Create bacterial strains with multiple antibiotic resistance?

The ongoing development of antibiotic resistance represents a major global challenge, as it limits treatment options. Pathogens collectively known as ESKAPE pose a particularly significant problem in everyday clinical practice. ESKAPE stands for: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp . These bacteria are often the cause of life-threatening nosocomial infections, especially in critically ill and immunocompromised individuals. ESKAPE pathogens, in particular, often develop multiple antibiotic resistance.

In accordance with the WHO's "Global Action Plan on Antimicrobial Resistance" and DART2030 ( German Antibiotic Resistance Strategy ), the ZKBS generally recommends avoiding, as far as possible, the handling and generation of multi-resistant bacterial strains as well as the generation or introduction of additional resistance into already multi-resistant bacterial strains within the framework of genetic engineering work.

If the examination of alternatives reveals that such work is nevertheless necessary, a risk assessment will be carried out. In order to derive the sensitivity to the respective antibiotic groups, an antibiogram of the recipient organism must be created for a safety assessment in accordance with the guidelines of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). A case-by-case assessment by the ZKBS is required, among other things, if a multi-resistant pathogen, such as 4MRGN (multi-resistant Gram-negative rods with resistance to four of four antibiotic groups), MRSA (resistant to all β-lactam antibiotics), VRE (resistant to new reserve antibiotics), or C. difficile (resistant to therapeutically relevant antibodies), with a prevalence in Germany of less than 10%, or if the pathogen is airborne. The complete ZKBS statement can be found at File number 08020204.0002.0001 .