPs can largely circumvent the persistent problem of antibiotic resistance due to their bacteriolytic membrane mechanism, they have some drawbacks including a low activity profile and protease instability. AApeptides have recently been introduced as a new class of peptidomimetics with resistance to proteolysis, improved activity profile, and limitless possibilities for structural diversity. Furthermore, they have shown excellent antimicrobial activity.

Areas covered: This review updates the reader on the latest developments of antimicrobial AApeptides, the various derivatizations, and their development for antimicrobial applications. The most recent findings on the heterogeneous γ-AA backbone are also outlined.

Expert opinion: AApeptides have found diverse applications in antimicrobial studies. AApeptides are believed to exhibit bactericidal properties by imitating the membranolytic action of HDPs. They have shown broad-spectrum antimicrobial activity and are active against medicinally relevant drug-resistant pathogens. AApeptides and their derivatives could gain therapeutic relevance in the design and development of antibiotic agents.