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Special Issue "Antibiotic Treatment and Antibiotic Resistance of Enterococcus Infections"

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A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: 31 May 2023 | Viewed by 3517

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Special Issue Editors

Dr. Giovanni Boccia

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Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081 Salerno, Italy
Interests: public health; occupational medicine; health economics; preventive medicine; epidemiology; environmental health and food control
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Dr. Gianluigi Franci

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Dipartimento di Medicina, Chirurgia e Odontoiatria “Scuola Medica Salernitana”/DIPMED, Baronissi, Italy
Interests: peptides; microbial membranes; microbial drugs
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Dr. Biagio Santella

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Department of Experimental Medicine, Section of University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
Interests: biofilm; antimicrobial activity; antimicrobial strategy; natural extract; biofilm degradation; biofilm formation; virology; microorganism-host interaction; antibiotics
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Special Issue Information

Dear Colleagues,

Among Enterococcus species, Enterococcus faecalis and Enterococcus faecium represent a major cause of human infections. In the last decade, available data from North American and European centers have indicated E. faecalis as the third causative agent of infective endocarditis. Overall, the incidence and the antibiotic resistance rate are increasing, and these species have been included among the ESCAPEs as the main pathogens associated with nosocomial infections. To date, epidemiological studies, reporting resistance antibiotic trends, or the isolation of new resistance genes, are crucial to understand and improve therapy and patient outcomes.

On the other hand, sanitization of the hospital environment, hygiene procedures, and monitoring of pathogenic microorganisms could be needed to prevent this phenomenon and improve management of these infections.

For this purpose, the Special Issue will collect original articles, reviews, clinical studies, and epidemiological studies focused on these Species.

Dr. Giovanni Boccia
Dr. Gianluigi Franci
Dr. Biagio Santella
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Enterococcus faecium
Enterococcus faecalis
drug resistance
epidemiologic studies
endocarditis

Published Papers (4 papers)

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Research

Open AccessArticle

Comparison of Five Different Selective Agar for the Detection of Vancomycin-Resistant Enterococcus faecium

and

Antibiotics 2023, 12(4), 666; https://doi.org/10.3390/antibiotics12040666 - 29 Mar 2023

Viewed by 542

Abstract

Five commercially available selective agar were evaluated regarding sensitivity and specificity to detect vancomycin-resistant Enterococcus (E.) faecium. Altogether 187 E. faecium strains were included, comprising 119 van-carrying strains (phenotypically vancomycin-resistant n = 105; phenotypically vancomycin-susceptible VVE-B n = 14) and 68 vancomycin-susceptible isolates. Limit of detection was calculated for each selective agar for pure cultures, stool suspensions and artificial rectal swabs. After 24-h incubation sensitivity ranged between 91.6% and 95.0%. It increased in 2 out of 5 agar after 48-h incubation. Specificity ranged between 94.1% and 100% and was highest after 24 h in 4 out of the 5 agar. Sensitivity of van-carrying phenotypically vancomycin-resistant strains was higher after 24 h (97.1–100%) and 48 h (99.1–100%) when compared to van-carrying strains that tested vancomycin-susceptible (50.0–57.1% after both incubation periods). Overall, chromID VRE, CHROMagar VRE and Brilliance VRE demonstrated the highest detection rates after 24 h. Detection rates of Chromatic VRE and VRESelect improved after 48 h. Adjustment of incubation time depending on the applied media may be advised. As detection of VVE-B was impeded with all selective agar, screening for vancomycin-resistant enterococci relying solely on selective media would not be recommended for critical clinical samples, but rather in combination with molecular methods to improve detection of these strains. Furthermore, stool samples were demonstrated to be superior to rectal swabs and should be favoured, if possible, in screening strategies. Full article

(This article belongs to the Special Issue Antibiotic Treatment and Antibiotic Resistance of Enterococcus Infections)

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Open AccessArticle

Clinical Resistant Strains of Enterococci and Their Correlation to Reduced Susceptibility to Biocides: Phenotypic and Genotypic Analysis of Macrolides, Lincosamides, and Streptogramins

Syed Mohd Danish Rizvi

Afrasim Moin

El-Sayed Khafagy

Shams Tabrez

Abdullah Ali Al Balushi

and

Wael A. H. Hegazy

Antibiotics 2023, 12(3), 461; https://doi.org/10.3390/antibiotics12030461 - 24 Feb 2023

