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Microorganisms
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Three Years within COVID-19 Pandemic: Current Updates in Infectious Diseases
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Three Years within COVID-19 Pandemic: Current Updates in Infectious Diseases

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 9724

Special Issue Editors

Dr. Karolina Akinosoglou

E-Mail Website
Guest Editor
Department of Internal Medicine, University of Patras, 26504 Patras, Greece
Interests: HIV, sepsis; COVID-19; multi-drug-resistant pathogens; urogenital infections; immunology of infection
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Charalambos Gogos

E-Mail Website
Guest Editor
Department of Medicine, University of Patras, Metropolitan General Athens, Rio, Greece
Interests: sepsis; COVID-19; immunology of infection
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to invite you to the Special Issue of Microorganisms: Three Years within COVID-19 Pandemic: Current Updates in Infectious Diseases. Following three years within COVID-19 pandemic, the issue aims to review recent developments in the field of infectious diseases and highlight advances and controversies in clinical microbiology and infectious diseases including COVID-19.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but not limited to) the following: COVID-19 disease, HIV, sepsis, viral hepatitis, infection control, antimicrobial resistance, antimicrobial stewardship, public health, and clinical microbiology.

We look forward to receiving your contributions.

Dr. Karolina Akinosoglou
Prof. Dr. Charalambos Gogos
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. Microorganisms 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 2700 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

  • sepsis
  • infection
  • COVID-19
  • HIV
  • viral hepatitis
  • immunization
  • infection control
  • antimicrobial stewardship
  • antimicrobial resistance

Published Papers (5 papers)

