Microbiology
Antimalarial Effects of Nano Chloroquine Loaded Curcumin In vivo
Background: Malaria is still the deadliest parasitic disease caused by Plasmodium spp. Due to drug resistance and their unpleasant side effects of conventional researchers are enormously seeking to achieve antimalarial drugs with more curative effective less toxic and cost-affordable drugs using more advanced technology such as nanodrugs. Purpose: The present study aimed to examine the antimalarial effects of a novel synthesized nonochloroquine-loaded curcumin relying on dendrimer G2 in susceptible mice. Methods: Antimalarial activity and toxicity of the nanocomposite were examined on BALB/C mice with microscopy checking RBCs morphology and related enzymatic activity rate. Results: The maximum inhibitory effect of the nanocomposite was seen at 10 mg/kg killing 98% of P. berghei compared to sole chloroquine whereas ED50 was reported at 5.5 mg/kg. The safety of the synthesized nanocomposite was confirmed with biochemical tests with no detrimental effects on mice. The sustainability and longevity of the nanodrug increased significantly with the NDC-CQ assay compared to the control groups. Conclusion: The study showed that nonochloroquine-loaded curcumin had a promising inhibitory effect on P. berghei growth in infected mice compared to standard drugs. However further studies and clinical trials with large samples are recommended to study different aspects of using nanodrug.
Acknowledgements To Reviewers
Patient-Centric Approaches: Revolutionizing Rare Disease Drug Research
Outbreak and Management Strategies of Nipah Virus: A Scenario from the Southern Part of India
Two Birds with One Stone: Drug Regime Targets Viral Pathogenesis Phases and COVID-19 ARDS at the Same Time
Background: Severe COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a kind of viral pneumonia induced by infection with the coronavirus that causes ARDS. It involves symptoms that are a combination of viral pneumonia and ARDS. Antiviral or immunosuppressive medicines are used to treat many COVID-19 patients. Several drugs are now undergoing clinical studies in order to see if they can be repurposed in the future. Material and Methods: In this study in silico biomarker-targeted methodologies such as target/ molecule virtual screening by docking technique and drug repositioning strategy as well as data mining approach and meta-analysis of investigational data were used. Results: In silico findings of used combination of drug repurposing and high-throughput docking methods presented acetaminophen ursodiol and β-carotene as a three-drug therapy regimen to treat ARDS induced by viral pneumonia in addition to inducing direct antiviral effects against COVID-19 viral infection. Conclusion: In the current study drug repurposing and high throughput docking methods have been employed to develop combination drug regimens as multiple-molecule drugs for the therapy of COVID-19 and ARDS based on a multiple-target therapy strategy. This approach offers a promising avenue for the treatment of COVID-19 and ARDS and highlights the potential benefits of drug repurposing in the fight against the current pandemic.
Imidazo[1,2-A]Pyridine: Potent Biological Activity, SAR and Docking Investigations (2017-2022)
Background: Regarding scientific research Imidazo[12-a] pyridine derivatives are constantly being developed due to the scaffold’s intriguing chemical structure and varied biological activity. They are distinctive organic nitrogen-bridged heterocyclic compounds that have several uses in medicines organometallics and natural products. It has become a vital tool for medicinal chemists. Methods: In order to gather scientific information on Imidazo[12-a] pyridines derivative Google PubMed Scopus Google Scholar and other databases were searched. In the current study the medicinal value and therapeutic effect of Imidazo[12-a] pyridines were investigated using above mentioned databases. The current study analyzed the detailed pharmacological activities of Imidazo[12-a] pyridine analogs through literature from diverse scientific research works. Results: Due to its wide range of biological activities including antiulcer anticonvulsant antiprotozoal anthelmintic antiepileptic antifungal antibacterial analgesic antiviral anticancer anti-inflammatory antituberculosis and antitumor properties imidazopyridine is one of the most significant structural skeletons in the field of natural and pharmaceutical products. An imidazopyridine scaffold serves as the basis for a number of therapeutically utilized medications including zolpidem alpidem olprinone zolimidine and necopidem. Conclusion: This comprehensive study covers the period of the last five years and it sheds light on the developments and emerging pharmacological actions of Imidazo[12-a] pyridines. Additionally the structure-activity relationship and molecular docking studies are carefully documented throughout the paper providing medicinal chemists with a clear picture for developing new drugs.
