Submit to Antibiotics Review for Antibiotics Propose a Special Issue

Journal Menu

Journal Browser

Carbapenem-Resistant Organisms (CRO) as Leading Cause of Hospital Associated Infections

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Published Papers

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

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 26381

Share This Special Issue

Special Issue Editor

Dr. Marianna Meschiari

E-Mail Website
Guest Editor

Department of Infectious Diseases, Azienda Ospedaliero-Universitaria, University of Modena and Reggio Emilia, Via del Pozzo 71, 41122 Modena, Italy
Interests: infectious diseases control and prevention; drug resistance; infectious diseases surveillance; infectious diseases transmission
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Healthcare-associated infections (HAIs) continue to be a major global health challenge, particularly because of the increasing prevalence of multidrug-resistant organisms and their ability to cause outbreaks in the hospital setting. Antimicrobial resistance has deleterious implications both for patients (in terms of mortality, morbidity, and health-related quality of life), as well as for the healthcare system (economic costs).

Three species in particular pose the greatest global concern: carbapenemase-producing or carbapenem-resistant Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumanii.

These Carbapenem-resistant organisms (CROs) represent a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters.

In response to the publication of the list of priority pathogens by the WHO in 2017, new antibiotic drugs have been developed and were later approved to provide new therapeutic options against these resistant pathogens. Despite this, in recent years, the appearance of resistances to several of these agents has already been observed, and the CRO mortality remains significant.

Therefore, improving knowledge on CRO hospital burden and on diagnostic and therapeutic pathways should be considered a priority.

The goal of this Special Issue of Antibiotics is to collect original research articles that could help clinicians to acknowledge the CRO burden, both directly on patient outcomes and on healthcare systems, and to mutually share diagnostic algorithms aiming to optimize prescriptive appropriateness against CROs.

Dr. Marianna Meschiari
Guest Editor

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 2900 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

carbapenem resistant organisms (CROs)
carbapenem-resistant Enterobacterales (CRE)
carbapenem-resistant Pseudomonas aeruginosa (CRPA)
carbapenem-resistant Acinetobacter baumanii (CRAB)
healthcare associated infections (HAIs)
antimicrobial resistance (AMR)

Published Papers (9 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

Jump to: Review, Other

11 pages, 659 KiB

Open AccessArticle

Carbapenem-Resistant Enterobacteriaceae (CRE) among Children with Cancer: Predictors of Mortality and Treatment Outcome

by Youssef Madney, Shaimaa Aboubakr, Reham Khedr, Hanafy Hafez, Naglaa Ahmed, Khaled Elsheshtawy, Mervat Elanany, Abdelhamid Salahelden, Lobna Shalaby and Ola Galal Behairy

Antibiotics 2023, 12(2), 405; https://doi.org/10.3390/antibiotics12020405 - 17 Feb 2023

Cited by 4 | Viewed by 2180

Abstract

Carbapenem-resistant Enterobacteriaceae (CRE) is an important emerging threat among pediatric cancer patients, with a high mortality rate. This retrospective study included all pediatric cancer patients with (CRE) bloodstream infections (BSIs) at a children’s cancer hospital in Egypt (2013–2017). Two hundred and fifty-four pediatric cancer patients with CRE BSI were identified; 74% had hematological malignancies, and 26% had solid tumors. Acute myeloid leukemia was the most common hematological malignancy (50%). The main clinical features for acquiring CRE-BSI were previous antibiotics exposure (90%), profound neutropenia (84%), prolonged steroid use (45%), previous colonization with a resistant pathogen (35%), ICU admission within 90 days (28%), and central venous catheter use (24%). E. coli was the most common isolated pathogen (56%), followed by Klebsiella pneumoniae (37%). All isolates were resistant to carbapenem with an MIC < 4–8 μg/mL in 100 (45%) and >8 μg/mL in 153 (55%). The overall mortality rate was 57%, and 30 day mortality was reported in 30%. Upon multivariate analysis, for the patients with Klebsiella pneumoniae BSI, carbapenem resistance with an MIC > 8 μg/mL and associated typhlitis or pneumonia were predictors of poor outcome. In conclusion, CRE-BSI is a major threat among pediatric cancer patients in limited resource countries with limited options for treatment. Antimicrobial stewardship for early detection through routine screening, adequate empirical treatment, and timely adequate therapy may impact the outcome for such high-risk patient groups. Full article

