Nanomaterials against antimicrobial resistance and beyond: toward mitigating bacterial resuscitation

Abstract

Antimicrobial resistance (AMR) has emerged as one of the most pressing global health challenges, ranking as the second leading cause of mortality worldwide. The uncontrolled and prolonged use of antibiotics, coupled with biofilm-associated infections and the formation of persister cells, has accelerated the rise of multidrug-resistant pathogens, particularly the ESKAPE group, which is responsible for the majority of fatal infections. The limitation and stagnation in traditional antibiotic discovery have a major contribution to the therapeutic gaps. This review examines the expanding role of nanotechnology in combating AMR, highlighting how diverse nanoscale materials —including metals, metal oxides, organic nanoparticles, and nanocomposites—that offer broad-spectrum antimicrobial activity via multimodal mechanisms such as membrane disruption, oxidative stress induction, and biofilm inhibition. Therefore, nanomaterials can overcome the limitations of conventional drugs that act as single-target agents. While extensive efforts have been directed toward overcoming AMR, an equally critical but largely overlooked phenomenon is bacterial resuscitation—the ability of dormant persister cells to regain activity and reinitiate infection. Despite its clinical importance, resuscitation has received very limited attention in antimicrobial research and remains an underexplored frontier. Based on this, the review highlights emerging evidence on nanosystems specifically designed to inhibit or prevent bacterial resuscitation, positioning them as a promising but underexplored frontier in infectious disease management. Finally, we have also assessed the potential for bacteria to develop resistance against nanoformulations. The review concludes with future perspectives on integrating nanotechnology into next-generation antimicrobial platforms capable of simultaneously suppressing AMR, targeting persister cells, and preventing resuscitation-driven infection recurrence, ultimately paving the way for more durable antimicrobial therapies.

Topics & Concepts