Review Article | | Peer-Reviewed

Sepsis, Antimicrobial Resistance, and Alternative Therapies

Received: 2 February 2024    Accepted: 22 February 2024    Published: 7 March 2024
Views:       Downloads:
Abstract

Sepsis, a life-threatening condition caused by the body's excessive response to an infection, has emerged as a global health menace. Around 20% of all global deaths are attributable to sepsis. Conversely, the presence of antimicrobial resistance (AMR) poses a significant peril to the health system. AMR constitutes an escalating pandemic that we must not disregard, as the absence of effective antibiotics would compromise the treatment of even commonplace bacterial infections. Therefore, the increasing prevalence of AMR further adds complexity to the management and outcomes of individuals with sepsis. AMR plays a contributory role in aggravating the consequences of sepsis, ranging from prolonged hospitalization to mortality. The World Health Organization (WHO) has prioritized AMR as a major concern necessitating immediate action to prevent dire consequences in the future. Though, One Health approach, infection prevention, rational use of antibiotics, strengthening surveillance systems, as well as research and development, are crucial strategies in combating antimicrobial resistance, alternative therapies, such as phage therapy and immunotherapeutics, are being explored for the management of AMR infections. Advances in these therapies show promise in addressing the challenges posed by antibiotic resistance in treating sepsis. In this critical assessment, we succinctly delineate the existing challenges of AMR in managing sepsis cases, and we provide an overview of the advancements in treating sepsis through alternative therapeutic modalities.

Published in American Journal of Health Research (Volume 12, Issue 1)
DOI 10.11648/j.ajhr.20241201.12
Page(s) 8-18
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Sepsis, Antimicrobial Resistance, Alternative Therapy, Phage Therapy, Immunotherapeutics