(This article belongs to the Special Issue Carbapenem-Resistant Organisms (CRO) as Leading Cause of Hospital Associated Infections)

► Show Figures

Figure 1

28 pages, 713 KiB

Open AccessArticle

Characterization of Carbapenemase-Producing Klebsiella pneumoniae Isolates from Two Romanian Hospitals Co-Presenting Resistance and Heteroresistance to Colistin

by Annamária Főldes, Mihaela Oprea, Edit Székely, Codruța-Romanița Usein and Minodora Dobreanu

Antibiotics 2022, 11(9), 1171; https://doi.org/10.3390/antibiotics11091171 - 30 Aug 2022

Cited by 1 | Viewed by 1755

Abstract

Klebsiella pneumoniae is a notorious human pathogen involved in healthcare-associated infections. The worldwide expansion of infections induced by colistin-resistant and carbapenemase-producing Enterobacterales (CPE) isolates has been increasingly reported. This study aims to analyze the phenotypic and molecular profiles of 10 colistin-resistant (CR) isolates and 2 pairs of colistin-heteroresistant (ChR) (parental and the corresponding resistant mutants) isolates of K. pneumoniae CPE sourced from two hospitals. The phenotypes of strains in the selected collection had been previously characterized. Antimicrobial susceptibility testing was performed using a Vitek 2 Compact system (BioMérieux SA, Marcy l’Etoile, France), the disc diffusion method, and broth microdilution (BMD) for colistin. Whole-genome sequencing (WGS) did not uncover evidence of any mobile colistin resistance (mcr) genes, although the mgrB gene of seven isolates appeared to be disrupted by insertion sequences (ISKpn25 or ISKpn26). Possible deleterious missense mutations were found in phoP (L4F), phoQ (Q426L, L26Q, L224Q, Q317K), pmrB (R256G, P95L, T157P, V352E), and crrB (P151S) genes. The identified isolates belonged to the following clonal lineages: ST101 (n = 6), ST147 (n = 5), ST258 (n = 2), and ST307 (n = 1). All strains harbored IncF plasmids. OXA-48 producers carried IncL and IncR plasmids, while one bla_NDM-1 genome was found to harbor IncC plasmids. Ceftazidime–avibactam remains a therapeutic option for KPC-2 and OXA-48 producers. Resistance to meropenem–vaborbactam has emerged in some bla_kPC-2-carrying isolates. Our study demonstrates that the results of WGS can provide essential evidence for the surveillance of antimicrobial resistance. Full article

(This article belongs to the Special Issue Carbapenem-Resistant Organisms (CRO) as Leading Cause of Hospital Associated Infections)

► Show Figures

Figure 1

16 pages, 2166 KiB

Open AccessArticle

Control of Healthcare-Associated Carbapenem-Resistant Acinetobacter baumannii by Enhancement of Infection Control Measures

by Shuk-Ching Wong, Pui-Hing Chau, Simon Yung-Chun So, Germaine Kit-Ming Lam, Veronica Wing-Man Chan, Lithia Lai-Ha Yuen, Christine Ho-Yan Au Yeung, Jonathan Hon-Kwan Chen, Pak-Leung Ho, Kwok-Yung Yuen and Vincent Chi-Chung Cheng

Antibiotics 2022, 11(8), 1076; https://doi.org/10.3390/antibiotics11081076 - 08 Aug 2022

