How can we escape the ESKAPEs: Antimicrobial resistance mechanisms and what lies ahead?

The ESKAPE pathogens, including Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp., are multidrug-resistant (MDR) nosocomial pathogens that can "escape" current antimicrobials through various mechanisms. These pathogens are listed as urgent or serious threats to public health by organizations such as the World Health Organization (WHO) and the Center for Disease Control and Prevention (CDC). The article discusses the intrinsic and acquired antimicrobial resistance mechanisms employed by these pathogens and explores future therapeutic avenues, such as bacteriophage therapy, antisense oligonucleotide (ASO) therapeutics, and antimicrobial peptides (AMPs). However, more research is needed before these novel therapeutics can become standard interventions. The review emphasizes the importance of addressing antimicrobial resistance through global research efforts, antimicrobial stewardship, infection prevention and control measures, strict antibiotic prescription, and public education. [Extracted from the article]