Antimicrobial Resistance: A Global Challenge

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Microbiology in Human Health and Disease".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 14049

Special Issue Editor


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Guest Editor
Department Infectious Diseases, Italian National Institute of Health, Rome, Italy
Interests: antimicrobial resistance; healthcare acquired infections; vaccination programmes

Special Issue Information

Dear Colleagues,

Antimicrobial resistance (AMR) has become a worldwide public health threat caused by inappropriate and massive consumption and disposal of antimicrobial drugs in the medicine, veterinary, zootechnical and agricultural fields.

Infectious diseases can be caused by multidrug-resistant microorganisms (MDRO) in hospitals, communities and livestock, threatening medical procedures or food production chains of both animal and plant origin.

As a global health challenge, an effective response to the AMR “silent pandemic” needs the One Health approach to reduce the risk for emerging zoonotic disease outbreaks as well as environmental spread of resistant pathogens and genes. This Special Issue will bring together scientific research studies and review papers focused on evidence-based interventions, sustainable use of antimicrobial treatments, monitoring strategies, tools, models, health determinants and estimates of the AMR burden in order to favor awareness and offer insights on how to address this critical issue for the ecosystem and human health.

Dr. Michela Sabbatucci
Guest Editor

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Keywords

  • antimicrobial resistance
  • resistant pathogens
  • antimicrobial treatments
  • evidence-based interventions

Published Papers (4 papers)

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Research

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11 pages, 1584 KiB  
Article
Prevalence of mecA- and mecC-Associated Methicillin-Resistant Staphylococcus aureus in Clinical Specimens, Punjab, Pakistan
by Muhammad Mubashar Idrees, Khadija Saeed, Muhammad Akbar Shahid, Muhammad Akhtar, Khadija Qammar, Javariya Hassan, Tayyaba Khaliq and Ali Saeed
Biomedicines 2023, 11(3), 878; https://doi.org/10.3390/biomedicines11030878 - 13 Mar 2023
Cited by 4 | Viewed by 3756
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a clinically prevalent bacterium and is resistant to many drugs. Genetic factors such as mec genes are considered to be responsible for this resistance. Recently, Staphylococcal Cassette Chromosome mec (SCCmec) element mutations produced mecC, a [...] Read more.
Methicillin-resistant Staphylococcus aureus (MRSA) is a clinically prevalent bacterium and is resistant to many drugs. Genetic factors such as mec genes are considered to be responsible for this resistance. Recently, Staphylococcal Cassette Chromosome mec (SCCmec) element mutations produced mecC, a new genetic variant that encodes a transpeptidase enzyme (63% similarity with mecA-encoded PBP2a). This cross-sectional study was conducted to establish the prevalence of the mecA and mecC genes among phenotypically identified MRSA and their effectiveness against different antibiotics in clinical specimens. The prevalence of Staphylococcus aureus was 10.2% (n = 102) in the total number of clinical specimens collected (n = 1000). However, the prevalence of MRSA was 6.3% (n = 63) of the total samples collected, while it was 61.8% among total Staphylococcus aureus isolates. mec genes were confirmed in 96.8% (n = 61) isolates of MRSA, while 3.2% (n = 2) were found to be negative for mec genes. The combination of mecA and mecC was detected in 57.1% (n = 36) of the MRSA isolates. The prevalence of lone mecA was 31.8% (n = 20) and that of lone mecC was 7.9% (n = 5) among all the MRSA samples. Penicillin and amoxicillin/clavulanic acid were the most resistant antibiotics followed by norfloxacin (91.2%), levofloxacin (87.1%), ciprofloxacin (83.9%), azithromycin (78.6%), erythromycin (77.4%), moxifloxacin (69.8%), and sulfamethoxazole/trimethoprim (54.9%). On the other hand, vancomycin and teicoplanin (98.4%) were more effective drugs against MRSA followed by linezolid (96.7%), clindamycin (84.6%), chloramphenicol (83.7%), fusidic acid (70.6%), gentamicin (67.7%), and tetracycline (56.8%). In conclusion, a significant prevalence of mecA and mecC has been found among MRSA isolated from clinical specimens, which is likely responsible for antibiotic resistance in MRSA in our clinical settings. However, vancomycin, teicoplanin, and linezolid were found the top three most effective drugs against MRSA in our clinical settings. Thus, MRSA endemics in local areas require routine molecular and epidemiological investigation. Full article
(This article belongs to the Special Issue Antimicrobial Resistance: A Global Challenge)
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14 pages, 1749 KiB  
Article
Carbapenem-Resistant Gram-Negative Fermenting and Non-Fermenting Rods Isolated from Hospital Patients in Poland—What Are They Susceptible to?
by Małgorzata Brauncajs, Filip Bielec, Anna Macieja and Dorota Pastuszak-Lewandoska
Biomedicines 2022, 10(12), 3049; https://doi.org/10.3390/biomedicines10123049 - 25 Nov 2022
Cited by 3 | Viewed by 2997
Abstract
Gram-negative fermenting and non-fermenting bacteria are important etiological factors of nosocomial and community infections, especially those that produce carbapenemases. Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa are the most frequently-detected carbapenemase-producing microorganisms. The predominant type of resistance is metallo-β-lactamase (MBL). These bacteria [...] Read more.
Gram-negative fermenting and non-fermenting bacteria are important etiological factors of nosocomial and community infections, especially those that produce carbapenemases. Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa are the most frequently-detected carbapenemase-producing microorganisms. The predominant type of resistance is metallo-β-lactamase (MBL). These bacteria are predominantly isolated from bronchial alveolar lavage, urine, and blood. Carbapenemase-producing Enterobacterales (CPE) strains are always multi-drug-resistant. This significantly limits the treatment options for this type of infection, extends the time of patient hospitalization, and increases the risk of a more severe and complicated disease course. Preventing the transmission of these microorganisms should be a major public health initiative. New antibiotics and treatment regimens offer hope against these infections. Full article
(This article belongs to the Special Issue Antimicrobial Resistance: A Global Challenge)
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17 pages, 2629 KiB  
Article
Efficacy and Safety of Fecal Microbiota Transplantation for Clearance of Multidrug-Resistant Organisms under Multiple Comorbidities: A Prospective Comparative Trial
by Jongbeom Shin, Jung-Hwan Lee, Soo-Hyun Park, Boram Cha, Kye Sook Kwon, Hyungkil Kim and Yong Woon Shin
Biomedicines 2022, 10(10), 2404; https://doi.org/10.3390/biomedicines10102404 - 26 Sep 2022
Cited by 2 | Viewed by 1618
Abstract
Fecal microbiota transplantation (FMT) could decolonize multidrug-resistant organisms. We investigated FMT effectiveness and safety in the eradication of carbapenem-resistant Enterobacteriaceae (CRE) and vancomycin-resistant enterococci (VRE) intestinal colonization. A prospective non-randomized comparative study was performed with 48 patients. FMT material (60 g) was obtained [...] Read more.
Fecal microbiota transplantation (FMT) could decolonize multidrug-resistant organisms. We investigated FMT effectiveness and safety in the eradication of carbapenem-resistant Enterobacteriaceae (CRE) and vancomycin-resistant enterococci (VRE) intestinal colonization. A prospective non-randomized comparative study was performed with 48 patients. FMT material (60 g) was obtained from a healthy donor, frozen, and administered via endoscopy. The primary endpoint was 1-month decolonization, and secondary endpoints were 3-month decolonization and adverse events. Microbiota analysis of fecal samples was performed using 16S rRNA sequencing. Intention-to-treat analysis revealed overall negative conversion between the FMT and control groups at 1 (26% vs. 10%, p = 0.264) and 3 (52% vs. 24%, p = 0.049) months. The 1-month and 3-month CRE clearance did not differ significantly by group (36% vs. 10%, p = 0.341; and 71% vs. 30%, p = 0.095, respectively). Among patients with VRE, FMT was ineffective for 1-month or 3-month negative conversion (13% vs. 9%, p > 0.999; and 36% vs. 18%, p = 0.658, respectively) However, cumulative overall negative-conversion rate was significantly higher in the FMT group (p = 0.037). Enterococcus abundance in patients with VRE significantly decreased following FMT. FMT may be effective at decolonizing multidrug-resistant organisms in the intestinal tract. Full article
(This article belongs to the Special Issue Antimicrobial Resistance: A Global Challenge)
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Review