Cited by 8 | Viewed by 2726

Abstract

Antimicrobial stewardship and infection control measures are equally important in the control of antimicrobial-resistant organisms. We conducted a retrospective analysis of the incidence rate of hospital-onset carbapenem-resistant Acinetobacter baumannii (CRAB) infection (per 1000 patient days) in the Queen Mary Hospital, a 1700-bed, university-affiliated teaching hospital, from period 1 (1 January 2007 to 31 December 2013) to period 2 (1 January 2014 to 31 December 2019), where enhanced infection control measures, including directly observed hand hygiene before meal and medication rounds to conscious patients, and the priority use of single room isolation, were implemented during period 2. This study aimed to investigate the association between enhanced infection control measures and changes in the trend in the incidence rate of hospital-onset CRAB infection. Antimicrobial consumption (defined daily dose per 1000 patient days) was monitored. Interrupted time series, in particular segmented Poisson regression, was used. The hospital-onset CRAB infection increased by 21.3% per year [relative risk (RR): 1.213, 95% confidence interval (CI): 1.162–1.266, p < 0.001], whereas the consumption of the extended spectrum betalactam-betalactamase inhibitor (BLBI) combination and cephalosporins increased by 11.2% per year (RR: 1.112, 95% CI: 1.102–1.122, p < 0.001) and 4.2% per year (RR: 1.042, 95% CI: 1.028–1.056, p < 0.001), respectively, in period 1. With enhanced infection control measures, the hospital-onset CRAB infection decreased by 9.8% per year (RR: 0.902, 95% CI: 0.854–0.953, p < 0.001), whereas the consumption of the extended spectrum BLBI combination and cephalosporins increased by 3.8% per year (RR: 1.038, 95% CI: 1.033–1.044, p < 0.001) and 7.6% per year (RR: 1.076, 95% CI: 1.056–1.097, p < 0.001), respectively, in period 2. The consumption of carbapenems increased by 8.4% per year (RR: 1.84, 95% CI: 1.073–1.094, p < 0.001) in both period 1 and period 2. The control of healthcare-associated CRAB could be achieved by infection control measures with an emphasis on directly observed hand hygiene, despite an increasing trend of antimicrobial consumption. Full article

(This article belongs to the Special Issue Carbapenem-Resistant Organisms (CRO) as Leading Cause of Hospital Associated Infections)

► Show Figures

Figure 1

19 pages, 7328 KiB

Open AccessArticle

Rectal and Tracheal Carriage of Carbapenemase Genes and Class 1 and 2 Integrons in Patients in Neurosurgery Intensive Care Unit

by Ekaterina S. Kuzina, Tatiana S. Novikova, Evgeny I. Astashkin, Galina N. Fedyukina, Angelina A. Kislichkina, Natalia V. Kurdyumova, Ivan A. Savin, Olga N. Ershova and Nadezhda K. Fursova

Antibiotics 2022, 11(7), 886; https://doi.org/10.3390/antibiotics11070886 - 03 Jul 2022

Cited by 2 | Viewed by 1626

Abstract

The spread of multidrug-resistant Gram-negative bacteria, which is associated with the distribution of beta-lactamase genes and class 1 and 2 integrons, is a global problem. In this study, in the Moscow neurosurgery intensive care unit (neuro-ICU), the high prevalence of the above-stated genes was found to be associated with intestinal and tracheal carriage. Seven-point prevalence surveys, which included 60 patients in the neuro-ICU, were conducted weekly in the period from Oct. to Nov. 2019. A total of 293 clinical samples were analyzed, including 146 rectal and 147 tracheal swabs; 344 Gram-negative bacteria isolates were collected. Beta-lactamase genes (n = 837) were detected in the isolates, including beta-lactamase bla_TEM (n = 162), bla_SHV (n = 145), cephalosporinase bla_CTX–M (n = 228), carbapenemase bla_NDM (n = 44), bla_KPC (n = 25), bla_OXA–48 (n = 126), bla_{OXA–51–like} (n = 54), bla_{OXA–40-like} (n = 43), bla_{OXA–23-like} (n = 8), and bla_VIM (n = 2), as well as class 1 (n = 189) and class 2 (n = 12) integrons. One extensively drug-resistant Klebsiella pneumoniae strain (sequence type ST39 and capsular type K23), simultaneously carried beta-lactamase genes, bla_SHV–40 and bla_TEM–1B, three carbapenemase genes, bla_NDM, bla_KPC, and bla_OXA–48, the cephalosporinase gene bla_CTX–M, and two class 1 integrons. Before this study, such heavily armed strains have not been reported, suggesting the ongoing evolution of antibiotic resistance. Full article