The Risk of Crimean Congo Haemorrhagic Fever in India as a Growing Health Concern
Every year witnesses an outbreak of some or the other zoonotic disease that causes the unparalled loss of human life. The year 2022 presented the outbreak of Crimean Congo haemorrhagic fever (CCHF) which brought unprecedented challenges to individuals as well as to the healthcare system all around the world making it a serious health concern. Rising health concerns have highlighted the importance of managing and decreasing the further transmission of the CCHF virus. CCHF is one of tick-borne viral diseases which spreads due to various reasons like changes in global warming environmental influences and other ecological factors. All these factors somehow impact the disease prevalence. This disease has a negative impact on both humans and livestock. The diverse climate and significant livestock population of India make it susceptible to the prevalence of CCHF. Therefore it is the need of the hour to develop some strategies in order to tackle the challenges posed by CCHF. This article includes all the cases of CCHF that have occurred in India from the year 2011 along with the fatality rates associated with this disease. Also this study discusses the need to explore some specific drugs for the management and prevention of such diseases. In addition the pathogenesis of the disease progression along with some protective measures suggested by the government has been described for prevention of CCHF. Subsequently this article attempted to draw attention towards the risk that may be posed by CCHF in the coming scenario emphasizing the importance of taking proactive measures in anticipation of such risks.
Identification of Genes Encoded Toxin-Antitoxin System in Mycobacterium Tuberculosis Strains from Clinical Sample
Background: The toxin-antitoxin system is a genetic element that is highly present in Mycobacterium tuberculosis (MTB) the causative agent of tuberculosis. The toxin-antitoxin system comprises toxin protein and antitoxin protein or non-encoded RNA interacting with each other and inhibiting toxin activity. M. Tuberculosis has more classes of TA loci than non-tubercle bacilli and other microbes including VapBC HigBA MazEF ParDE RelBE MbcTA PemIK DarTG MenTA one tripartite type II TAC chaperone system and hypothetical proteins. Aims: The study aims to demonstrate the genes encoded toxin-antitoxin system in mycobacterium tuberculosis strains from clinical samples. Materials and Methods: The pulmonary and extra-pulmonary tuberculosis clinical samples were collected and smear microscopy (Ziehl-Neelsen staining) was performed for the detection of high bacilli (3+) count followed by nucleic acid amplification assay. Bacterial culture and growth assay genomic DNA extraction and polymerase chain reaction were also carried out. Results: The positive PTB and EPTB samples were determined by 3+ in microscopy smear and the total count of tubercle bacilli determined by NAAT assay was 8.0×1005in sputum and 1.3×1004CFU/ml in tissue abscess. Moreover the genomic DNA was extracted from culture and the amplification of Rv1044 and Rv1045 genes in 624 and 412 base pairs (between 600-700 and 400-500 in ladder) respectively in the H37Rv and clinical samples was observed. Conclusion: It has been found that Rv1044 and Rv1045 are hypothetical proteins with 624 and 882 base pairs belonging to the AbiEi/AbiEii family of toxin-antitoxin loci. Moreover the significant identification of TA-encoded loci genes may allow for the investigation of multidrugresistant and extensively drug-resistant tuberculosis.