References
[1] Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. The Lancet. 2020; 395(10219): 200-11.
[2] Buchman TG, Simpson SQ, Sciarretta KL, Finne KP, Sowers N, Collier M, et al. Sepsis among medicare beneficiaries: 1. The burdens of sepsis, 2012–2018. Critical care medicine. 2020; 48(3): 276. https://doi.org/10.1097/CCM.0000000000004224
[3] Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). Jama. 2016; 315(8): 801-10. https://doi.org/10.1001/jama.2016.0287
[4] Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Jama. 2016; 315(8): 762-74. https://doi.org/10.1001/jama.2016.0288
[5] Rhee C, Jones TM, Hamad Y, Pande A, Varon J, O’Brien C, et al. Prevalence, underlying causes, and preventability of sepsis-associated mortality in US acute care hospitals. JAMA network open. 2019; 2(2): e187571-e. https://doi.org/10.1001/jamanetworkopen.2018.7571
[6] Mayr FB, Yende S, Angus DC. Epidemiology of severe sepsis. Virulence. 2014; 5(1): 4-11. https://doi.org/10.4161/viru.27372
[7] Fair RJ, Tor Y. Antibiotics and bacterial resistance in the 21st century. Perspectives in medicinal chemistry. 2014; 6: PMC. S14459.
[8] Busch LM, Kadri SS. Antimicrobial treatment duration in sepsis and serious infections. The Journal of Infectious Diseases. 2020; 222 (Supplement_2): S142-S55. https://doi.org/10.1093/infdis/jiaa247
[9] Paul M, Shani V, Muchtar E, Kariv G, Robenshtok E, Leibovici L. Systematic review and meta-analysis of the efficacy of appropriate empiric antibiotic therapy for sepsis. Antimicrobial agents and chemotherapy. 2010; 54(11): 4851-63. https://doi.org/10.1128/aac.00627-10
[10] D’Costa VM, King CE, Kalan L, Morar M, Sung WW, Schwarz C, et al. Antibiotic resistance is ancient. Nature. 2011; 477(7365): 457-61.
[11] Felden B, Cattoir V. Bacterial adaptation to antibiotics through regulatory RNAs. Antimicrobial agents and chemotherapy. 2018; 62(5): https://doi.org/10.1128/aac. 02503-17
[12] Davies J, Davies D. Origins and evolution of antibiotic resistance. Microbiology and molecular biology reviews. 2010; 74(3): 417-33. https://doi.org/10.1128/mmbr.00016-10
[13] Organization WH. World health statistics 2020. 2020.
[14] Tommasi R, Brown DG, Walkup GK, Manchester JI, Miller AA. ESKAPEing the labyrinth of antibacterial discovery. Nature reviews Drug discovery. 2015; 14(8): 529-42. https://doi.org/10.1038/nrd4572
[15] Talebi Bezmin Abadi A, Rizvanov AA, Haertlé T, Blatt NL. World Health Organization report: current crisis of antibiotic resistance. BioNanoScience. 2019; 9: 778-88. https://doi.org/10.1007/s12668-019-00658-4
[16] Salehi B, Abu-Darwish M, Tarawneh A, Cabral C, Gadetskaya A, Salgueiro L, et al. Antimicrobial resistance collaborators global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022; 399: 629-55.
[17] Salam MA, Al-Amin MY, Salam MT, Pawar JS, Akhter N, Rabaan AA, et al., editors. Antimicrobial resistance: a growing serious threat for global public health. Healthcare; 2023: MDPI. https://doi.org/10.3390/healthcare11131946
[18] O'Neill J. Review on antimicrobial resistance: tackling drug-resistant infections globally: final report and recommendations. Review on antimicrobial resistance: tackling drug-resistant infections globally: final report and recommendations. 2016.
[19] Baraldi E, Lindahl O, Savic M, Findlay D, Årdal C. Antibiotic pipeline coordinators. The Journal of Law, Medicine & Ethics. 2018; 46(1_suppl): 25-31.
[20] Singer M, Deutschman MCS. Improving the prevention, diagnosis and clinical management of sepsis. WHO [Internet]. 2017: 2017. https://doi.org/10.1001/jama.2016.0287
[21] Rochford C, Sridhar D, Woods N, Saleh Z, Hartenstein L, Ahlawat H, et al. Global governance of antimicrobial resistance. The Lancet. 2018; 391(10134): 1976-8. https://doi.org/10.1016/S0140-6736(18)31117-6
[22] Mestrovic T, Aguilar GR, Swetschinski LR, Ikuta KS, Gray AP, Weaver ND, et al. The burden of bacterial antimicrobial resistance in the WHO European region in 2019: A cross-country systematic analysis. The Lancet Public Health. 2022; 7(11): e897-e913. https://doi.org/10.1016/S2468-2667(22)00225-0
