Antibiotic-Resistant Bacteria: Innovative Solutions to Future Challenges

20 серпня 2025
709
УДК:  577.18+004.8
Резюме

Resistance to antibiotics has become a significant health crisis in most parts of the world, posing the risk of reducing the usefulness of existing treatment methods and is one of the leading causes of death. Methicillin-resistant Staphylococcus aureus and Klebsiella pneumoniae among other multidrug-resistant bacteria have acquired complicated mechanisms, which disempower the standard use of antibiotics.

Objective. In this paper, alternate solutions in the form of artificial intelligence, bacteriophage therapy, CRISPR gene editing, developing vaccines, and exploration of natural compounds shall be discussed.

Methods. A detailed literature review of peer-reviewed works for the period 2019–2024 was conducted. Resistance-related mechanisms were classified and discussed, such as gene mutations, the production of enzymes, and the efflux pumps. Technological interventions were tested in terms of feasibility, efficacy and potential to use in clinical settings.

Results. The use of artificial intelligence in drug design like in the case of halicin showed improvements in speeding up discovery and better targeting the resistant strains. Bacteriophage treatment was specific and its side effect was less. The technology of CRISPR-Cas9 allowed editing the genes precisely to inactivate resistant genes. Probiotics and vaccines boosted immune mechanisms, whereas natural compounds such as curcumin or salinosporamide showed good bacteria killing. Enzyme inhibitor and dual-target antibiotics combination therapy were effective.

Conclusion. The fight against antibiotic resistance should be multidisciplinary and multinational because it has to embrace technological innovation, international partnerships and education of the population. They also require long-term research and regulatory framework that should be invested in long-term so that they are safely and clearly implemented. The artificial intelligence combination and molecular biology show a future solution to future resistance.

Introduction

Antibiotic resistance has become one of the most urgent global health menaces of the 21st century with some estimations stating that 10 million people will be dying annually by 2050 in case the current trends will not be changed [1]. Multidrug-resistant bacteria like methicillin-resistant Staphylococcus aureus (MRSA) and Klebsiella pneumoniae have evolved advanced mechanisms that confer resistance to normal antibiotics according to mechanisms like genetic mutations, production of enzymes, and pumping flow mechanisms among others [2].

The recent research source highlights the necessity to implement new and multidisciplinary ways of fighting this crisis. As a case in point, J.M. Stokes et al. (2020) presented the possibility of AI in speeding up antibiotic discovery by the creation of a new substance called halicin, which shows efficacy against resistant types. Correspondently, another study by D. Bikard et al. (2021) investigated the potential application of CRISPR-Cas9 gene editing method to selective inactivate the genes of resistance as a precision-based treatment strategy [3, 4].

In addition to molecular interventions, the use of probiotics and vaccines to modulate host immunity and decrease infection rates was indicated by C. Hill et al. (2022). Plants derived and marine organism-derived low molecular molecules curcumin and salinosporamide have also exhibited potential antibacterial potency [5, 6]. The findings support this argument that non-traditional sources of antimicrobial agents would be worth investigating.

Irrespective of all these, a lot of challenges still exist. The processes of clinical trials take extended periods of time, the cost of development is expensive, and regulatory barriers tend to create a gap between laboratory findings and clinical practice [7]. In addition, the misuse of antibiotics in farming and health care facilities also remains a significant catalyst of the emergence of resistance and requires effective care schemes and awareness among the citizens [8].

The given paper will present an overview of other approaches to the problem of antibiotic resistance with consideration of five main directions: use of artificial intelligence (AI), phage therapy, CRISPR-based modification of genes, immunological treatment, and the study of naturally-occurring substances. The study hypothesis is to assess how viable, effective, and translatable these methods could be in clinical and population health responsibilities by reviewing the recent corpus of peer-reviewed studies (2019–2024).

It is necessary to note that the fight against antibiotic resistance demands international cooperation and a long-term investment in research and development as well as the incorporation of the latest technologies and microbiological expertise. According to A. Esteva et al. (2023), the integration of AI, genomics and molecular biology can be a solution in overcoming resistance and safeguarding humanity in the next generation [9].