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13 pages, 467 KiB  
Review
Antifungal Drug Resistance: An Emergent Health Threat
by Antonio Vitiello, Francesco Ferrara, Mariarosaria Boccellino, Annarita Ponzo, Carla Cimmino, Emilio Comberiati, Andrea Zovi, Salvatore Clemente and Michela Sabbatucci
Biomedicines 2023, 11(4), 1063; https://doi.org/10.3390/biomedicines11041063 - 31 Mar 2023
Cited by 21 | Viewed by 4902
Abstract
Fungal infections, named mycosis, can cause severe invasive and systemic diseases that can even lead to death. In recent years, epidemiological data have recorded an increase in cases of severe fungal infections, caused mainly by a growing number of immunocompromised patients and the [...] Read more.
Fungal infections, named mycosis, can cause severe invasive and systemic diseases that can even lead to death. In recent years, epidemiological data have recorded an increase in cases of severe fungal infections, caused mainly by a growing number of immunocompromised patients and the emergence of fungal pathogenic forms that are increasingly resistant to antimycotic drug treatments. Consequently, an increase in the incidence of mortality due to fungal infections has also been observed. Among the most drug-resistant fungal forms are those belonging to the Candida and Aspergillus spp. Some pathogens are widespread globally, while others are endemic in some areas only. In addition, some others may represent a health threat for some specific subpopulations and not for the general public. In contrast to the extensive therapeutic armamentarium available for the antimicrobial chemotherapeutic treatment of bacteria, for fungal infections there are only a few classes of antimycotic drugs on the market, such as polyenes, azoles, echinocandins, and a few molecules are under trial. In this review, we focused on the systemic mycosis, highlighted the antifungal drug compounds available in the pipeline, and analyzed the main molecular mechanisms for the development of antifungal resistance to give a comprehensive overview and increase awareness on this growing health threat. Full article
(This article belongs to the Special Issue Antimicrobial Resistance: A Global Challenge)
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