(This article belongs to the Special Issue Carbapenem-Resistant Organisms (CRO) as Leading Cause of Hospital Associated Infections)

► Show Figures

Figure 1

6 pages, 466 KiB

Open AccessArticle

German Multicenter Study Analyzing Antimicrobial Activity of Ceftazidime-Avibactam of Clinical Meropenem-Resistant Pseudomonas aeruginosa Isolates Using a Commercially Available Broth Microdilution Assay

by Jana Manzke, Raphael Stauf, Bernd Neumann, Ernst Molitor, Gunnar Hischebeth, Michaela Simon, Jonathan Jantsch, Jürgen Rödel, Sören L. Becker, Alexander Halfmann, Thomas A. Wichelhaus, Michael Hogardt, Annerose Serr, Christina Hess, Andreas F. Wendel, Ekkehard Siegel, Holger Rohde, Stefan Zimmermann and Jörg Steinmann

Antibiotics 2022, 11(5), 545; https://doi.org/10.3390/antibiotics11050545 - 19 Apr 2022

Cited by 3 | Viewed by 3331

Abstract

Multidrug resistance is an emerging healthcare issue, especially concerning Pseudomonas aeruginosa. In this multicenter study, P. aeruginosa isolates with resistance against meropenem detected by routine methods were collected and tested for carbapenemase production and susceptibility against ceftazidime-avibactam. Meropenem-resistant isolates of P. aeruginosa from various clinical materials were collected at 11 tertiary care hospitals in Germany from 2017–2019. Minimum inhibitory concentrations (MICs) were determined via microdilution plates (MICRONAUT-S) of ceftazidime-avibactam and meropenem at each center. Detection of the presence of carbapenemases was performed by PCR or immunochromatography. For meropenem-resistant isolates (n = 448), the MIC range of ceftazidime-avibactam was 0.25–128 mg/L, MIC₉₀ was 128 mg/L and MIC₅₀ was 16 mg/L. According to EUCAST clinical breakpoints, 213 of all meropenem-resistant P. aeruginosa isolates were categorized as susceptible (47.5%) to ceftazidime-avibactam. Metallo-β-lactamases (MBL) could be detected in 122 isolates (27.3%). The MIC range of ceftazidime-avibactam in MBL-positive isolates was 4–128 mg/L, MIC₉₀ was >128 mg/L and MIC₅₀ was 32 mg/L. There was strong variation in the prevalence of MBL-positive isolates among centers. Our in vitro results support ceftazidime-avibactam as a treatment option against infections caused by meropenem-resistant, MBL-negative P. aeruginosa. Full article

(This article belongs to the Special Issue Carbapenem-Resistant Organisms (CRO) as Leading Cause of Hospital Associated Infections)

► Show Figures

Figure 1

Review

Jump to: Research, Other

28 pages, 634 KiB

Open AccessEditor’s ChoiceReview

Epidemiology, Mechanisms of Resistance and Treatment Algorithm for Infections Due to Carbapenem-Resistant Gram-Negative Bacteria: An Expert Panel Opinion

by Nicola Coppola, Alberto Enrico Maraolo, Lorenzo Onorato, Riccardo Scotto, Federica Calò, Luigi Atripaldi, Anna Borrelli, Antonio Corcione, Maria Giovanna De Cristofaro, Emanuele Durante-Mangoni, Amelia Filippelli, Gianluigi Franci, Maria Galdo, Gaspare Guglielmi, Pasquale Pagliano, Alessandro Perrella, Ornella Piazza, Marco Picardi, Rodolfo Punzi, Ugo Trama and Ivan Gentile Show full author list Hide full author list