[23] Murray CJ, Ikuta KS, Sharara F, Swetschinski L, Aguilar GR, Gray A, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet. 2022; 399(10325): 629-55. https://doi.org/10.1016/S0140-6736(21)02724-0
[24] Walia K, editor Emerging problem of antimicrobial resistance in developing countries: Intertwining socioeconomic issues. Reg Health Forum; 2003: Citeseer.
[25] Okeke IN, Laxminarayan R, Bhutta ZA, Duse AG, Jenkins P, O'Brien TF, et al. Antimicrobial resistance in developing countries. Part I: recent trends and current status. The Lancet infectious diseases. 2005; 5(8): 481-93. https://doi.org/10.1016/S1473-3099(05)70189-4
[26] Weldon I, Hoffman SJ. Antimicrobial Resistance. Global Health Law and Policy: Ensuring Justice for a Healthier World. 2023: 395.
[27] Cohen J, Vincent J-L, Adhikari NK, Machado FR, Angus DC, Calandra T, et al. Sepsis: a roadmap for future research. The Lancet infectious diseases. 2015; 15(5): 581-614. https://doi.org/10.1016/S1473-3099(15)70112-X
[28] Kirkham R. Parliamentary scrutiny of the Parliamentary and Health Services Ombudsman. Journal of Social Welfare and Family Law. 2022: 1-12. https://doi.org/10.1080/09649069.2022.2031108
[29] Rhee C, Kadri SS, Danner RL, Suffredini AF, Massaro AF, Kitch BT, et al. Diagnosing sepsis is subjective and highly variable: a survey of intensivists using case vignettes. Critical care. 2016; 20: 1-8. https://doi.org/10.1186/s13054-016-1266-9
[30] Bochud P-Y, Glauser MP, Calandra T. Antibiotics in sepsis. Intensive Care Med. 2001; 27(Suppl 1): S33-S48.
[31] Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Critical care medicine. 2006; 34(6): 1589-96. https://doi.org/10.1097/01.CCM.0000217961.75225.E9
[32] Burgess D, Abate J. Antimicrobial regimen selection. Pharmacotherapy a pathophysiologic approach 6th ed New York: McGraw-Hill. 2005: 1920-1.
[33] Orsini J, Mainardi C, Muzylo E, Karki N, Cohen N, Sakoulas G. Microbiological profile of organisms causing bloodstream infection in critically ill patients. Journal of clinical medicine research. 2012; 4(6): 371.
[34] Suharjo J. Cahyono J. Terapi antibiotik empiris pada pasien sepsis berdasarkan organ terinfeksi Dexa Media. 2007; 20: 85-90.
[35] Kollef MH, Sherman G, Ward S, Fraser VJ. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest. 1999; 115(2): 462-74. https://doi.org/10.1378/chest.115.2.462
[36] Kollef MH. Bench-to-bedside review: antimicrobial utilization strategies aimed at preventing the emergence of bacterial resistance in the intensive care unit. Critical care. 2005; 9: 1-6. https://doi.org/10.1186/cc3757
[37] Hollands JM, Micek ST, McKinnon PS, Kollef MH. 13 Early Appropriate Empiric Therapy and Antimicrobial De-Escalation. Antimicrobial Resistance: Problem Pathogens and Clinical Countermeasures. 2007: 231.
[38] Aminov RI. A brief history of the antibiotic era: lessons learned and challenges for the future. Frontiers in microbiology. 2010; 1: 134. https://doi.org/10.3389/fmicb.2010.00134
[39] Şen Karaman D, Ercan UK, Bakay E, Topaloğlu N, Rosenholm JM. Evolving technologies and strategies for combating antibacterial resistance in the advent of the postantibiotic era. Advanced Functional Materials. 2020; 30(15): 1908783. https://doi.org/10.1002/adfm.201908783
[40] Marik PE, Stephenson E. The ability of Procalcitonin, lactate, white blood cell count and neutrophil-lymphocyte count ratio to predict blood stream infection. Analysis of a large database. Journal of Critical Care. 2020; 60: 135-9. https://doi.org/10.1016/j.jcrc.2020.07.026
[41] Cheng AC, West TE, Limmathurotsakul D, Peacock SJ. Strategies to reduce mortality from bacterial sepsis in adults in developing countries. PLoS medicine. 2008; 5(8): e175. https://doi.org/10.1371/journal.pmed.0050175
[42] Negussie A, Mulugeta G, Bedru A, Ali I, Shimeles D, Lema T, et al. Bacteriological profile and antimicrobial susceptibility pattern of blood culture isolates among septicemia suspected children in selected hospitals Addis Ababa, Ethiopia. International journal of biological and medical research. 2015; 6(1): 4709.