A Day Saved is a Life Saved: Direct Antimicrobial Susceptibility Testing from Positively Flagged Blood Culture Bottles and their Concordance with the Routine Method
Background: Sepsis is a major health problem worldwide and is associated with high morbidity and mortality with every hour delay in initiation of therapy. A conventional method of blood culture and Antimicrobial Susceptibility Testing (AST) takes around 48-72 hours. Empirical antibiotics need to be administered until the sensitivity report is made available. It has been estimated that 20-50% of the empirical antibiotics are inappropriate resulting in prolonged hospital stays adverse effects and emergence of drug resistance. Additionally this also puts an extra financial burden on both the patients and healthcare settings. Performing direct Antimicrobial Sensitivity Testing (dAST) is an important tool to reduce turn-around time (TAT) by at least 18-24 hours thus reducing morbidity and mortality among critically ill patients. Methods: Direct AST (dAST) was performed from the positively flagged blood culture bottles received between December 2021 to May 2022 from Intensive Care Units (ICUs) on Mueller- Hinton Agar (MHA) using four drops of withdrawn blood. dAST was performed for six drugs: Ceftriaxone-30 μg (CTR) Piperacillin/Tazobactam-100/10 μg (PIT) Meropenem-10 μg (MRP) Ciprofloxacin-5 μg (CIP) Aztreonam-30 μg (AT) and Colistin (CL). The zone of inhibition was interpreted as per CLSI M100 ed32 2022 guidelines. A parallel conventional method was also performed to examine for categorical agreement and disagreement. Identification was carried out using MALDI-TOF MS from the colonies that appeared on the dAST plate on the subsequent day. Results: A total of 162 positively flagged blood culture bottles were included in the study. The majority of the Gram-negative organisms were from Enterobacterales (n=109) followed by Acinetobacter spp. (n=28) and Pseudomonas aeruginosa (n=25). Out of the 972 isolate-antimicrobial combinations overall Categorical Agreement (CA) was seen in 936 (96.3%) whereas disagreement was observed in 36 with minor error (mE) in 21 (2.2%) major error (ME) in 7 (0.7%) and very major error (VME) in 8 (0.8%) when compared to the routine method. Categorical agreement (CA) of > 99% was seen in ceftriaxone (CTR) and ciprofloxacin (CIP). In comparison the lowest CA was observed with meropenem (MRP) at 92%. Colistin dAST was performed using the E-strip method and the result obtained was highly convincing with an overall disagreement of only 1.2%. Conclusion: Rapid dAST from positively flagged blood culture bottles proved to significantly reduce the TAT from the time of sample collection to the first availability of antimicrobial susceptibility report with excellent categorical agreement of > 95% using the conventional disc diffusion method. Results obtained were within the acceptance criteria set by U. S. Food and Drug Administration (FDA) guidelines of > 90% categorical agreement for a new method. We were able to obtain excellent concordance for colistin using the E-strip method. Performing dAST not only saves a “day” but its proper implementation would save a “life”.
Design of RNA Polymerase Inhibitors as Therapeutics for Tuberculous Meningitis
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. The current treatment protocols for pulmonary tuberculosis are quite effective even though the treatment requires 3-6 months. The current treatment protocols for extrapulmonary tuberculosis are based on the same drugs that are used for pulmonary tuberculosis. However the success rates are much lower for certain types of extrapulmonary tuberculosis such as tuberculous meningitis. Tuberculous meningitis is one of the very few diseases attributable to bacteria that have a very high short-term mortality rate among diagnosed patients even after treatment with antibiotics that are effective for pulmonary tuberculosis. For example rifampicin is highly effective for the treatment of pulmonary tuberculosis but its effectiveness for the treatment of tuberculous meningitis is much lower. The reason for the lower effectiveness of rifampicin against tuberculous meningitis is that it has low Blood-Brain Barrier (BBB) permeability which results in lower concentrations of the drug at the required sites in the central nervous system.
In this work ligands having increased BBB permeability and pharmacokinetic and pharmacodynamic properties either similar to or better than that of rifampicin have been designed. The BBB permeability of the designed molecules was assessed by using pkCSM a machine-learning model. Pharmacokinetic properties drug-likeness and synthesizability were assessed by using SWISS-MODEL. The binding affinity of the designed drugs was assessed by using AutoDock Vina. A customized scoring function StWN score was used for a quantitative weighted assessment of all the properties of interest to rank the designed molecules.
In this study drug-like ligands have been designed that have been predicted to have high BBB permeability as well as high affinity for RNA polymerase β of Mycobacterium tuberculosis.
The best ligands generated by the tools employed were selected as potential drugs to address the current need for better options for the treatment of tuberculous meningitis.
Sulbactam-Durlobactam, A Novel Drug for the Treatment of Multidrug Resistant Acinetobacter baumannii Infections - A Systematic Review
Background: Sulbactam-durlobactam (SUL-DUR) has been tested in vitro for its ability to generate resistance in clinical isolates of Acinetobacter species. According to prior studies combining durlobactam with sulbactam causes sulbactam-resistant isolates to become more active and revert to susceptibility. We aimed to conduct a systematic review of the in vitro activity of SUL-DUR on A. baumannii (Ab) isolates including carbapenem-resistant A. baumannii (CRAb) to provide an overview for physicians dealing with Ab infections. Methods: The following keywords were searched in the PubMed Google Scholar and EMBASE databases to look for eligible original works that have been published without restrictions till June 30 2023: A. baumannii and sulbactam-durlobactam SUL-DUR durlobactam and sulbactam-ETX2514. We also searched clinicaltrials.gov and the Clinical Trials Registry of India (CTRI) for clinical trials involving sulbactamdurlobactam and Acinetobacter. Results: There were a total of 852 abstracts found. Among them 633 articles with titles abstracts and keywords were reviewed and 574 articles were removed after the initial screening. A total of 59 full-text eligible articles were evaluated and 51 of them were eliminated because they did not satisfy the criteria set for inclusion. The full texts of the final 8 in vitro studies on A. baumanii and sulbactam/durlobactam were further evaluated. There were 5 trials on A. baumanii and sulbactam/durlobactam found on clinicaltrials.gov and the Clinical Trial Registry of India (CTRI). Conclusion: The findings from the studies show that SUL-DUR might be a successful therapeutic option for multidrug-resistant-Ab infections. Future clinical trials will be required to validate the possibility of using this combination to treat multidrug-resistant A. baumannii infections.
