Antimicrobial Resistance: Is There a Light' at the End of the Tunnel?

In recent years, with the increases in microorganisms that express a multitude of antimicrobial resistance (AMR) mechanisms, the threat of antimicrobial resistance in the global population has reached critical levels. The introduction of the COVID-19 pandemic has further contributed to the influx of infections caused by multidrug-resistant organisms (MDROs), which has placed significant pressure on healthcare systems. For over a century, the potential for light-based approaches targeted at combatting both cancer and infectious diseases has been proposed. They offer effective killing of microbial pathogens, regardless of AMR status, and have not typically been associated with high propensities of resistance development. To that end, the goal of this review is to describe the different mechanisms that drive AMR, including intrinsic, phenotypic, and acquired resistance mechanisms. Additionally, the different light-based approaches, including antimicrobial photodynamic therapy (aPDT), antimicrobial blue light (aBL), and ultraviolet (UV) light, will be discussed as potential alternatives or adjunct therapies with conventional antimicrobials. Lastly, we will evaluate the feasibility and requirements associated with integration of light-based approaches into the clinical pipeline.

Automated summary

In recent years, the global population has faced a serious threat of antimicrobial resistance (AMR) due to the increase in microorganisms with multiple AMR mechanisms. The COVID-19 pandemic has further worsened the situation by causing an influx of infections caused by multidrug-resistant organisms (MDROs), putting enormous pressure on healthcare systems. Light-based approaches have been proposed as a potential solution to combat both cancer and infectious diseases for over a century. These approaches are effective in killing microbial pathogens regardless of their AMR status and are less likely to result in the development of resistance. This review aims to describe the different mechanisms driving AMR and discuss light-based approaches such as antimicrobial photodynamic therapy (aPDT), antimicrobial blue light (aBL), and ultraviolet (UV) light as potential alternatives or adjunct therapies to conventional antimicrobials. The feasibility and requirements of integrating light-based approaches into clinical practice will also be evaluated.