[43] Keeley A, Hine P, Nsutebu E. The recognition and management of sepsis and septic shock: a guide for non-intensivists. Postgraduate medical journal. 2017; 93(1104): 626-34. https://doi.org/10.1136/postgradmedj-2016-134519
[44] Eliopoulos GM, Cosgrove SE, Carmeli Y. The impact of antimicrobial resistance on health and economic outcomes. Clinical infectious diseases. 2003; 36(11): 1433-7. https://doi.org/10.1086/375081
[45] Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest. 2000; 118(1): 146-55. https://doi.org/10.1378/chest.118.1.146
[46] Carmeli Y, Troillet N, Karchmer AW, Samore MH. Health and economic outcomes of antibiotic resistance in Pseudomonas aeruginosa. Archives of Internal Medicine. 1999; 159(10): 1127-32. https://doi.org/10.1001/archinte.159.10.1127
[47] Gahamanyi N, Ishema L, Mushayija JP, Ntamugabumwe L, Ngabo E, Mugabo E, et al. Celebrating the World Antimicrobial Awareness Week (WAAW 2022) in Rwanda.
[48] Alhmoud B, Melley D, Khan N, Bonicci T, Patel R, Banerjee A. Evaluating a novel, integrative dashboard for health professionals’ performance in managing deteriorating patients: a quality improvement project. BMJ open quality. 2022; 11(4): e002033. https://doi.org/10.1136/bmjoq-2022-002033
[49] Rhee C, editor Using procalcitonin to guide antibiotic therapy. Open forum infectious diseases; 2017: Oxford University Press US.
[50] Tacconelli E, Carrara E, Savoldi A, Harbarth S, Mendelson M, Monnet DL, et al. Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis. The Lancet infectious diseases. 2018; 18(3): 318-27. https://doi.org/10.1016/S1473-3099(17)30753-3
[51] Twort FW. An investigation on the nature of ultra-microscopic viruses. Acta Kravsi. 1961.
[52] d'Herelle M. Sur un microbe invisible antagoniste des bacilles dysentériques. Acta Kravsi. 1961.
[53] Levin BR, Bull JJ. Population and evolutionary dynamics of phage therapy. Nature Reviews Microbiology. 2004; 2(2): 166-73. https://doi.org/10.1038/nrmicro822
[54] Comeau AM, Hatfull GF, Krisch HM, Lindell D, Mann NH, Prangishvili D. Exploring the prokaryotic virosphere. Research in microbiology. 2008; 159(5): 306-13. https://doi.org/10.1016/j.resmic.2008.05.001
[55] Suttle CA. Marine viruses—major players in the global ecosystem. Nature reviews microbiology. 2007; 5(10): 801-12. https://doi.org/10.1038/nrmicro1750
[56] Alemayehu D, Casey PG, McAuliffe O, Guinane CM, Martin JG, Shanahan F, et al. Bacteriophages ϕMR299-2 and ϕNH-4 can eliminate Pseudomonas aeruginosa in the murine lung and on cystic fibrosis lung airway cells. MBio. 2012; 3(2): https://doi.org/10.1128/mbio.00029-12
[57] Singla S, Harjai K, Katare OP, Chhibber S. Bacteriophage-loaded nanostructured lipid carrier: improved pharmacokinetics mediates effective resolution of Klebsiella pneumoniae–induced lobar pneumonia. The Journal of infectious diseases. 2015; 212(2): 325-34. https://doi.org/10.1093/infdis/jiv029
[58] Chhibber S, Kaur S, Kumari S. Therapeutic potential of bacteriophage in treating Klebsiella pneumoniae B5055-mediated lobar pneumonia in mice. Journal of medical microbiology. 2008; 57(12): 1508-13. https://doi.org/10.1099/jmm.0.2008/002873-0
[59] Jennes S, Merabishvili M, Soentjens P, Pang KW, Rose T, Keersebilck E, et al. Use of bacteriophages in the treatment of colistin-only-sensitive Pseudomonas aeruginosa septicaemia in a patient with acute kidney injury—a case report. Critical Care. 2017; 21: 1-3. https://doi.org/10.1186/s13054-017-1709-y
[60] Schooley RT, Biswas B, Gill JJ, Hernandez-Morales A, Lancaster J, Lessor L, et al. Development and use of personalized bacteriophage-based therapeutic cocktails to treat a patient with a disseminated resistant Acinetobacter baumannii infection. Antimicrobial agents and chemotherapy. 2017; 61(10): https://doi.org/10.1128/aac. 00954-17