Materials and Methods

The review was carried out in the state of innovative approaches to overcome the problem of antibiotic-resistant bacteria with the qualitative analysis of peer-reviewed literature published in 2019–2024. PubMed, Scopus, and Web of Science were systematically searched through the keywords of antibiotic resistance, AI drug discovery, CRISPR-Cas9, bacteriotherapy, and natural antibiotics. The methods used in the research were borrowed after the description of [7, 9].

Original research articles, systematic reviews, and institutional reports about resistance mechanisms or new treatment methods were subject to inclusion as they are original research. Non-English publication, studies published prior to 2019 and studies conducted without any experimental or clinical validation were the exclusion criteria [1].

All in all, 42 sources on the basis of relevance, citation power, and translatability were chosen. Among the approaches highlighted during the analysis, there were approaches proving to be clinically viable, molecular-specific, and cross-disciplinary, such as vehicle screening using AI [3], gene editing using CRISPR-Cas9 [4], and an increase in immune functions through probiotics [5].

Results and Discussion

The challenge of antibiotic resistance is complicated and facilitated by a huge variety of bacterial processes. Resistance is currently analyzed into three simple categories of genetic mutation, enzyme production and flow pumps and all of these contribute to the decreasing of effectiveness of antibiotics. As shown in Table 1, genetic mutations such as mecA in MRSA alter penicillin-binding proteins, while producing Klebsiella pneumoniae produces carbapenems that break down β-lactam antibiotics. Flow systems such as AcrAB-TolC in Escherichia coli actively expel antibiotics, further complicating treatment strategies [7, 8].

Table 1. Comparison of mechanisms of antibiotic resistance

Mechanism Description Examples
Gene mutation Alteration of genes to make proteins ineffective Mutation of mecA gene in MRSA
Enzyme production Production of β-lactamase to degrade antibiotics Klebsiella pneumoniae and carbapenemases
Efflux pumps Actively expel antibiotics out of the bacterial cell AcrAB-TolC pump in Escherichia coli

The global health impact of resistance is profound. Treating infections such as pneumonia, sepsis, and urinary tract infections is becoming increasingly difficult, especially in low-resource settings [9]. The World Health Organization estimates that resistance-related deaths could reach 10 million annually by 2050, exceeding death rates from diseases such as cancer and AIDS. Figure 1, which previously lacked scientific content, should be replaced with a diagram showing the sequence from resistance mechanisms to clinical outcomes and economic burden [10, 11].

Figure 1. The escalating cascade of antibiotic resistance: from molecular mechanisms to global burden

The economic consequences are equally worrying. Resistant infections prolong hospital stays and require expensive last-line antibiotics [12]. In the United States alone, direct costs exceed $20 billion annually, with an additional loss in productivit­y of $35 billion. The agricultural sector is also suffering, as the overuse of antibiotics in livestock contributes to the emergence of resistant strains entering the food chain [13, 14].

Probiotics and vaccines offer protective potential. As shown in Table 2, probiotics enhance immune responses and restore gut microbiota balance after antibiotic exposure. Figure 2 illustrates the synergistic immunological mechanisms that vaccines and probiotics employ to reduce the prevalence of antibiotic-resistant infections. Vaccines stimulate B-cell responses, leading to the production of targeted antibodies against resistant pathogens, while probiotics such as strains of Lactobacillus and Bifidobacterium enhance T-cell activation and restore gut microbiota balance. Together, they contribute to lowering infection rates and improving clinical outcomes, as supported by recent findings from C. Hill et al. (2022). This immunological layering offers a preventative strategy alongside traditional treatments [5, 15].

Table 2. Relationship between probiotics and antibiotic resistance

Aspect Role of Probiotics Impact
Immune enhancement Strengthens natural defenses against infections Reduces occurrence of resistant bacteria
Restoring balance Restores gut microbiota disrupted by antibiotics Promotes recovery and health
Synergistic effect Enhances effectiveness of concurrent antibiotic treatments Improves infection outcomes
Figure 2. Immunological defense synergy: vaccines and probiotics in infection prevention

Innovative technologies are reshaping resistance management. The discovery of AI-based drugs, as demonstrated by J.M. Stokes et al. (2020), led to the development of halicin, a compound effective against Acinetobacter baumannii [3]. CRISPR-Cas9 enables precise gene editing to inactivate resistance genes, while bacteriophages provide targeted killing of bacteria with minimal side effects (Table 3) [16].