Cited by 2 | Viewed by 735

Abstract

Enterococci are troublesome nosocomial, opportunistic Gram-positive cocci bacteria showing enhanced resistance to many commonly used antibiotics. This study aims to investigate the prevalence and genetic basis of antibiotic resistance to macrolides, lincosamides, and streptogramins (MLS) in Enterococci, as well as the correlation between MLS resistance and biocide resistance. From 913 clinical isolates collected from King Khalid Hospital, Hail, Saudi Arabia, 131 isolates were identified as Enterococci spp. The susceptibility of the clinical enterococcal isolates to several MLS antibiotics was determined, and the resistance phenotype was detected by the triple disk method. The MLS-involved resistance genes were screened in the resistant isolates. The current results showed high resistance rates to MLS antibiotics, and the constitutive resistance to all MLS (cMLS) was the most prevalent phenotype, observed in 76.8% of resistant isolates. By screening the MLS resistance-encoding genes in the resistant isolates, the erythromycin ribosome methylase (erm) genes that are responsible for methylation of bacterial 23S rRNA were the most detected genes, in particular, ermB. The ereA esterase-encoding gene was the most detected MLS modifying-encoding genes, more than lnuA (adenylation) and mphC (phosphorylation). The minimum inhibitory concentrations (MICs) of commonly used biocides were detected in resistant isolates and correlated with the MICs of MLS antibiotics. The present findings showed a significant correlation between MLS resistance and reduced susceptibility to biocides. In compliance with the high incidence of the efflux-encoding genes, especially mefA and mefE genes in the tolerant isolates with higher MICs to both MLS antibiotics and biocides, the efflux of resistant isolates was quantified, and there was a significant increase in the efflux of resistant isolates with higher MICs as compared to those with lower MICs. This could explain the crucial role of efflux in developing cross-resistance to both MLS antibiotics and biocides. Full article

(This article belongs to the Special Issue Antibiotic Treatment and Antibiotic Resistance of Enterococcus Infections)

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Open AccessArticle

Molecular Rapid Diagnostics Improve Time to Effective Therapy and Survival in Patients with Vancomycin-Resistant Enterococcus Bloodstream Infections

Sarah M. Bandy

Christopher B. Jackson

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Antibiotics 2023, 12(2), 210; https://doi.org/10.3390/antibiotics12020210 - 19 Jan 2023

Viewed by 575

Abstract

Delays in appropriate antibiotic therapy are a key determinant for deleterious outcomes among patients with vancomycin-resistant Enterococcus (VRE) bloodstream infections (BSIs). This was a multi-center pre/post-implementation study, assessing the impact of a molecular rapid diagnostic test (Verigene^® GP-BC, Luminex Corporation, Northbrook, IL, USA) on outcomes of adult patients with VRE BSIs. The primary outcome was time to optimal therapy (TOT). Multivariable logistic and Cox proportional hazard regression models were used to determine the independent associations of post-implementation, TOT, early vs. delayed therapy, and mortality. A total of 104 patients with VRE BSIs were included: 50 and 54 in the pre- and post-implementation periods, respectively. The post- vs. pre-implementation group was associated with a 1.8-fold faster rate to optimized therapy (adjusted risk ratio, 1.841 [95% CI 1.234–2.746]), 6-fold higher likelihood to receive early effective therapy (<24 h, adjusted odds ratio, 6.031 [2.526–14.401]), and a 67% lower hazards for 30-day in-hospital mortality (adjusted hazard ratio, 0.322 [0.124–1.831]), after adjusting for age, sex, and severity scores. Inversely, delayed therapy was associated with a 10-fold higher risk of in-hospital mortality (aOR 10.488, [2.497–44.050]). Reduced TOT and in-hospital mortality were also observed in subgroups of immunosuppressed patients in post-implementation. These findings demonstrate that the addition of molecular rapid diagnostic tests (mRDT) to clinical microbiology and antimicrobial stewardship practices are associated with a clinically significant reduction in TOT, which is associated with lower mortality for patients with VRE BSIs, underscoring the importance of mRDTs in the management of VRE infections. Full article

(This article belongs to the Special Issue Antibiotic Treatment and Antibiotic Resistance of Enterococcus Infections)

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Open AccessArticle

Clinical Impact of Vancomycin Treatment in Ampicillin-Susceptible Enterococci Bloodstream Infections

Jatapat Hemapanpairoa

Dhitiwat Changpradub

and

Wichai Santimaleeworagun

Antibiotics 2022, 11(12), 1698; https://doi.org/10.3390/antibiotics11121698 - 25 Nov 2022

Cited by 2 | Viewed by 1158

Abstract

Enterococci are major causes of bacteremia. Although the mortality rate of ampicillin- susceptible enterococci (ASE) bloodstream infections (BSI) is lower, compared with that of ampicillin-resistant enterococci BSI, the role of treatment regimens in ASE BSI remains to be determined. This retrospective study aimed to evaluate the treatment outcomes and factors associated with mortality among patients with ASE BSI. The charts of 145 enrolled patients with ASE BSI between January 2013 and April 2022 at Phramongkutklao Hospital were reviewed. The 30-day and in-hospital mortality rates were 28.8 and 41.9%, respectively. The 30-day mortality rate was higher in the vancomycin treatment group than in the beta-lactam treatment group (61.5 vs. 26%; p = 0.02). Pitt bacteremia score (OR 1.44, 95% CI 1.20–1.71); age-adjusted Charlson Comorbidity Index (OR 1.34, 95% CI 1.14–1.58); and vancomycin treatment (OR 4.07, 95% CI 1.02–16.22) were independent factors associated with 30-day mortality. The severity of illness, comorbidity and definitive therapy with vancomycin increased the mortality rate of patients with ASE BSI. Anti-enterococcal beta-lactams remain the first line antibiotics for ASE bacteremia. Full article

(This article belongs to the Special Issue Antibiotic Treatment and Antibiotic Resistance of Enterococcus Infections)

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