[61] Rao S, Betancourt-Garcia M, Kare-Opaneye YO, Swierczewski BE, Bennett JW, Horne BA, et al. Critically ill patient with multidrug-resistant Acinetobacter baumannii respiratory infection successfully treated with intravenous and nebulized bacteriophage therapy. Antimicrobial Agents and Chemotherapy. 2022; 66(1): e00824-21. https://doi.org/10.1128/AAC.00824-21
[62] Petrovic Fabijan A, Lin RC, Ho J, Maddocks S, Ben Zakour NL, Iredell JR, et al. Safety of bacteriophage therapy in severe Staphylococcus aureus infection. Nature microbiology. 2020; 5(3): 465-72. https://doi.org/10.1038/s41564-019-0634-z
[63] van der Poll T, van de Veerdonk FL, Scicluna BP, Netea MG. The immunopathology of sepsis and potential therapeutic targets. Nature Reviews Immunology. 2017; 17(7): 407-20. https://doi.org/10.1038/nri.2017.36
[64] Steinhagen F, Schmidt SV, Schewe J-C, Peukert K, Klinman DM, Bode C. Immunotherapy in sepsis-brake or accelerate? Pharmacology & therapeutics. 2020; 208: 107476. https://doi.org/10.1016/j.pharmthera.2020.107476
[65] Rubio I, Osuchowski MF, Shankar-Hari M, Skirecki T, Winkler MS, Lachmann G, et al. Current gaps in sepsis immunology: new opportunities for translational research. The Lancet infectious diseases. 2019; 19(12): e422-e36. https://doi.org/10.1016/S1473-3099(19)30567-5
[66] Burke JD, Young HA, editors. IFN-γ: A cytokine at the right time, is in the right place. Seminars in immunology; 2019: Elsevier. https://doi.org/10.1016/j.smim.2019.05.002
[67] Boomer JS, To K, Chang KC, Takasu O, Osborne DF, Walton AH, et al. Immunosuppression in patients who die of sepsis and multiple organ failure. Jama. 2011; 306(23): 2594-605. https://doi.org/10.1001/jama.2011.1829
[68] Döcke W-D, Randow F, Syrbe U, Krausch D, Asadullah K, Reinke P, et al. Monocyte deactivation in septic patients: restoration by IFN-γ treatment. Nature medicine. 1997; 3(6): 678-81. https://doi.org/10.1038/nm0697-678
[69] Gallin JI, Farber JM, Holland SM, Nutman TB. Interferon-γ in the management of infectious diseases. Annals of internal medicine. 1995; 123(3): 216-24. https://doi.org/10.7326/0003-4819-123-3-199508010-00009
[70] Patterson TF, Thompson III GR, Denning DW, Fishman JA, Hadley S, Herbrecht R, et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the Infectious Diseases Society of America. Clinical infectious diseases. 2016; 63(4): e1-e60. https://doi.org/10.1093/cid/ciw326
[71] Delsing CE, Gresnigt MS, Leentjens J, Preijers F, Frager FA, Kox M, et al. Interferon-gamma as adjunctive immunotherapy for invasive fungal infections: a case series. BMC infectious diseases. 2014; 14: 1-12. https://doi.org/10.1186/1471-2334-14-166
[72] Keane C, Jerkic M, Laffey JG. Stem cell–based therapies for sepsis. Anesthesiology. 2017; 127(6): 1017-34. https://doi.org/10.1097/ALN.0000000000001882
[73] Schlosser K, Wang J-P, Dos Santos C, Walley KR, Marshall J, Fergusson DA, et al. Effects of mesenchymal stem cell treatment on systemic cytokine levels in a phase 1 dose escalation safety trial of septic shock patients. Critical care medicine. 2019; 47(7): 918-25. https://doi.org/10.1097/CCM.0000000000003657
[74] Xia S, Gong H, Zhao Y, Guo L, Wang Y, Zhang B, et al. Association of Pulmonary Sepsis and Immune Checkpoint Inhibitors: A Pharmacovigilance Study. Cancers. 2022; 15(1): 240. https://doi.org/10.3390/cancers15010240
[75] Patil NK, Guo Y, Luan L, Sherwood ER. Targeting immune cell checkpoints during sepsis. International journal of molecular sciences. 2017; 18(11): 2413. https://doi.org/10.3390/ijms18112413
[76] Guignant C, Lepape A, Huang X, Kherouf H, Denis L, Poitevin F, et al. Programmed death-1 levels correlate with increased mortality, nosocomial infection and immune dysfunctions in septic shock patients. Critical care. 2011; 15(2): 1-11. https://doi.org/10.1186/cc10112
[77] Shao R, Fang Y, Yu H, Zhao L, Jiang Z, Li C-S. Monocyte programmed death ligand-1 expression after 3–4 days of sepsis is associated with risk stratification and mortality in septic patients: a prospective cohort study. Critical care. 2016; 20: 1-10. https://doi.org/10.1186/s13054-016-1301-x