A New-fangled COVID-19 Variant, Eris, Might be the One to Lookout in 2023 or far from Over
Coronavirus Disease-19 (COVID-19) is an infectious disease brought on by the extremely pathogenic and contagious severe acute respiratory syndrome-virus-2 (SARS-CoV-2). The agenda for the COVID-19 pandemic is dynamic and includes recent developments. Seven variants under monitoring (VUMs) one variant of interest (VOI) XBB.1.5 and their offspring lineages are currently being actively monitored by WHO. The VUMs are BA.2.75 CH.1.1 BQ.1 XBB (with the exception of XBB.1.5 XBB.1.16 and XBB.1.9.1) XBF and XBB.1.16. With 95 countries having reported finding XBB.1.5 (VOI) it is still the most common strain worldwide responsible for 47.9% of cases from epidemiological January to March 2023. Seventy nations discovered XBB.1.5 in February and March 2023 and posted sequencing data to GISAID. Of the 43 nations that uploaded more than 50 sequences XBB.1.5 prevalence has increased to more than 50% in 11 nations. Over 23000 deaths and 3 million new cases were recorded globally in March and April 2023. Worldwide detection of a new COVID-19 strain has prompted specialists to issue a warning that the virus is "circulating unchecked". The Greek goddess of conflict and discord Eris has inspired the nicknaming of EG 5.1 a subvariant of Omicron. The strain is becoming more prevalent in the USA and cases are increasing in the UK. The severity of each SARS-CoV- 2 variant has been comparable although a more severe form might develop. Eris is an ancestor of Omicron and exhibits some of its characteristics. Reinfection risk can be influenced by a variety of variables including age location and health equity and the COVID-19 vaccine is more or less effective depending on the strain.
Stratified Mucin-Producing Intraepithelial Lesion of the Cervix in an HPV-16 Positive Woman: A Rare Encounter
Background: Cervical cancer is the fourth most common cancer among women globally and has a strong association with Human Papillomavirus (HPV) infection. Stratified mucinproducing intraepithelial lesion (SMILE) a variant of Adenocarcinoma in situ (AIS) is a rare cervical precancer lesion that is often missed or detected incidentally. Case Presentation: The present case report briefs the finding of a 39-year-old woman who presented to the gynecological outpatient department with complaints of vaginal discharge for 6-8 months. She had no history of irregular menstrual cycles or postcoital bleeding. Her routine Pap smear revealed atypical squamous cells of undetermined significance (ASCUS) and was positive for HPV-16 type. Her cervical biopsy report revealed AIS and her histopathological report of hysterectomy revealed SMILE a variant of AIS. Discussion: The SMILE variant of AIS is a rare cervical precancerous lesion characterized by the morphological overlap of both squamous intraepithelial lesions and AIS. It is often difficult to diagnose on Pap smear and is commonly associated with high-risk HPV infections. The management of SMILE is the same as that for AIS which is the excisional procedure followed by a hysterectomy if the margins are negative and depending on the fertility desires of the patient followed by regular follow-up with HPV testing. Conclusion: SMILE is a rare variant of AIS which is often missed on cytological screening of the cervix. It is commonly associated with high-risk types of HPV. Hence incorporating HPV testing in the screening of cervical cancer is important and recommended to increase the overall sensitivity of screening for adenocarcinoma lesions.
