About this Research Topic

Background

The emergence and spread of drug resistance is a global threat to public health and requires immediate action. Drug resistance is prevalent in antimicrobials, which include antibiotics, antivirals, antifungals, and antiprotozoals. According to the WHO, antibiotic resistance is currently one of the greatest threats to global health, food security and development. It is expected that if the current trend continues, in 2050 the number of 10 million deaths from diseases caused by multiresistant microorganisms will be reached. Antibiotic resistance, particularly in Gram-negative bacteria multi-, extended- or pan-drug resistant strains such as Acinetobacter baumannii, Pseudomonas aeruginosa and certain members of Enterobacteriaceae, is an accelerating crisis. In 2014, most areas of the world reported that more than 50% of infections caused by Escherichia coli and Klebsiella pneumoniae were resistant to third-generation cephalosporins, widespread resistance to fluoroquinolones, and accelerated resistance to third-generation carbapenems. On the other hand, antifungal resistance is an emerging and worrying issue in the field of medical mycology. Fungal infections affect more than 300 million people worldwide, resulting in 1,660,000 deaths. In fact, 90% of all deaths from fungal infections are due to fungi of the genera Cryptococcus, Candida, Pneumocystis, and Aspergillus. Each year, viral infections produces millions of deaths and the use of antiviral treatments to target those infection can lead to drug resistance and decrease the potency of antiviral therapies in several viral pathogens such as herpes simplex virus (HSV), hepatitis C virus (HCV), hepatitis B virus (HBV), varicella-zoster virus (VZV), cytomegalovirus (CMV), influenza virus, and human immunodeficiency virus-1 (HIV-1) among others.

Despite these pathogens cause a large number of infections, both in clinical and community settings, the number of therapeutic options currently available is limited. On the one hand this is due to the rapid appearance and spread of resistance. On the other hand, there is a moderate discovery of new drug with the approaches used to date. Therefore, the conventional antimicrobial drug discovery strategies have to be reconsidered and new avenues have to be explored. In addition to the health issue they pose, infections by resistant microorganisms have an important economic impact, in either high-, middle- and low- income countries. Improvement in diagnostic and prognostic methods may help to better detect these pathogens, detect their distribution paths and predict infections outcomes.

Altogether, the increasing importance of multidrug-resistant infections caused by different types of pathogens and the need for developing novel therapeutic approaches is an unmet clinical need that urges to be solved. An integrative solution against this problem from different perspectives is required. First, by controlling these microorganisms distribution and spread. Second by improving our understanding of the mechanisms of resistance and how it is acquired. A rapid diagnostic is also crucial to apply the best therapeutic option and mitigate both the health and economic impact caused by these infections. Lastly, to substantially increase the repertoire of therapeutic tools against these pathogens is urgently needed.

The main aim of this Research Topic is to gain understanding of the mechanisms of resistance that microorganisms present to current therapies and collect potential novel strategies, apart from those currently in use, that are being explored to fight against this threat.

We particularly welcome contributions as Original Research articles and Reviews but, other article types welcomed in the journal will also be considered such as Perspective, Methods, Mini Reviews and Brief Research Reports. Submissions focusing on, but not limited to, the following subtopics will be considered:

• Surveillance and epidemiology of resistant pathogens (either bacteria, viruses, fungi or protozoa) in both clinical and community settings
• Description of novel resistance mechanisms and/or how they are acquired as well as new therapeutic targets
• Development of new diagnostic or prognostic methods for infections caused by resistant pathogens
• Therapies to treat resistant pathogens including: physical, chemical (natural/synthetic) and biological (antimicrobials, antifungals, phage therapy, active and passive immunization).

Keywords: Pan-resistant bacteria, drug resistance, antimicrobial, antifungal, antiviral, therapeutical targets

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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