Antibiotics 2022, 11(9), 1263; https://doi.org/10.3390/antibiotics11091263 - 17 Sep 2022

Cited by 14 | Viewed by 5695

Abstract

Antimicrobial resistance represents a serious threat for global health, causing an unacceptable burden in terms of morbidity, mortality and healthcare costs. In particular, in 2017, carbapenem-resistant organisms were listed by the WHO among the group of pathogens for which novel treatment strategies are urgently needed. Fortunately, several drugs and combinations have been introduced in recent years to treat multi-drug-resistant (MDR) bacteria. However, a correct use of these molecules is needed to preserve their efficacy. In the present paper, we will provide an overview on the epidemiology and mechanisms of resistance of the most common MDR Gram-negative bacteria, proposing a treatment algorithm for the management of infections due to carbapenem-resistant bacteria based on the most recent clinical evidence. Full article

(This article belongs to the Special Issue Carbapenem-Resistant Organisms (CRO) as Leading Cause of Hospital Associated Infections)

► Show Figures

Figure 1

14 pages, 427 KiB

Open AccessReview

Is It Possible to Eradicate Carbapenem-Resistant Acinetobacter baumannii (CRAB) from Endemic Hospitals?

by Filippo Medioli, Erica Bacca, Matteo Faltoni, Giulia Jole Burastero, Sara Volpi, Marianna Menozzi, Gabriella Orlando, Andrea Bedini, Erica Franceschini, Cristina Mussini and Marianna Meschiari

Antibiotics 2022, 11(8), 1015; https://doi.org/10.3390/antibiotics11081015 - 28 Jul 2022

Cited by 12 | Viewed by 2240

Abstract

Background: Despite the global efforts to antagonize carbapenem-resistant Acinetobacter baumannii (CRAB) spreading, it remains an emerging threat with a related mortality exceeding 40% among critically ill patients. The purpose of this review is to provide evidence concerning the best infection prevention and control (IPC) strategies to fight CRAB spreading in endemic hospitals. Methods: The study was a critical review of the literature aiming to evaluate all available studies reporting IPC measures to control CRAB in ICU and outside ICU in both epidemic and endemic settings in the past 10 years. Results: Among the 12 included studies, the majority consisted of research reports of outbreaks mostly occurred in ICUs. The reported mortality reached 50%. Wide variability was observed related to the frequency of application of recommended CRAB IPC measures among the studies: environmental disinfection (100%); contact precautions (83%); cohorting staff and patients (75%); genotyping (66%); daily chlorhexidine baths (58%); active rectal screening (50%); closing or stopping admissions to the ward (33%). Conclusions: Despite effective control of CRAB spreading during the outbreaks, the IPC measures reported were heterogeneous and highly dependent on the different setting as well as on the structural characteristics of the wards. Reinforced ‘search and destroy’ strategies both on the environment and on the patient, proved to be the most effective measures for permanently eliminating CRAB spreading. Full article

(This article belongs to the Special Issue Carbapenem-Resistant Organisms (CRO) as Leading Cause of Hospital Associated Infections)

17 pages, 1053 KiB

Open AccessReview

Cefiderocol for Carbapenem-Resistant Bacteria: Handle with Care! A Review of the Real-World Evidence

by Pasquale Sansone, Luca Gregorio Giaccari, Francesco Coppolino, Caterina Aurilio, Alfonso Barbarisi, Maria Beatrice Passavanti, Vincenzo Pota and Maria Caterina Pace

Antibiotics 2022, 11(7), 904; https://doi.org/10.3390/antibiotics11070904 - 06 Jul 2022