Estimating Hidden Population Size of COVID-19 using Respondent-Driven Sampling Method - A Systematic Review
Introduction: Currently the ongoing COVID-19 pandemic is posing a challenge to health systems worldwide. Unfortunately the true number of infections is underestimated due to the existence of a vast number of asymptomatic infected individual’s proportion. Detecting the actual number of COVID-19-affected patients is critical in order to treat and prevent it. Sampling of such populations so-called hidden or hard-to-reach populations is not possible using conventional sampling methods. The objective of this research is to estimate the hidden population size of COVID-19 by using respondent-driven sampling (RDS) methods. Methods: This study is a systematic review. We have searched online databases of PubMed Web of Science Scopus Embase and Cochrane to identify English articles published from the beginning of December 2019 to December 2022 using purpose-related keywords. The complete texts of the final chosen articles were thoroughly reviewed and the significant findings are condensed and presented in the table. Results: Of the 7 included articles all were conducted to estimate the actual extent of COVID-19 prevalence in their region and provide a mathematical model to estimate the asymptomatic and undetected cases of COVID-19 amid the pandemic. Two studies stated that the prevalence of COVID-19 in their sample population was 2.6% and 2.4% in Sierra Leone and Austria respectively. In addition four studies stated that the actual numbers of infected cases in their sample population were significantly higher ranging from two to 50 times higher than the recorded reports. Conclusions: In general our study illustrates the efficacy of RDS in the estimation of undetected asymptomatic cases with high cost-effectiveness due to its relatively trouble-free and low-cost methods of sampling the population. This method would be valuable in probable future epidemics.
Dog Bite Injury: Rusk Became a Risk - A Case Report
Background: Dog bites are a worldwide problem that disproportionately affects children. It might be difficult to keep in mind that even a man's closest buddy can be dangerous to people. In light of the significant morbidity and mortality associated with dog bites we report herein an intriguing case in which a two-year-old boy appeared with eyelid facial lacerations as a result of a dog bite. Case Presentation: A two-year-old boy presented with bleeding around the right and left eyes. Local examination of the eyes revealed laceration and disfiguration of the left orbit and abrasion around the right eye. Preoperatively parenteral antibiotics were started and continued postoperatively. Dressing was done for the right eye. Lid reconstruction surgery for the left eye was scheduled and it was carried out under general anaesthesia. The child was monitored for a month and showed satisfactory wound healing with no visible scars or complications. Discussion: The standard treatment for bites is direct suture grafting or local flaps depending on the type of wound and the surgeon's preference regardless of the time since the attack. Crush wounds are difficult to treat because the damage to the tissues is often so profound that amputation is unavoidable. Conclusion: The global injuries caused by dog bites are the consequence of uncommon illnesses and often manifest as peri-orbital and ocular lesions. Most rabies cases occur in underserved rural and urban areas with a high frequency of stray dogs without immunisation.
Factors Associated with Mortality in Patients with Coronavirus Disease (COVID-19) in Babol, North of Iran
Background: The spectrum of the clinical features of coronavirus disease 2019 (COVID-19) spans from asymptomatic or mild disease to severe respiratory failure while different factors are related to its mortality rate. This research aimed to determine the clinical and laboratory characteristics and the associated factors of mortality in patients with COVID-19. Materials and Methods: Data were collected from hospitalized patients (May to June 2020) and COVID-19 was confirmed in patients by real-time polymerase chain reaction (PCR). The patient group was classified into survivor and deceased groups. The chi-square and the independent t-test with Statistical Package for the Social Sciences (SPSS) software program version 18 were used for analysis. Results: Mean age hemoglobin serum C-reactive protein (CRP) alkaline phosphatase (ALP) white blood cells and level of procalcitonin in non-survivors were significantly higher than in survivors. Serum tumour necrosis factor-alpha (TNF-a) had a significant relationship with Ddimer (p = 0.0006). The risk of mortality in patients with serum CRP ≥ 100 mg/dl was significantly higher than those with CRP < 100 mg/dl (odds ratio (OR) = 4.8 (95% CI 1.33-12.44 p = 0.01). Conclusion: COVID-19 has different clinical features and can be an asymptomatic mild or severe disease. Thus findings about the disease and the consequent outcomes differ in patients. Further studies are needed to evaluate the clinical features and consequences of COVID-19 infection.
Actinomyces-induced Osteomyelitis of the Mandible - A Rare Disease?