Table 3. Innovations in combating resistance

Innovation Description Advantages
AI Analysis of bacterial genomes to develop new antibiotics Accelerates drug design processes
Bacteriophages Viruses that specifically target resistant bacteria Reduced side effects, selective action
CRISPR Gene editing to remove resistance-causing genes Precision-targeted bacterial control

Despite the progress made, challenges remain. Clinical trials are long and expensive, while emerging resistance still trumps drug development. As shown in Table 4, proposed solutions include computational modeling to speed up testing and supervision programs to reduce misuse [17, 18].

Table 4. Challenges and proposed solutions

Challenge Description Proposed Solution
Lengthy clinical trials Time-consuming and expensive testing processes Use computational models to accelerate trials
Emerging new resistance Overuse of antibiotics leading to novel resistance Enhance education and implement stewardship programs

Furthermore, combining combination therapies such as pairing beta-lactam antibiotics with enzyme inhibitors such as clavulanic acid or avibactam has shown promising results in restoring bacterial sensitivity. Studies are also exploring combining conventional antibiotics with CRISPR-based gene silencing or phage delivery systems to enhance efficacy [19].

Figure 3 presents a layered therapeutic model integrating conventional antibiotics, emerging molecular technologies, and AI-based computational support. Traditional compounds such as β-lactams and fluoroquinolones form the foundational layer. Complementary strategies including CRISPR-Cas gene editing, bacteriophage therapy, and efflux pump inhibitors target resistance mechanisms directly.

Figure 3. Boosting immunity with probiotics to reduce antibiotic resistance

Natural compounds remain promising frontiers. D.J. Newman, G.M. Cragg (2023) reviewed sea-derived agents such as salosporamide, while A. Rahman et al. (2025) emphasized the role of environmental alkaloids such as curcumin in combating resistant strains. These discoveries highlight the importance of ethnobotanical screening and AI-assisted vehicle selection [6, 20].

While this review highlights innovative solutions to antibiotic resistance, several limitations must be acknowledged. Many proposed technologies such as CRISPR-based antibiotics, AI-guided drug discovery, and bacterial therapy remain in the early stages of development and lack widespread clinical validation [13, 15]. The majority of data come from laboratory or preclinical studies, limiting generalizability to real-world settings. Furthermore, safety concerns regarding gene editing systems and virus delivery vectors remain regulatory challenges [4]. The scalability of these interventions, especially in low-resource settings, remains uncertain given high development costs, infrastructure gaps, and limited public health awareness [21, 22].

Future research should focus on designing multicenter clinical trials to evaluate efficacy and safety across different populations. Emphasis should be placed on integrating AI-based models with real-time microbial surveillance to detect early outbreaks of resistant diseases [3]. In addition, multidisciplinary collaboration between microbiologists, computing scientists, and healthcare organizations is needed to accelerate the translation process from laboratory to patient bed. One promising frontier involves ethno-pharmacological screening of natural compounds using AI-based predictive models to detect new antimicrobial agents from unexplored environments [6]. Finally, public health strategies should prioritize education and supervision programs to prevent misuse and maintain the effectiveness of available treatments.

Conclusions

Antibiotic resistance is a multinational, multicausal health emergency that is, by far, an overwhelming problem whose effects impact a diverse range of illnesses or diseases. It was evident in this review that there are important bacterial mechanisms employed such like gene mutation, enzyme degradation and flow mechanisms that hamper the effectiveness of conventional antimicrobial treatment. The rising rate of multidrug-resistant organisms like MRSA and Klebsiella pneumoniae poses an imminent call to action, a multidisciplinary action.

There are opportunities of innovative technologies. Antibiotic discovery has been expedited using the power of artificial intelligence in molecular modeling and compound screening to predict antibiotics, which showed success with the discovery of halicin. The effect of bacterial therapy has been antibacterial and precise, with little disturbance to the healthy microbiome of the gut, and CRISPR-Cas9 gene editing provides a highly selective means to disable genetic components that impart resistance. At the same time, probiotics and vaccines help enhance the immune system to avoid getting infected, and natural products, like salosporamide and curcumin, possess wide antimicrobial prospects.

Although that has happened, a lot needs to be done. Numerous new technologies are experimental and cannot be used unless they are well-tested clinically. Regulatory structures undertaking CRISPR and phage applications have to shift to embrace the aspects of safety and ethics. Additionally, fairness of access to new therapies is restricted due to costs of development and infrastructure gaps particularly in low-income regions.