[78] Brahmamdam P, Inoue S, Unsinger J, Chang KC, McDunn JE, Hotchkiss RS. Delayed administration of anti-PD-1 antibody reverses immune dysfunction and improves survival during sepsis. Journal of leukocyte biology. 2010; 88(2): 233-40. https://doi.org/10.1189/jlb.0110037
[79] Zhang Y, Zhou Y, Lou J, Li J, Bo L, Zhu K, et al. PD-L1 blockade improves survival in experimental sepsis by inhibiting lymphocyte apoptosis and reversing monocyte dysfunction. Critical care. 2010; 14(6): 1-9. https://doi.org/10.1186/cc9354
[80] Grimaldi D, Pradier O, Hotchkiss RS, Vincent J-L. Nivolumab plus interferon-γ in the treatment of intractable mucormycosis. The Lancet Infectious Diseases. 2017; 17(1): 18. https://doi.org/10.1016/S1473-3099(16)30541-2
[81] Hotchkiss RS, Colston E, Yende S, Angus DC, Moldawer LL, Crouser ED, et al. Immune checkpoint inhibition in sepsis: a Phase 1b randomized, placebo-controlled, single ascending dose study of anti-PD-L1 (BMS-936559). Critical care medicine. 2019; 47(5): 632. https://doi.org/10.1097/CCM.0000000000003685
[82] Chambers HF, Fowler Jr VG, Group ARL. Confronting antimicrobial resistance together. American Physiological Society Rockville, MD; 2022. p. L643-L5. https://doi.org/10.1152/ajplung.00327.2022
[83] Sharma C, Rokana N, Chandra M, Singh BP, Gulhane RD, Gill JPS, et al. Antimicrobial resistance: its surveillance, impact, and alternative management strategies in dairy animals. Frontiers in veterinary science. 2018; 4: 237. https://doi.org/10.3389/fvets.2017.00237
[84] Kapi A. The evolving threat of antimicrobial resistance: Options for action. Indian Journal of Medical Research. 2014; 139(1): 182.
[85] Organization WH. Improving infection prevention and control at the health facility: interim practical manual supporting implementation of the WHO guidelines on core components of infection prevention and control programmes. World Health Organization; 2018.
[86] Control CfD, Prevention. CDC's campaign to prevent antimicrobial resistance in health-care settings. MMWR Morbidity and mortality weekly report. 2002; 51(15): 343.
[87] Essack S. Strategies for the prevention and containment of antibiotic resistance. South African family practice. 2006; 48(1): 17-e.
[88] Holloway K, Dijk Lv. Rational use of medicines. 2011.
[89] Monnier AA, Eisenstein BI, Hulscher ME, Gyssens IC. Towards a global definition of responsible antibiotic use: results of an international multidisciplinary consensus procedure. Journal of Antimicrobial Chemotherapy. 2018; 73(suppl_6): vi3-vi16. https://doi.org/10.1093/jac/dky114
[90] Morgan DJ, Okeke IN, Laxminarayan R, Perencevich EN, Weisenberg S. Non-prescription antimicrobial use worldwide: a systematic review. The Lancet infectious diseases. 2011; 11(9): 692-701. https://doi.org/10.1016/S1473-3099(11)70054-8
[91] Holmes AH, Moore LS, Sundsfjord A, Steinbakk M, Regmi S, Karkey A, et al. Understanding the mechanisms and drivers of antimicrobial resistance. The Lancet. 2016; 387(10014): 176-87. https://doi.org/10.1016/S0140-6736(15)00473-0
[92] Ha DR, Haste NM, Gluckstein DP. The role of antibiotic stewardship in promoting appropriate antibiotic use. American Journal of Lifestyle Medicine. 2019; 13(4): 376-83.
[93] Harbarth S, Balkhy HH, Goossens H, Jarlier V, Kluytmans J, Laxminarayan R, et al. Antimicrobial resistance: one world, one fight!: Springer; 2015. https://doi.org/10.1186/s13756-015-0091-2
[94] Uchil RR, Kohli GS, KateKhaye VM, Swami OC. Strategies to combat antimicrobial resistance. Journal of clinical and diagnostic research: JCDR. 2014; 8(7): ME01. https://doi.org/10.7860/JCDR/2014/8925.4529
[95] Leung E, Weil DE, Raviglione M, Nakatani H. The WHO policy package to combat antimicrobial resistance. Bulletin of the World Health Organization. 2011; 89: 390-2.
[96] Organization WH. Global antimicrobial resistance and use surveillance system (GLASS) report: 2021. 2021.
Cite This Article
  • APA Style