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Research

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16 pages, 316 KiB  
Article
Mortality due to Multidrug-Resistant Gram-Negative Bacteremia in an Endemic Region: No Better than a Toss of a Coin
by Olga Tsachouridou, Dimitrios Pilalas, Sideris Nanoudis, Athanasios Antoniou, Isidora Bakaimi, Theofilos Chrysanthidis, Konstantinos Markakis, Angeliki Kassomenaki, Paraskevi Mantzana, Efthymia Protonotariou, Lemonia Skoura and Symeon Metallidis
Microorganisms 2023, 11(7), 1711; https://doi.org/10.3390/microorganisms11071711 - 30 Jun 2023
Cited by 1 | Viewed by 1320
Abstract
The incidence of multidrug-resistant (MDR) bloodstream infections (BSIs) is associated with high morbidity and mortality. Little evidence exists regarding the epidemiology of BSIs and the use of appropriate empirical antimicrobial therapy in endemic regions. Novel diagnostic tests (RDTs) may facilitate and improve patient [...] Read more.
The incidence of multidrug-resistant (MDR) bloodstream infections (BSIs) is associated with high morbidity and mortality. Little evidence exists regarding the epidemiology of BSIs and the use of appropriate empirical antimicrobial therapy in endemic regions. Novel diagnostic tests (RDTs) may facilitate and improve patient management. Data were assessed from patients with MDR Gram-negative bacteremia at a university tertiary hospital over a 12-month period. In total, 157 episodes of MDR Gram-negative BSI were included in the study. The overall mortality rate was 50.3%. Rapid molecular diagnostic tests were used in 94% of BSI episodes. In univariate analysis, age (OR 1.05 (95% CI 1.03, 1.08) p < 0.001), Charlson Comorbidity Index (OR 1.51 (95% CI 1.25, 1.83) p < 0.001), procalcitonin ≥ 1(OR 3.67 (CI 95% 1.73, 7.79) p < 0.001), and monotherapy with tigecycline (OR 3.64 (95% CI 1.13, 11.73) p = 0.030) were the only factors associated with increased overall mortality. Surprisingly, time to appropriate antimicrobial treatment had no impact on mortality. MDR pathogen isolation, other than Klebsiella pneumoniae and Acinetobacter baumanii, was associated with decreased mortality (OR 0.35 (95% CI 0.16, 0.79) p = 0.011). In multivariate analysis, the only significant factor for mortality was procalcitonin ≥ 1 (OR 2.84 (95% CI 1.13, 7.11) p = 0.025). In conclusion, in an endemic area, mortality rates in MDR BSI remain notable. High procalcitonin was the only variable that predicted death. The use of rapid diagnostics did not improve mortality rate. Full article
(This article belongs to the Special Issue Three Years within COVID-19 Pandemic: Current Updates in Infectious Diseases)
15 pages, 1942 KiB  
Article
Association of Antiretroviral Therapy with Platelet Function and Systemic Inflammatory Response in People Living with HIV: A Cross-Sectional Study
by Karolina Akinosoglou, Martha Kolosaka, George Schinas, Anne-Lise Delastic, Stefania Antonopoulou, Angelos Perperis, Markos Marangos, Athanasia Mouzaki and Charalambos Gogos
Microorganisms 2023, 11(4), 958; https://doi.org/10.3390/microorganisms11040958 - 6 Apr 2023
Viewed by 1455
Abstract
People living with HIV (PLWHIV) present an increased risk of adverse cardiovascular events. We aimed to assess whether antiretroviral therapy (ART) pharmacologically enhances platelet reactivity and platelet activation intensity, and explore the potential association with underlying inflammatory status. This was a cross-sectional cohort [...] Read more.
People living with HIV (PLWHIV) present an increased risk of adverse cardiovascular events. We aimed to assess whether antiretroviral therapy (ART) pharmacologically enhances platelet reactivity and platelet activation intensity, and explore the potential association with underlying inflammatory status. This was a cross-sectional cohort study carried out among PLWHIV on diverse ART regimens. Platelet reactivity and activation intensity were assessed using the bedside point-of-care VerifyNow assay, in P2Y12 reaction units (PRU), measurements of monocyte-platelet complexes, and P-selectin and GPIIb/IIIa expression increase, following activation with ADP, respectively. Levels of major inflammatory markers and whole blood parameters were also evaluated. In total, 71 PLWHIV, 59 on ART and 22 healthy controls, were included in this study. PRU values were significantly elevated in PLWHIV compared to controls [Mean; 257.85 vs. 196.67, p < 0.0001], but no significant differences were noted between ART-naïve or ART-experienced PLWHIV, or between TAF/TDF and ABC based regimens, similar to systemic inflammatory response. However, within-group analysis showed that PRUs were significantly higher in ABC/PI vs ABC/INSTI or TAF/TDF + PI patients, in line with levels of IL-2. PRU values did not correlate strongly with CD4 counts, viral load, or cytokine values. P-selectin and GPIIb/IIIa expression increased following ADP activation and were significantly more prominent in PLWHIV (p < 0.005). Platelet reactivity and platelet activation intensity were shown to be increased in PLWHIV, but they did not appear to be related to ART initiation, similar to the underlying systemic inflammatory response. Full article
(This article belongs to the Special Issue Three Years within COVID-19 Pandemic: Current Updates in Infectious Diseases)
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11 pages, 1618 KiB  
Article
Changes in Etiology and Clinical Outcomes of Pleural empyema during the COVID-19 Pandemic
by King-Pui Florence Chan, Ting-Fung Ma, Siddharth Sridhar, David Chi-Leung Lam, Mary Sau-Man Ip and Pak-Leung Ho
Microorganisms 2023, 11(2), 303; https://doi.org/10.3390/microorganisms11020303 - 24 Jan 2023
Cited by 3 | Viewed by 2183
Abstract
Healthcare-seeking behavior changed during the COVID-19 pandemic and might alter the epidemiology of pleural empyema. In this study, the incidence, etiology and outcomes of patients admitted for pleural empyema in Hong Kong in the pre-COVID-19 (January 2015–December 2019) and post-COVID-19 (January 2020–June 2022) [...] Read more.
Healthcare-seeking behavior changed during the COVID-19 pandemic and might alter the epidemiology of pleural empyema. In this study, the incidence, etiology and outcomes of patients admitted for pleural empyema in Hong Kong in the pre-COVID-19 (January 2015–December 2019) and post-COVID-19 (January 2020–June 2022) periods were compared. Overall, Streptococcus pneumoniae was the predominant organism in <18-year-old patients, while Streptococcus anginosus, anaerobes and polymicrobial infections were more frequent in adults. In the post-COVID-19 period, a marked decline in the incidence of pleural empyema in children was observed (pre-COVID-19, 18.4 ± 4.8 vs. post-COVID-19, 2.0 ± 2.9 cases per year, p = 0.036), while the incidence in adults remained similar (pre-COVID-19, 189.0 ± 17.2 vs. post-COVID-19, 198.4 ± 5.0 cases per year; p = 0.23). In the post-COVID-19 period, polymicrobial etiology increased (OR 11.37, p < 0.0001), while S. pneumoniae etiology decreased (OR 0.073, p < 0.001). In multivariate analysis, clinical outcomes (length of stay, ICU admission, use of intrapleural fibrinolytic therapy, surgical intervention, death) were not significantly different in pre- and post-COVID-19 periods. In conclusion, an increase in polymicrobial pleural empyema was observed during the pandemic. We postulate that this is related to the delayed presentation of pneumonia to hospitals. Full article
(This article belongs to the Special Issue Three Years within COVID-19 Pandemic: Current Updates in Infectious Diseases)
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Review

