An insight on the progress of quorum sensing mechanisms, impact of quorum sensing on antimicrobial resistance and quorum sensing inhibition: A narrative review

Quorum sensing (QS) is a cellular mechanism of communication by bacteria to coordinate gene expression based on population density. This mechanism is necessary for regulating a number of physiological processes, such as biofilm formation, virulence factors, and the antibiotic resistance development. The overuse and improper use of antibiotics have made antimicrobial resistance (AMR) as a worldwide health concern. Conventional antibiotics exert selective pressure that promotes the emergence and spread of resistant strains. Quorum sensing inhibitors (QSIs) offer a potential approach to managing AMR. By interfering with bacterial communication channels, QSIs weaken the pathogenicity of bacteria and increase their susceptibility to both conventional antibiotics and human immune responses. In contrast, quorum sensing inhibitors primarily disrupt the bacterial communication and virulence rather than directly killing bacteria or inhibiting their growth, and thereby imposing lower selective pressure for the development of resistance. This review summarized the molecular mechanisms that support QS and its involvement in AMR, also the potential of QSIs as innovative therapeutic medicines and addresses the existing obstacles and prospects in this developing field. Thus, that integrating QSIs into clinical practice could completely alter the management of bacterial infections and reduce the growing problem of AMR.