    Debela, N., Nekahiwot, S. (2024). Sepsis, Antimicrobial Resistance, and Alternative Therapies. American Journal of Health Research, 12(1), 8-18. https://doi.org/10.11648/j.ajhr.20241201.12

    Copy | Download

    ACS Style

    Debela, N.; Nekahiwot, S. Sepsis, Antimicrobial Resistance, and Alternative Therapies. Am. J. Health Res. 2024, 12(1), 8-18. doi: 10.11648/j.ajhr.20241201.12

    Copy | Download

    AMA Style

    Debela N, Nekahiwot S. Sepsis, Antimicrobial Resistance, and Alternative Therapies. Am J Health Res. 2024;12(1):8-18. doi: 10.11648/j.ajhr.20241201.12

    Copy | Download

  • @article{10.11648/j.ajhr.20241201.12,
      author = {Negeri Debela and Solome Nekahiwot},
      title = {Sepsis, Antimicrobial Resistance, and Alternative Therapies},
      journal = {American Journal of Health Research},
      volume = {12},
      number = {1},
      pages = {8-18},
      doi = {10.11648/j.ajhr.20241201.12},
      url = {https://doi.org/10.11648/j.ajhr.20241201.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.20241201.12},
      abstract = {Sepsis, a life-threatening condition caused by the body's excessive response to an infection, has emerged as a global health menace. Around 20% of all global deaths are attributable to sepsis. Conversely, the presence of antimicrobial resistance (AMR) poses a significant peril to the health system. AMR constitutes an escalating pandemic that we must not disregard, as the absence of effective antibiotics would compromise the treatment of even commonplace bacterial infections. Therefore, the increasing prevalence of AMR further adds complexity to the management and outcomes of individuals with sepsis. AMR plays a contributory role in aggravating the consequences of sepsis, ranging from prolonged hospitalization to mortality. The World Health Organization (WHO) has prioritized AMR as a major concern necessitating immediate action to prevent dire consequences in the future. Though, One Health approach, infection prevention, rational use of antibiotics, strengthening surveillance systems, as well as research and development, are crucial strategies in combating antimicrobial resistance, alternative therapies, such as phage therapy and immunotherapeutics, are being explored for the management of AMR infections. Advances in these therapies show promise in addressing the challenges posed by antibiotic resistance in treating sepsis. In this critical assessment, we succinctly delineate the existing challenges of AMR in managing sepsis cases, and we provide an overview of the advancements in treating sepsis through alternative therapeutic modalities.
    },
     year = {2024}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Sepsis, Antimicrobial Resistance, and Alternative Therapies
    AU  - Negeri Debela
    AU  - Solome Nekahiwot
    Y1  - 2024/03/07
    PY  - 2024
    N1  - https://doi.org/10.11648/j.ajhr.20241201.12
    DO  - 10.11648/j.ajhr.20241201.12
    T2  - American Journal of Health Research
    JF  - American Journal of Health Research
    JO  - American Journal of Health Research
    SP  - 8
    EP  - 18
    PB  - Science Publishing Group
    SN  - 2330-8796
    UR  - https://doi.org/10.11648/j.ajhr.20241201.12
    AB  - Sepsis, a life-threatening condition caused by the body's excessive response to an infection, has emerged as a global health menace. Around 20% of all global deaths are attributable to sepsis. Conversely, the presence of antimicrobial resistance (AMR) poses a significant peril to the health system. AMR constitutes an escalating pandemic that we must not disregard, as the absence of effective antibiotics would compromise the treatment of even commonplace bacterial infections. Therefore, the increasing prevalence of AMR further adds complexity to the management and outcomes of individuals with sepsis. AMR plays a contributory role in aggravating the consequences of sepsis, ranging from prolonged hospitalization to mortality. The World Health Organization (WHO) has prioritized AMR as a major concern necessitating immediate action to prevent dire consequences in the future. Though, One Health approach, infection prevention, rational use of antibiotics, strengthening surveillance systems, as well as research and development, are crucial strategies in combating antimicrobial resistance, alternative therapies, such as phage therapy and immunotherapeutics, are being explored for the management of AMR infections. Advances in these therapies show promise in addressing the challenges posed by antibiotic resistance in treating sepsis. In this critical assessment, we succinctly delineate the existing challenges of AMR in managing sepsis cases, and we provide an overview of the advancements in treating sepsis through alternative therapeutic modalities.
    
    VL  - 12
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Department of Medical Laboratory Science, College of Health Sciences, Arsi University, Asella, Ethiopia

  • Department of Medical Laboratory Science, College of Health Sciences, Arsi University, Asella, Ethiopia

  • Sections