Multidrug Resistance in the 2020's: A Threat in the Hospital and in the Community

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Antimicrobial Agents and Resistance".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 4434

Special Issue Editors

Antimicrobial Optimisation Group, UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
Interests: critical care; infectious diseases; sepsis; healthcare-associated infections; severe respiratory infections; multidrug-resistant microorganisms; antibiotic optimization; high fidelity medical simulation
Special Issues, Collections and Topics in MDPI journals
Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
Interests: clinical epidemiology of severe infections in critically ill patients; infection prevention; education in quality improvement interventions

Special Issue Information

Dear Colleagues,

Multidrug Resistance represent a major concern for public health and the pressure for hospitals and communities. During the ongoing COVID-19 pandemic, antibiotics and antifungals have been extensively used for the management of hospitalized patients infected with SARS-CoV-2. Unintended consequences of antimicrobial overuse include, among others, the increment of resistance and the circulation of multidrug-resistant organisms (MDROs). On the other hand, the management of hospitalized SARS-CoV-2 patients increases the risk of outbreak due to MDROs for several reasons, including the increased number of patients, increased length of hospital stay, extensive antibiotic use, lack of infection prevention and control measures and interruption of antimicrobial stewardship programs.

In this Special Issue, we encourage colleagues to submit manuscripts related to the multidrug-resistant pathogens and relevant treatment—from hospital to communities. We also welcome manuscripts describing new methods and the adaption or creation of technologies for the study, prevention, and control of multidrug resistance.

Dr. Despoina Koulenti
Prof. Dr. Stijn Blot
Guest Editors

Manuscript Submission Information

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Keywords

  • multidrug resistance
  • antibiotics
  • antifungals
  • multidrug resistant pathogen

Published Papers (2 papers)

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Research

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13 pages, 2949 KiB  
Article
Epidemiology and Resistance Phenotypes of Carbapenem-Resistant Klebsiella pneumoniae in Corfu General Hospital (2019–2022): A Comprehensive Time Series Analysis of Resistance Gene Dynamics
by Glykeria Sorovou, Georgios Schinas, Aggeliki Pasxali, Angeliki Tzoukmani, Kyriaki Tryfinopoulou, Charalambos Gogos, George Dimopoulos and Karolina Akinosoglou
Microorganisms 2023, 11(10), 2537; https://doi.org/10.3390/microorganisms11102537 - 11 Oct 2023
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Abstract
Antimicrobial resistance is a significant global health challenge, with Klebsiella pneumoniae being one of the most common antibiotic-resistant pathogens. This study provides an in-depth analysis of the prevalence and resistance patterns of antibiotic-resistant Klebsiella pneumoniae in the General Hospital of Corfu, Greece, between [...] Read more.
Antimicrobial resistance is a significant global health challenge, with Klebsiella pneumoniae being one of the most common antibiotic-resistant pathogens. This study provides an in-depth analysis of the prevalence and resistance patterns of antibiotic-resistant Klebsiella pneumoniae in the General Hospital of Corfu, Greece, between 2019 and 2022, with the aim of understanding the potential impact of the COVID-19 pandemic on the epidemiology of this bacterium. Utilizing a retrospective epidemiological approach, this study analyzed 212 isolates obtained from the hospital’s Microbiology Department. These isolates were subjected to genotypic and phenotypic identification, with resistance genes (bla-KPC, bla-NDM, bla-VIM, bla-OXA-48, and mcr-1) and antibiotic resistance patterns as the primary focus. The results revealed a significant shift in resistance gene prevalence, with a notable increase in bla-KPC from 16.67% in 2021 to 58.46% in 2022, and a decrease in bla-NDM from 81.48% in 2021 to 38.46% in 2022. In terms of antibiotic resistance patterns, there was a consistent increase in resistance to amikacin and a significant decrease in resistance to ceftazidime/avibactam. These findings underscore the dynamic nature of carbapenem-resistant Klebsiella pneumoniae (CRKP) resistance and highlight the need for ongoing surveillance and adaptive therapeutic strategies in the face of evolving resistance patterns. Full article
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19 pages, 363 KiB  
Review
Antimicrobial Multidrug Resistance: Clinical Implications for Infection Management in Critically Ill Patients
by Gamze Kalın, Emine Alp, Arthur Chouaikhi and Claire Roger
Microorganisms 2023, 11(10), 2575; https://doi.org/10.3390/microorganisms11102575 - 16 Oct 2023
Cited by 1 | Viewed by 1698
Abstract
The increasing incidence of antimicrobial resistance (AMR) worldwide represents a serious threat in the management of sepsis. Due to resistance to the most common antimicrobials prescribed, multidrug-resistant (MDR) pathogens have been associated with delays in adequate antimicrobial therapy leading to significant increases in [...] Read more.
The increasing incidence of antimicrobial resistance (AMR) worldwide represents a serious threat in the management of sepsis. Due to resistance to the most common antimicrobials prescribed, multidrug-resistant (MDR) pathogens have been associated with delays in adequate antimicrobial therapy leading to significant increases in mortality, along with prolonged hospital length of stay (LOS) and increases in healthcare costs. In response to MDR infections and the delay of microbiological results, broad-spectrum antibiotics are frequently used in empirical antimicrobial therapy. This can contribute to the overuse and misuse of antibiotics, further promoting the development of resistance. Multiple measures have been suggested to combat AMR. This review will focus on describing the epidemiology and trends concerning MDR pathogens. Additionally, it will explore the crucial aspects of identifying patients susceptible to MDR infections and optimizing antimicrobial drug dosing, which are both pivotal considerations in the fight against AMR. Expert commentary: The increasing AMR in ICUs worldwide makes the empirical antibiotic therapy challenging in septic patients. An AMR surveillance program together with improvements in MDR identification based on patient risk stratification and molecular rapid diagnostic tools may further help tailoring antimicrobial therapies and avoid unnecessary broad-spectrum antibiotics. Continuous infusions of antibiotics, therapeutic drug monitoring (TDM)-based dosing regimens and combination therapy may contribute to optimizing antimicrobial therapy and limiting the emergence of resistance. Full article
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