New Perspectives of Antimicrobials from Marine Environment in the Treatment of Non-healing Foot Wounds of Diabetics.

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Diabetes mellitus is a persisting disorder with increasing prevalence all over the world with 280,442 cases in Mauritius. Type 2 diabetes mellitus is the outcome from the synergy of genetic and environmental factors which trigger insulin resistance, followed by severe health complications including non-healing foot wounds, gangrene, amputation, among others. Microbes either have a symbiotic balance with mankind or exist as pathogens causing internal harm to the body. Proteus species, Enterococcus species, Escherichia coli, Staphylococcus aureus, Klebsiella species, Bacillus species, Acinetobacter species, Serratia marcescens, Enterobacter species, Morganella morganii, Citobacter koseri and Pseudomonas aeruginosa have been isolated from non healing wounds. While ensuring the wellbeing of the population, pathogen adversaries previously led to the discovery and presently the overuse of antibiotics due to their pharmaceutical properties. Scientists have been motivated to search for new bioactive compounds with novel mode of action since lately, commonly used synthetic antibiotics are no longer effective against microorganisms which have led to antimicrobial resistance. Despite several strategies, drug evolution continues to fail which have triggered the thought that the streamline of drugs is overseen. Indigenous and traditional medicine, composed of considerable natural products and plant derivatives are widely used throughout the world as they have been validated to confer therapeutic benefits in clinical trials. Similarly, oceans nurture a wide variety of organisms which are biologically and chemically diverse, with several metabolic activities as they possess phenolic compounds, sulphated polysaccharides, organic acids and phytochemicals. Alongside, coastal greens have not only demonstrated effective de-novo synthesis in hypoglycaemic activities but also represent a potential for antimicrobials. Due to this assortment and molecular complexity of marine organisms, structure-tissue exposure-activity relationship (STAR) is suggested in terms of novel drug design instead of currently used structure-activity-relationship (SAR) for drug optimisation in the future. Also, the synergy of the biomolecules of aquatic creatures with commonly used drugs could be considered to treat actual treatment failures of non healing wounds while alleviating the burden of antimicrobial resistance. Though oceanic organisms have enormous health prospective in terms of a wide array of drug discovery, there is a gap remaining in the academic research of their extracts. This review has as objective to bring forth an extensive knowledge on the marine environment community and their challenges to the synthetic organic chemist by assembling research work and review articles (from 2015 to 2024). It also has as intention to discuss antimicrobial resistance of common antibiotics and the benefit of antimicrobials from selected marine organisms in the fight against non-healing foot wounds.

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