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11 pages, 649 KiB  
Review
Mycobacterium marinum: A Case-Based Narrative Review of Diagnosis and Management
by Giorgos Tsiolakkis, Angelos Liontos, Sempastian Filippas-Ntekouan, Rafail Matzaras, Eleftheria Theodorou, Michail Vardas, Georgia Vairaktari, Anna Nikopoulou and Eirini Christaki
Microorganisms 2023, 11(7), 1799; https://doi.org/10.3390/microorganisms11071799 - 13 Jul 2023
Cited by 1 | Viewed by 1902
Abstract
Skin and soft tissue infections caused by non-tuberculous mycobacteria are occurring more frequently in recent years. However, chronic skin and soft tissue lesions present a challenge for clinicians, as the diagnostic work-up and definitive diagnosis require knowledge and available laboratory resources. We present [...] Read more.
Skin and soft tissue infections caused by non-tuberculous mycobacteria are occurring more frequently in recent years. However, chronic skin and soft tissue lesions present a challenge for clinicians, as the diagnostic work-up and definitive diagnosis require knowledge and available laboratory resources. We present here the case of a 66-year-old male patient who presented with painful abscess-like nodules on his right hand and forearm, which worsened after treatment with an anti-TNF-a agent. The fluid specimen taken from the lesion was positive for mycobacteria according to the acid-fast stain. Mycobacterium marinum was identified, first by next-generation sequencing and finally grown on culture, after eight weeks. Acknowledging the complexity of diagnosing and managing infections by non-tuberculous mycobacteria, and especially Mycobacterium marinum, we provide a review of the current epidemiology, clinical characteristics, diagnosis and management of Mycobacterium marinum infection. Full article
(This article belongs to the Special Issue Three Years within COVID-19 Pandemic: Current Updates in Infectious Diseases)
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19 pages, 344 KiB  
Review
High-Dose Nebulized Colistin Methanesulfonate and the Role in Hospital-Acquired Pneumonia Caused by Gram-Negative Bacteria with Difficult-to-Treat Resistance: A Review
by Ilias Karaiskos, Aikaterini Gkoufa, Elena Polyzou, Georgios Schinas, Zoe Athanassa and Karolina Akinosoglou
Microorganisms 2023, 11(6), 1459; https://doi.org/10.3390/microorganisms11061459 - 31 May 2023
Cited by 5 | Viewed by 2205
Abstract
Hospital-acquired pneumonia, including ventilator-associated pneumonia (VAP) due to difficult-to-treat-resistant (DTR) Gram-negative bacteria, contributes significantly to morbidity and mortality in ICUs. In the era of COVID-19, the incidences of secondary nosocomial pneumonia and the demand for invasive mechanical ventilation have increased dramatically with extremely [...] Read more.
Hospital-acquired pneumonia, including ventilator-associated pneumonia (VAP) due to difficult-to-treat-resistant (DTR) Gram-negative bacteria, contributes significantly to morbidity and mortality in ICUs. In the era of COVID-19, the incidences of secondary nosocomial pneumonia and the demand for invasive mechanical ventilation have increased dramatically with extremely high attributable mortality. Treatment options for DTR pathogens are limited. Therefore, an increased interest in high-dose nebulized colistin methanesulfonate (CMS), defined as a nebulized dose above 6 million IU (MIU), has come into sight. Herein, the authors present the available modern knowledge regarding high-dose nebulized CMS and current information on pharmacokinetics, clinical studies, and toxicity issues. A brief report on types of nebulizers is also analyzed. High-dose nebulized CMS was administrated as an adjunctive and substitutive strategy. High-dose nebulized CMS up to 15 MIU was attributed with a clinical outcome of 63%. High-dose nebulized CMS administration offers advantages in terms of efficacy against DTR Gram-negative bacteria, a favorable safety profile, and improved pharmacokinetics in the treatment of VAP. However, due to the heterogeneity of studies and small sample population, the apparent benefit in clinical outcomes must be proven in large-scale trials to lead to the optimal use of high-dose nebulized CMS. Full article
(This article belongs to the Special Issue Three Years within COVID-19 Pandemic: Current Updates in Infectious Diseases)
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