Background: Actinomyces species are commensal oral cavity flora that can cause jaw osteomyelitis. Osteomyelitis of the jaw by Actinomyces is rare and its presentation can be confused with many different pathologies. Case presentation: This is the case of a 61-year-old female with breast cancer and on chemotherapy as well as non-invasive carcinoma of the tongue who initially presented to the dentist with white spots in the right mandible near the incisors associated with right mandible pain and swelling. Actinomyces-induced osteomyelitis of the mandible was diagnosed. The patient was treated with penicillin V for 6 weeks along with a course of hyperbaric oxygen therapy which resulted in the complete resolution of the infection. Conclusion: In summary jaw osteomyelitis caused by Actinomyces should always be part of the differential diagnosis; as these organisms are commensal flora. The symptoms manifested are non-specific and such a diagnosis could be easily missed resulting in delay of care and disease progression.
Disease X: Beyond Fear, Toward Preparedness
Association of COVID with Mycosis in General
Background: The COVID-19 pandemic caused by SARS-CoV-2 is a respiratory disease which created havoc worldwide was accompanied by another peculiar otherwise rare secondary fungal infection Mucormycosis which was observed at exceptionally high incidence in India during the second wave of COVID-19. The article explores possible links between the two infectious diseases to understand a higher-than-normal occurrence of Mucormycosis in COVID-19 patients. Coronavirus enters the patients through ACE-2 and many other receptors like- NRP-1 TfR CD-126 and CD-26. Virus bind to cells possessing these receptors and affect their proper functioning disturbing homeostatic metabolism and resulting in conditions like hyperglycemia Diabetic Ketoacidosis (DKA) low serum pH iron overload anemia hypoxia and immunosuppression as explained in the article. All these outcomes provide a very supportive environment for the attack and spread of Mucormycosis fungi. The major receptor for Mucormycosis in humans is the GRP-78. Its expression is upregulated by coronavirus entry and by hyperferritinemia hyperglycemia and acidic conditions prevalent in COVID patients thus providing an easy entry for the fungal species. Upregulation of GRP-78 furthermore damages pancreatic β-cells and intensifies hyperglycemia showing quite a synergic relationship. Inordinate rise of Mucormycosis cases in India might be explained by facts like- India possessing a large proportion of diabetic patients emergence of a very deadly strain of coronavirus- Delta strain higher doses of steroids and antibodies used to treat patients against this strain overburdened health care services sudden much higher need of oxygen supply and use of industrial oxygen could explain the Mucormycosis outbreak observed in India during the second wave of COVID-19. Objective: The present review discusses the functional interdependence between COVID-19 and Mucormycosis and summarizes the possible synergic links between COVID and Mucormycosis. Conclusion: The receptors and metabolic pathways affected by COVID-19 result in severe physiological conditions- hyperglycemia DKA anemia iron overload immunosuppression and hypoxia. All these conditions not only increase the expression of GRP-78 the major receptor for entry of fungi but also play a crucial role in providing quality media for Mucormycosis fungus to establish and grow. Hence explains the fungal epidemic observed in India during the second wave of COVID-19 in India.
Strategies to Overcome Antimicrobial Resistance in Nosocomial Infections, A Review and Update
Nosocomial infections also known as healthcare-associated infections are a significant global concern due to their strong association with high mortality and morbidity in both developed and developing countries. These infections are caused by a variety of pathogens particularly the ESKAPE group of bacteria which includes the six pathogens Enterococcus faecium Staphylococcus aureus Klebsiella pneumoniae Acinetobacter baumannii Pseudomonas aeruginosa and Enterobacter spp. These bacteria have demonstrated noteworthy resistance to different antibiotics. Antimicrobial resistance mechanisms can manifest in various forms including restricting drug uptake modifying drug targets inactivating drugs active drug efflux and biofilm formation. Accordingly various strategies have been developed to combat antibiotic-resistant bacteria. These strategies encompass the development of new antibiotics the utilization of bacteriophages that specifically target these bacteria antimicrobial combination therapy and the use of peptides or enzymes that target the genomes or essential proteins of resistant bacteria. Among promising approaches to overcome antibiotic resistance the CRISPR/Cas system stands out and offers many advantages. This system enables precise and efficient editing of genetic material at specific locations in the genome. Functioning as a bacterial "adaptive immune system" the CRISPR/Cas system recognizes degrades and remembers foreign DNA sequences through the use of spacer DNA segments that are transcribed into CRISPR RNAs (crRNA). This paper has focused on nosocomial infections specifically the pathogens involved in hospital infections the mechanisms underlying bacterial resistance and the strategies currently employed to address this issue. Special emphasis has been placed on the application of CRISPR/Cas technology for overcoming antimicrobial resistance.