Future directions must center on multicentric, large-scaled studies which aim at testing the combined treatment in real life scenarios. Artificial intelligence tools need to be integrated with dynamic monitoring systems that allow tracking patterns of resistance and guide clinical choices of treatment. Research on ethnopharmacology and sophisticated machine training could also be able to increase the discovery of unexploited potential antimicrobials in the natural world. Also, it is necessary to remember that some basic supervision and education efforts on the part of the population will be needed so that it is possible to limit the excess use of all the available antibiotics, and keep them working well.

Finally, an adequacy to global reactions to antibiotic resistance must be innovative as well as collaborative. The combination of machine learning, molecular biology, and environmental discovery shows the way forward which not just overcomes the current crisis but also predicts the future microbial challenges. Sustainable research investment, regulatory reforms, and international collaboration will play a central role in scaling emerging technologies in the form of safe, effective and scalable clinical solutions.

Acknowledgements

The authors would like to thank the University of Mosul for academic support.

Conflict of Interest

The authors declare no conflict of interest.

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Антибіотикорезистентність: інноваційні рішення майбутніх викликів

Е.В. Альхадіді, А.А. Давуд

Університет Мосула, Мосул, Ірак

Резюме. Стійкість до антибіотиків стала значною кризою охорони здоров’я в більшості частин світу, що створює ризик зниження корисності існуючих методів лікування та є однією з провідних причин смерті. Метицилінрезистентний Staphylococcus aureus та Klebsiella pneumoniae серед інших бактерій з множинною лікарською стійкістю набули складних механізмів, які позбавляють можливості стандартного застосування антибіотиків. Мета. У статті обговорено альтернативні рішення у вигляді штучного інтелекту, терапії бактеріофагами, редагування генів CRISPR, розробки вакцин та дослідження природних сполук. Методи. Проведено детальний огляд літератури рецензованих робіт за період 2019–2024 рр. Класифіковано та обговорено механізми, пов’язані зі стійкістю бактерій, такі як генні мутації, продукція ферментів та ефлюкс­ні насоси. Технологічні втручання перевірені з точки зору доцільності, ефективності та потенціалу використання в клінічних умовах. Результати. Використання штучного інтелекту в розробці ліків, як у випадку з галіцином, показало сприяння у пришвидшенні відкриття та кращому таргетуванні резистентних штамів. Обробка бактеріофагами була специфічною, а її побічні ефекти — менш помітними. Технологія CRISPR-Cas9 дозволила точно редагувати гени для інактивації резистентних генів. Пробіотики та вакцини посилювали імунні механізми, тоді як природні сполуки, такі як куркумін або саліноспорамід, продемонстрували ефективне знищення бактерій. Комбінована терапія інгібіторами ферментів та антибіотиками подвійної дії була ефективною. Висновок. Боротьба з антибіотикорезистентністю має бути багатопрофільною та багатонаціональною, і повинна охоплювати технологічні інновації, міжнародні партнерства та освіту населення. Вона також потребує довгострокових досліджень та регуляторної бази, в яку слід інвестувати в довгостроковій перспективі для безпечного та чіткого впровадження. Поєднання штучного інтелекту та молекулярної біології демонструє майбутнє рішення для розв’язання проблеми резистентності в майбутньому.

Ключові слова: антибіотики, бактерії, резистентність, вакцина, штучний інтелект.

Information about the authors:

Alhadidi Enass W. — M.Sc. Department of Biology, College of Science, University of Mosul, Iraq. ORCID: 0009-0004-2296-4094

Dawood Ali A. — Ph.D. Department of Anatomy, College of Medicine, University of Mosul, Iraq l. ORCID: 0000-0001-8988-5957

Інформація про авторів:

Альхадіді Енас В. — магістр наук, відділ біології, Науковий коледж Університету Мосула, Мосул, Ірак. ORCID: 0009-0004-2296-4094

Давуд Алі А. — доктор філософії, відділ анатомії, Медичний коледж Університету Мосула, Мосул, Ірак. ORCID: 0000-0001-8988-5957

Received/Надійшла до редакції: 04.08.2025
Accepted/Прийнято до друку: 12.08.2025