Klebsiella pneumoniae (K. pneumoniae) pose an emerging threat to public health sector worldwide. They are one of the potent nosocomial pathogens and cause variety of infections including pneumonia, septicaemia, wound infections, urinary tract infections and catheter-associated infections. From the last two decades, these pathogens are becoming more powerful due to the acquisition of resistomes on different types of plasmids and transposons. There are four main mechanisms of antibacterial resistance such as efflux pump, target alteration, membrane permeability and notably enzymes hydrolysis. K. pneumoniae produce different types of enzymes but most importantly extended spectrum-β-lactamase (ESBL), carbapenemase and metallo-β-lactamase (MBL). K. pneumoniae carbapenemases (KPCs) and New Delhi metallo-β-lactamase (NDM) producing isolates displayed resistance not only against the β-lactam drugs (penicillins, cephalosporins and carbapenems) but also to other classes of antibiotics (aminoglycosides and quinolones). Therapeutic options available to treat serious infections caused by these extensively drug-resistant pathogens are limited to colistin, tigecycline and fosfomycin. Hence, combination therapy has also been recommended to treat such bacteria with clinical side effects, therefore, new treatment regime must be required. Moreover, we are relying on conventional diagnostic tools, however, novel techniques must be required for robust identification of multi-drug-resistant bacteria.
Respiratory syncytial virus (RSV) infection is a major cause of severe respiratory disease in infants and young children worldwide and also forms a serious threat for the elderly. Vaccination could significantly relieve the burden of the RSV disease. However, unfortunately there is no licensed vaccine available so far. This is partly due to disastrous outcome of a clinical trial of formalin-inactivated RSV (FI-RSV) in children in 1960s; leading to enhanced respiratory disease upon natural infection. These findings contributed significantly to the delay of RSV vaccine development. Other key obstacles in development of RSV vaccine such as a peak of severe disease at 2–3 months of age, challenging biochemical behavior of key vaccine antigens and dependence on animal models that may not truly reflect human disease processes. These challenges could be overcome through maternal immunization, structure-based engineering of vaccine antigens, the design of a novel platform for safe infant immunization, and the development of improved animal models. Currently, several vaccine candidates are in pre-clinical and clinical trials targeting the diverse age groups; young children or older adults from the infection or can reduce incidence, mortality and morbidity among the RSV infected individuals.
Part of the book: The Burden of Respiratory Syncytial Virus Infection in the Young
Biofilm formation in clinical settings is an increasingly important issue particularly due to the emergence of multidrug-resistant strains, as it resulted in increased mortality, which poses a considerable financial burden on healthcare systems. The bacterial biofilms are quite resistant to the routine antimicrobial-based therapies; therefore, the novel strategies are desired in addition to the conventional antibiotics for the effective control of infections caused by biofilm-forming microbes. So far, the approaches being proposed to control the biofilm formation in clinical practice settings include the use of biofilm inhibitors and the use of modified biomaterials for the development of medical devices to thwart the formation of biofilms. In this chapter, we have focused on the latest developments in the anti-biofilm strategies through the interruption of the quorum-sensing system, which is crucial for biofilm formation and have summarized the various classes of antibacterial compounds for the control of biofilm formation. This agrees with the recent approaches suggested by the National Institute of Health (NIH) that advocates the use of combinational therapies based on the conventional methods and complementary treatment to explore the potential utility and safety concerns of the natural products. The studies regarding these emerging strategies could possibly lead to the establishment of better therapeutic alternates compared to conventional treatments.
Part of the book: Bacterial Biofilms