Cited by 13 | Viewed by 2475

Abstract

(1) Background: healthcare-associated infections are one of the most frequent adverse events in healthcare delivery worldwide. Several antibiotic resistance mechanisms have been developed, including those to carbapenemase. Cefiderocol (CFD) is a novel siderophore cephalosporin designed to treat carbapenem-resistant bacteria. (2) Methods: we performed a systematic review of all cases reported in the literature to outline the existing evidence. We evaluated real-world evidence studies of CFD in the treatment of carbapenem-resistant (CR) bacteria. (3) Results: a total of 19 publications treating cases of infection by CR bacteria were included. The three most frequent CR pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae. A regimen of 2 g every 8 h was most frequently adopted for CFD with a mean treatment duration of 25.6 days. CFD was generally well tolerated, with fewer side effects. The success rate of CFD therapy was satisfactory and almost 70% of patients showed clinical recovery; of these, nearly half showed negative blood cultures and infection-free status. (4) Conclusions: This review indicates that CFD is active against important GN organisms including Enterobacteriaceae, P. aeruginosa, and A. baumannii. CFD seems to have a safe profile. Full article

(This article belongs to the Special Issue Carbapenem-Resistant Organisms (CRO) as Leading Cause of Hospital Associated Infections)

► Show Figures

Figure 1

Other

Jump to: Research, Review

15 pages, 487 KiB

Open AccessCase Report

Ceftazidime/Avibactam in Ventilator-Associated Pneumonia Due to Difficult-to-Treat Non-Fermenter Gram-Negative Bacteria in COVID-19 Patients: A Case Series and Review of the Literature

by Giulia Jole Burastero, Gabriella Orlando, Antonella Santoro, Marianna Menozzi, Erica Franceschini, Andrea Bedini, Adriana Cervo, Matteo Faltoni, Erica Bacca, Emanuela Biagioni, Irene Coloretti, Gabriele Melegari, Jessica Maccieri, Stefano Busani, Elisabetta Bertellini, Massimo Girardis, Giulia Ferrarini, Laura Rofrano, Mario Sarti, Cristina Mussini and Marianna Meschiari Show full author list Hide full author list

Antibiotics 2022, 11(8), 1007; https://doi.org/10.3390/antibiotics11081007 - 26 Jul 2022

Cited by 13 | Viewed by 2718

Abstract

Ventilator-associated pneumonia (VAP) in critically ill patients with COVID-19 represents a very huge global threat due to a higher incidence rate compared to non-COVID-19 patients and almost 50% of the 30-day mortality rate. Pseudomonas aeruginosa was the first pathogen involved but uncommon non-fermenter gram-negative organisms such as Burkholderia cepacea and Stenotrophomonas maltophilia have emerged as other potential etiological causes. Against carbapenem-resistant gram-negative microorganisms, Ceftazidime/avibactam (CZA) is considered a first-line option, even more so in case of a ceftolozane/tazobactam resistance or shortage. The aim of this report was to describe our experience with CZA in a case series of COVID-19 patients hospitalized in the ICU with VAP due to difficult-to-treat (DTT) P. aeruginosa, Burkholderia cepacea, and Stenotrophomonas maltophilia and to compare it with data published in the literature. A total of 23 patients were treated from February 2020 to March 2022: 19/23 (82%) VAPs were caused by Pseudomonas spp. (16/19 DTT), 2 by Burkholderia cepacea, and 6 by Stenotrophomonas maltophilia; 12/23 (52.1%) were polymicrobial. Septic shock was diagnosed in 65.2% of the patients and VAP occurred after a median of 29 days from ICU admission. CZA was prescribed as a combination regimen in 86% of the cases, with either fosfomycin or inhaled amikacin or cotrimoxazole. Microbiological eradication was achieved in 52.3% of the cases and the 30-day overall mortality rate was 14/23 (60.8%). Despite the high mortality of critically ill COVID-19 patients, CZA, especially in combination therapy, could represent a valid treatment option for VAP due to DTT non-fermenter gram-negative bacteria, including uncommon pathogens such as Burkholderia cepacea and Stenotrophomonas maltophilia. Full article

(This article belongs to the Special Issue Carbapenem-Resistant Organisms (CRO) as Leading Cause of Hospital Associated Infections)

► Show Figures

Journal Menu

Journal Browser

Carbapenem-Resistant Organisms (CRO) as Leading Cause of Hospital Associated Infections

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Published Papers (9 papers)

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI