Journal Description
Antibiotics
Antibiotics
is an international, peer-reviewed, open access journal on all aspects of antibiotics, published monthly online by MDPI. The Croatian Pharmacological Society (CPS) is affiliated with Antibiotics and its members receive discounts on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, CAPlus / SciFinder, and other databases.
- Journal Rank: JCR - Q1 (Infectious Diseases) / CiteScore - Q1 (General Pharmacology, Toxicology and Pharmaceutics )
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 15 days after submission; acceptance to publication is undertaken in 2.6 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
4.6 (2024);
5-Year Impact Factor:
4.9 (2024)
Latest Articles
Comparative Effects of Intermittent vs. Constant Ceftiofur Hydrochloride Exposure on Staphylococcus aureus In Vitro
Antibiotics 2025, 14(7), 686; https://doi.org/10.3390/antibiotics14070686 (registering DOI) - 6 Jul 2025
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Background/Objectives: Ceftiofur hydrochloride (CEF) is a third-generation cephalosporin widely used in cattle to treat various disease. The recommended dosage was 1.1 to 2.2 mg/kg BW for 3 to 5 consecutive days by intramuscular or subcutaneous injection. Incomplete treatment, overuse, or misuse, often observed
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Background/Objectives: Ceftiofur hydrochloride (CEF) is a third-generation cephalosporin widely used in cattle to treat various disease. The recommended dosage was 1.1 to 2.2 mg/kg BW for 3 to 5 consecutive days by intramuscular or subcutaneous injection. Incomplete treatment, overuse, or misuse, often observed in clinical practice, are major contributors to resistance development. This study aims to explore how different concentrations, durations, and dosing frequencies affect susceptibility and bactericidal efficacy of Staphylococcus aureus to optimize CEF dosage regimens. Methods: First, CEF was intermittently administered at 1/2 × minimum inhibitory concentration (MIC), 2 × MIC, 6 × MIC, and 100 × MIC for 30 cycles. Second, CEF was continuously administered for 48, 72, 96, 120, 144, and 168 h. Bacterial susceptibility, regrowth, survival rate, and the emergence of persisters or tolerant phenotypes were assessed. Genetic mutations were identified by whole-genome resequencing. Membrane permeability, integrity, and efflux pump activity were analyzed to elucidate the mechanism of CEF. Results: After 30 cycles, the MIC increased eight-fold in the 2 × MIC group. No significant MIC increase was found in other groups, but a progression from susceptibility to persistence and then to tolerance was observed in the 100 × MIC intermittent group. The survival rate increased both in the 2 × MIC and 100 × MIC groups. With continuous exposure to ≥6 × MIC over 120 h, strains were completely eradicated without MIC increase. Resistance-associated single-nucleotide polymorphism (SNP) mutations were detected only in strains of the 2 × MIC and 100 × MIC intermittent groups. CEF altered the membrane hydrophobicity, damaging membrane integrity after 30 cycles. Conclusions: These findings suggest that high-dose, prolonged exposure is more effective for eliminating Staphylococcus aureus and avoiding resistance, whereas intermittent dosing may promote persistence, tolerance, and resistance evolution.
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Open AccessArticle
Canine Pyoderma and Otitis Externa: A Retrospective Analysis of Multidrug-Resistant Bacterial Carriage in Hong Kong
by
Wing Yu Chan, Stefan Hobi, Andrew Ferguson and Ibrahim Elsohaby
Antibiotics 2025, 14(7), 685; https://doi.org/10.3390/antibiotics14070685 (registering DOI) - 6 Jul 2025
Abstract
Background: Canine pyoderma and otitis externa are prevalent bacterial skin infections in veterinary practice, frequently complicated by the emergence of multidrug-resistant (MDR) pathogens. Objectives: To investigate the frequency, antimicrobial resistance (AMR) profiles, and frequency of MDR bacterial isolates from dogs with pyoderma
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Background: Canine pyoderma and otitis externa are prevalent bacterial skin infections in veterinary practice, frequently complicated by the emergence of multidrug-resistant (MDR) pathogens. Objectives: To investigate the frequency, antimicrobial resistance (AMR) profiles, and frequency of MDR bacterial isolates from dogs with pyoderma or otitis externa in Hong Kong. Methods: A retrospective study of bacterial isolates from 215 clinical samples collected from dogs presenting with pyoderma (n = 63) or otitis externa (n = 152) at veterinary clinics across Hong Kong between 2018 and 2022. Bacterial isolates were identified and subjected to antimicrobial susceptibility testing against 13 antimicrobial classes. Results: Staphylococcus spp., particularly S. pseudintermedius, were the most commonly isolated species, followed by Pseudomonas spp. and Proteus spp. High resistance rates were observed for orbifloxacin (61.3% in pyoderma; 76.7% in otitis externa), doxycycline (59.3%; 69.2%), clindamycin (62%; 68.9%), and enrofloxacin (50%; 55.5%). Most isolates were sensitive to ofloxacin, ticarcillin–clavulanate, tobramycin, ciprofloxacin, cefpodoxime, cefuroxime, and cefixime. MDR was detected in 67.5% of pyoderma and 66.8% of otitis externa isolates. Gram-negative bacteria exhibited significantly higher MDR rates than Gram-positive isolates. The multiple antibiotic resistance (MAR) index averaged 0.41 for pyoderma and 0.52 for otitis externa isolates. We found no significant associations between MDR and non-modifiable risk factors (i.e., age, sex, breed, and reproductive status). Conclusions: These findings highlight the critical need for prudent antimicrobial use and continuous surveillance of AMR trends in companion animals. A higher focus should be placed on topical antiseptic therapy, with oral antibiotics used only in exceptional cases and after susceptibility testing. From a One Health perspective, the potential transmission of MDR bacteria between companion animals and humans underscores the importance of a coordinated approach to antimicrobial stewardship across both veterinary and human medicine.
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(This article belongs to the Special Issue Companion Animals: Antimicrobial Resistance in Bacterial and Fungal Pathogens Associated with Skin and Ear Infections)
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Mapping the AMR Infection Landscape in Bihar: Implications for Strengthening Policy and Clinical Practice
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Vinay Modgil, Sundeep Sahay, Neelam Taneja, Burhanuddin Qayyumi, Ravikant Singh, Arunima Mukherjee, Bibekananda Bhoi and Gitika Arora
Antibiotics 2025, 14(7), 684; https://doi.org/10.3390/antibiotics14070684 (registering DOI) - 5 Jul 2025
Abstract
Background: Antimicrobial resistance (AMR) poses a significant threat to public health, especially in low- and middle-income countries (LMICs), where surveillance infrastructure is underdeveloped. Bihar, India’s third most populous state and one of its least-resourced states, has remained largely absent from national AMR monitoring
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Background: Antimicrobial resistance (AMR) poses a significant threat to public health, especially in low- and middle-income countries (LMICs), where surveillance infrastructure is underdeveloped. Bihar, India’s third most populous state and one of its least-resourced states, has remained largely absent from national AMR monitoring initiatives. Methods: This study aimed to characterize the AMR infection landscape across five public tertiary care hospitals in Bihar over three years (2022–2024) and to assess the feasibility of integrating digital workflows for real-time microbiological reporting. Standardized antimicrobial susceptibility testing (AST) was performed on >48,000 urine, pus, and blood samples using CLSI guidelines. Facility-level data were digitized into an open-source AMR reporting system, enabling automated antibiogram generation. Results: The findings revealed substantial resistance: high resistance to beta-lactams, carbapenems, and fluoroquinolones across pathogens. For instance, E. coli sensitivity to nitrofurantoin varied from 86.5% at NMCH (Patna) to 44.7% at JLNMCH (Bhagalpur), while cephalosporin sensitivity in Klebsiella spp. dropped below 2% in several hospitals. MRSA prevalence exceeded 65% in two facilities, far above the national average of 47.8%. Digital integration led to a four-fold increase in culture testing in all facilities and improved data completeness and turnaround times. Spatial analysis and microbiology laboratory assessment revealed significant geographic disparities in diagnostic access, with facilities in remote districts facing delays of over four hours for basic testing. Conclusions: Our study is the first study from India to create such a broad, facility-associated AMR picture over time at a state level. Policy implications include the need for a state-level AMR surveillance dashboard, alignment of procurement with facility-specific resistance patterns, and routine stewardship audits. Clinically, this study demonstrates the utility of localized antibiograms for guiding empirical therapy in resource-limited settings. This study provides a scalable framework for embedding AMR surveillance into routine health system workflows in LMICs.
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(This article belongs to the Special Issue Antibiotic Stewardship Implementation Strategies)
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Outcomes of Implementing a Multidimensional Antimicrobial Stewardship Program in a Medical Ward in a Third-Level University Hospital in Northern Italy
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Maria Mazzitelli, Daniele Mengato, Gianmaria Barbato, Sara Lo Menzo, Fabio Dalla Valle, Margherita Boschetto, Paola Stano, Cristina Contessa, Daniele Donà, Vincenzo Scaglione, Giacomo Berti, Elisabetta Mariavittoria Giunco, Tiziano Martello, Francesca Venturini, Ignazio Castagliuolo, Michele Tessarin, Paolo Simioni and Annamaria Cattelan
Antibiotics 2025, 14(7), 683; https://doi.org/10.3390/antibiotics14070683 (registering DOI) - 5 Jul 2025
Abstract
Background/Objectives: Antimicrobial stewardship programs (ASPs) optimize antimicrobial use, improving outcomes and reducing resistance. This study assessed the impact of a ward-specific ASP. Methods: A pre/post quasi-experimental study was conducted in an internal medicine ward at a tertiary hospital in Padua, Italy.
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Background/Objectives: Antimicrobial stewardship programs (ASPs) optimize antimicrobial use, improving outcomes and reducing resistance. This study assessed the impact of a ward-specific ASP. Methods: A pre/post quasi-experimental study was conducted in an internal medicine ward at a tertiary hospital in Padua, Italy. During the intervention year (September 2023–August 2024), a multidisciplinary team (infectious disease consultants, pharmacists, microbiologists, nurses, and hygienists) held bi-weekly ward-based audits, reviewing antimicrobial prescriptions and performing bedside assessments. Therapy adjustments followed guidelines and local epidemiology. Educational sessions and infection prevention and control (IPC) protocols were also reinforced. Outcomes were compared to the previous year, considering patient characteristics. The primary outcome was antimicrobial consumption (DDD/100 patient days, DDD/100PD); secondary outcomes included cost savings, length of stay (LOS), and mortality. Results: Fifty audits assessed 1074 patients and 1401 antimicrobial treatments. Patient characteristics were similar. Antibiotic suspension or de-escalation occurred in 37.9% and 22% of patients, respectively. AWARE ACCESS class use increased (+17.5%), while carbapenem (−54.4%) and fluoroquinolone (−42.0%) use significantly declined (p < 0.05). IPC and microbiological culture guidance were provided in 12.1% of cases. Antimicrobial consumption dropped from 107.7 to 84.4 DDD/100PD (p < 0.05). No significant changes in LOS or mortality were observed. Antimicrobial costs fell by 48.8% (with EUR 57,100 saved). Conclusions: ASP reduced antimicrobial consumption, improved prescription quality, and cut costs without compromising patient outcomes. Multidisciplinary collaboration, audits, and education proved essential. Future studies should assess long-term resistance trends and integrate rapid diagnostics for enhanced stewardship.
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(This article belongs to the Special Issue Antibiotic Stewardship Implementation Strategies)
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In Vitro Susceptibility to Imipenem/Relebactam and Comparators in a Multicentre Collection of Mycobacterium abscessus Complex Isolates
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Alejandro Seoane-Estévez, Pablo Aja-Macaya, Andrea Garcia-Pose, Paula López-Roa, Alba Ruedas-López, Verónica Gonzalez-Galán, Jaime Esteban, Jorge Arca-Suárez, Martín Pampín, Alejandro Beceiro, Marina Oviaño, Germán Bou and on behalf of the GEIM-SEIMC Study Group
Antibiotics 2025, 14(7), 682; https://doi.org/10.3390/antibiotics14070682 (registering DOI) - 5 Jul 2025
Abstract
Background and Objectives: Infections caused by non-tuberculous mycobacteria (NTM), including Mycobacterium abscessus complex (MABc), are increasing globally and are notoriously difficult to treat due to the intrinsic resistance of these bacteria to many common antibiotics. The aims of this study were to demonstrate
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Background and Objectives: Infections caused by non-tuberculous mycobacteria (NTM), including Mycobacterium abscessus complex (MABc), are increasing globally and are notoriously difficult to treat due to the intrinsic resistance of these bacteria to many common antibiotics. The aims of this study were to demonstrate the in vitro activity of imipenem/relebactam against MABc clinical isolates and to determine any in vitro synergism between imipenem/relebactam and other antimicrobials. Methods: A nationwide collection of 175 MABc clinical respiratory isolates obtained from 24 hospitals in Spain (August 2022–April 2023) was studied. Fifteen different antimicrobial agents were comprised, including imipenem/relebactam. MICs were determined according to CLSI criteria, and the synergism studies were performed with the selected clinical isolates. Results: Of the 175 isolates obtained, 110 were identified as M. abscessus subsp. abscessus (62.9%), 51 as M. abscessus subsp. massiliense (29.1%), and 14 as M. abscessus subsp. bolleti (8%). The antibiotics yielding the highest susceptibility rates were tigecycline, eravacycline, and omadacycline (100%); followed by imipenem/relebactam and clofazimine (97.6%); and finally amikacin (94.6%). Only four isolates were resistant to imipenem/relebactam, three of which were further characterized by WGS, revealing MABc mutations in BlaMab as well as D,D- and L,D-transpeptidades and mspA porin, which may play an important role in reduced susceptibility to imipenem/relebactam, even though none were previously described or associated with resistance to β-lactams. Conclusions: Our data demonstrate that relebactam improved the anti-MABc activity of imipenem, representing a β-lactam for the treatment of MABc infections. Furthermore, imipenem/relebactam demonstrated in vitro synergism with other anti-MABc treatments, thus supporting its use as part of dual regimens.
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(This article belongs to the Section Novel Antimicrobial Agents)
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Clinical Outcomes of Escherichia coli Acute Bacterial Prostatitis: A Comparative Study of Oral Sequential Therapy with β-Lactam Versus Quinolone Antibiotics
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Laura Gisbert, Beatriz Dietl, Mariona Xercavins, Aina Mateu, María López, Ana Martínez-Urrea, Lucía Boix-Palop and Esther Calbo
Antibiotics 2025, 14(7), 681; https://doi.org/10.3390/antibiotics14070681 (registering DOI) - 5 Jul 2025
Abstract
Background/Objectives: Optimal management of acute bacterial prostatitis (ABP) remains uncertain, but the use of antibiotics with good prostatic tissue penetration is critical to prevent recurrence and chronic progression. This study aimed to describe clinical characteristics and outcomes of ABP due to Escherichia coli
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Background/Objectives: Optimal management of acute bacterial prostatitis (ABP) remains uncertain, but the use of antibiotics with good prostatic tissue penetration is critical to prevent recurrence and chronic progression. This study aimed to describe clinical characteristics and outcomes of ABP due to Escherichia coli (ABP-E.coli), compare effectiveness of sequential high-dose cefuroxime (ABP-CXM) versus ciprofloxacin (ABP-CIP), and identify risk factors for clinical failure. Methods: We conducted a retrospective study including men >18 years diagnosed with ABP-E. coli between January 2010 and November 2023 at a 400-bed hospital. Patients received oral cefuroxime (500 mg/8 h) or oral ciprofloxacin (500 mg/12 h). Outcomes over 90 days included clinical cure, recurrence and reinfection. Definitions: Clinical cure—resolution of symptoms without recurrences; recurrence—new ABP episode with the same E. coli strain; reinfection—ABP involving different microorganism or E. coli strain; clinical failure—lack of cure, recurrence, or reinfection. Results: Among 326 episodes (158 ABP-CXM, 168 ABP-CIP), ABP-CXM patients were younger (median 63.5 vs. 67.5 years, p = 0.005) and had fewer comorbidities. Clinical cure was higher in ABP-CIP (96.9% vs. 85.7%, p < 0.001). Recurrence occurred only in ABP-CXM (6.96% vs. 0%, p < 0.001), while reinfection and mortality were similar. Multivariable analysis showed ciprofloxacin was protective against clinical failure (OR: 0.16, 95% CI: 0.06–0.42, p < 0.001), while prior urinary tract infection (UTI) increased failure risk (OR: 2.87, 95% CI: 1.3–6.3). Conclusions: Ciprofloxacin was more effective than cefuroxime in treating ABP-E. coli. Patients with recent UTIs may need closer monitoring or alternative therapies.
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(This article belongs to the Section Antibiotic Therapy in Infectious Diseases)
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First-Line Prescriptions and Effectiveness of Helicobacter pylori Eradication Treatment in Ireland over a 10-Year Period: Data from the European Registry on Helicobacter pylori Management (Hp-EuReg)
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Sinéad M. Smith, Olga P. Nyssen, Rebecca FitzGerald, Thomas J. Butler, Deirdre McNamara, Asghar Qasim, Conor Costigan, Anna Cano-Catalá, Pablo Parra, Leticia Moreira, Francis Megraud, Colm O’Morain and Javier P. Gisbert
Antibiotics 2025, 14(7), 680; https://doi.org/10.3390/antibiotics14070680 (registering DOI) - 5 Jul 2025
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Background: Local audits of Helicobacter pylori (H. pylori) prescriptions and outcomes are necessary to assess guideline awareness among clinicians and treatment effectiveness. Aims: The aims were to investigate first-line prescriptions and effectiveness over a 10-year period in Ireland and evaluate the
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Background: Local audits of Helicobacter pylori (H. pylori) prescriptions and outcomes are necessary to assess guideline awareness among clinicians and treatment effectiveness. Aims: The aims were to investigate first-line prescriptions and effectiveness over a 10-year period in Ireland and evaluate the influence of the 2017 Irish consensus guidelines on these trends. Methods: Data were collected at e-CRF AEG-REDCap from the European Registry on H. pylori management (Hp-EuReg) and quality reviewed from 2013 to 2022. All treatment-naïve cases were assessed for effectiveness by modified intention-to-treat (mITT) analysis. Multivariate analysis was also performed. Results: Data from 1000 patients (mean age 50 ± 15 years; 54% female) were analyzed. Clarithromycin (C) and amoxicillin (A) triple therapy represented 88% of treatments, followed by sequential C, A, and metronidazole (M) therapy (4.3%) and triple C + M (2.7%). Bismuth quadruple therapy was prescribed in 1.7% of cases. Treatment durations of 14, 10, and 7 days accounted for 87%, 4.5%, and 8.5% of prescriptions, respectively. High-, standard-, and low-dose proton pump inhibitors (PPIs; 80 mg, 40 mg, and 20 mg omeprazole equivalent b.i.d.) were used in 86%, 0.9%, and 13% of cases, respectively. The overall eradication rate was 80%, while it was 81% for triple C + A. Good compliance and high-dose PPI were associated with higher overall mITT eradication rates (OR 4.5 and OR 1.9, respectively) and triple C + A eradication rates (OR 4.2 and OR 1.9, respectively). Overall eradication rates increased from 74% pre-2017 to 82% (p < 0.05) by the end of 2022. Similarly, the triple C + A eradication rates increased from 76% to 83% (p < 0.05). Conclusions: While first-line treatment effectiveness improved in clinical practice over time, cure rates remain below 90%. Alternative first-line strategies are required in Ireland.
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Open AccessArticle
Microbial Profile and Antibiotic Resistance Patterns in Bile Aspirates from Patients with Acute Cholangitis: A Multicenter International Study
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Matei-Alexandru Cozma, Mihnea-Alexandru Găman, Camelia Cristina Diaconu, Arthur Berger, Frank Zerbib and Radu Bogdan Mateescu
Antibiotics 2025, 14(7), 679; https://doi.org/10.3390/antibiotics14070679 (registering DOI) - 4 Jul 2025
Abstract
Objectives: Significant differences in antibiotic resistance (AR) rates and multi-drug resistant (MDR) bacteria incidence exist in patients with acute cholangitis (AC) from different countries or regions. We aim to characterize and compare the microbial spectrum and AR patterns in patients with AC from
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Objectives: Significant differences in antibiotic resistance (AR) rates and multi-drug resistant (MDR) bacteria incidence exist in patients with acute cholangitis (AC) from different countries or regions. We aim to characterize and compare the microbial spectrum and AR patterns in patients with AC from two tertiary centers in Europe. Methods: We conducted a prospective, observational, multicentric study including patients diagnosed with AC and a positive bile culture, admitted to the Colentina Clinical Hospital (CCH), Bucharest, Romania, and the Haut-Lévêque Hospital (HLH), Bordeaux, France, between April 2022 and October 2023. Results: We included a total of 144 patients from the CCH with 190 positive bile cultures (31 patients had up to five episodes of AC during the study period) and 241 identified microbial strains, and 62 patients from the HLH with 67 positive bile cultures (5 patients had two episodes of AC) and 194 identified microbial strains. The most frequently isolated bacteria were Escherichia coli (30.70%) and Pseudomonas spp. (27.80%) in the CCH group, and Enterococcus faecalis (15.46%) and Escherichia coli (22/11.34%) in the HLH group. Furthermore, 51 (21.16%) of the strains identified in the CCH group and 15 (7.21%) in the HLH group were MDR, such as extended-spectrum beta-lactamase-producing Enterobacteriaceae or carbapenemase-producing Enterobacterales. The resistance rates for common antibiotics were 13.69% in the CCH group vs. 8.76% in the HLH group for ceftriaxone, 9.54% vs. 2.06% for meropenem, 16.59% vs. 6.70% for piperacillin/tazobactam, and 25.31% vs. 7.73% for levofloxacin. Conclusions: This comparative study shows significant differences between these countries in terms of the AR rates and MDR bacteria prevalence, highlighting the role of bile cultures as a safe and cost-effective method for guiding antibiotic treatment, thereby reducing the AR rates and complications.
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(This article belongs to the Special Issue Epidemiological Data on Antibiotic Resistance)
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Mobilome of Environmental Isolates of Clostridioides difficile
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Khald Blau and Claudia Gallert
Antibiotics 2025, 14(7), 678; https://doi.org/10.3390/antibiotics14070678 - 4 Jul 2025
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Background/Objectives: Clostridioides difficile is a “One Health” pathogen and a cause of antibiotics-associated diarrhea and pseudomembranous colitis. Mobile genetic elements (MGEs) have been documented in the genomes of clinical C. difficile strains; however, the presence of MGEs in environmental strains remains poorly characterized.
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Background/Objectives: Clostridioides difficile is a “One Health” pathogen and a cause of antibiotics-associated diarrhea and pseudomembranous colitis. Mobile genetic elements (MGEs) have been documented in the genomes of clinical C. difficile strains; however, the presence of MGEs in environmental strains remains poorly characterized. Thus, the present study was conducted with the objective of identifying the prevalence of MGEs, including mobilizable transposons (MTns), conjugative transposons (CTns), plasmids, and insertion sequences, in whole genome sequences (WGSs) of environmental C. difficile isolates. Methods: The analysis of MGEs was conducted using 166 WGSs obtained from C. difficile strains isolated from various environmental sources contaminated with feces. The MGEs were identified using bioinformatic tools. Results: A total of 48.2% (80/166) of the studied genomes were identified to harbor nine transposons, including Tn916, Tn6194-like, Tn5397, Tn6215, Tn4001, Tn6073, Tn6110, Tn6107, or Tn5801-like. The majority of MTns and CTns could be found within C. difficile sequence types ST11, ST3, and ST35. The results demonstrated close genetic relatedness among the studied genomes, the array of antimicrobial resistance (AMR) genes, such as tetM, ermB, and aac(6′)-aph(2″), and the presence of CTns. Furthermore, the analysis revealed that 24.7% (41/166) of the genome sequences of isolates were associated with various predominant plasmid groups, including pCD6, pCD-ECE4-6, pCD-WTSI1-4, pCDBI1, and pCd1_3, which belonged to 16 different sequence types. Furthermore, several plasmids were identified as harboring the prophage phiCDHM19. Conclusions: The results of the current study suggest that the identified plasmids are abundant and may encode functions that are relevant to C. difficile physiology. The genomes of C. difficile strains examined contain closely related CTns, suggesting that horizontal transfer of AMR is important in this species or other bacterial species. Further research is required to ascertain the effect of these genetic elements and their transferability on the biology of C. difficile.
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Antimicrobial and Antioxidant Activity of Essential Oils from Selected Pinus Species from Bosnia and Herzegovina
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Snježana Mirković, Milica Martinović, Vanja M. Tadić, Ivana Nešić, Aleksandra Stolić Jovanović and Ana Žugić
Antibiotics 2025, 14(7), 677; https://doi.org/10.3390/antibiotics14070677 - 3 Jul 2025
Abstract
Essential oils are lipophilic secondary metabolites produced in various parts of aromatic plants and stored in specialized secretory structures. They play a vital role in plant defense, offering protection against microorganisms and herbivores. These oils are known for a wide range of biological
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Essential oils are lipophilic secondary metabolites produced in various parts of aromatic plants and stored in specialized secretory structures. They play a vital role in plant defense, offering protection against microorganisms and herbivores. These oils are known for a wide range of biological activities, including antibacterial, anti-inflammatory, antitumor, analgesic, antioxidant, and immunomodulatory effects. Given the increasing interest in natural alternatives to synthetic drugs, this review explored the therapeutic relevance of Pinus-derived essential oils as promising candidates in modern phytotherapy. Species of the genus Pinus have been widely investigated for their phytochemical composition and biological potential, with a focus on their medicinal and pharmaceutical applications. This review aimed to assess the biological properties of Pinus species commonly used in traditional medicine. In this paper, thorough insight into the chemical composition, as well as into the antimicrobial and antioxidant activities of essential oils obtained from the different parts of Pinus species, was given. Although recognized for their antimicrobial activity against a wide range of bacterial strains, including both Gram-positive and Gram-negative bacteria, the practical application of Pinus essential oils is often limited by their physicochemical instability and volatility. Therefore, this review highlighted the advances in formulation strategies, particularly encapsulation techniques, as the possible direction of future research concerning essential oils.
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(This article belongs to the Special Issue Antimicrobial and Antioxidant Efficacy of Essential Oils)
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Open AccessArticle
Antibiotic Prescription in Dentistry: Trends, Patient Demographics, and Drug Preferences in Germany
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Lisa Lotta Cirkel, Jens Martin Herrmann, Claudia Ringel, Bernd Wöstmann and Karel Kostev
Antibiotics 2025, 14(7), 676; https://doi.org/10.3390/antibiotics14070676 - 3 Jul 2025
Abstract
Background and objectives: ABs are widely used in dental practice in the treatment of odontogenic infections and as systemic prophylaxis in high-risk patients. However, AB overuse contributes to antimicrobial resistance (AMR), which is a major global concern. This study examined dental AB prescribing
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Background and objectives: ABs are widely used in dental practice in the treatment of odontogenic infections and as systemic prophylaxis in high-risk patients. However, AB overuse contributes to antimicrobial resistance (AMR), which is a major global concern. This study examined dental AB prescribing trends in Germany in 2024, focusing on the share of overall AB prescriptions, patient demographics, and commonly used agents. Methods: This retrospective cross-sectional study used data from the IQVIA Longitudinal Prescription Database (LRx), covering approximately 80% of prescriptions reimbursed by statutory health insurance funds in Germany. Patients with at least one AB prescription (ATC code: J01) issued by a dentist in 2024 were analyzed. Descriptive statistics covered age, sex, and prescribed substances. Results: In 2024, German dentists prescribed ABs to 2,325,500 patients, accounting for 13.9% of all patients in the database who received AB prescriptions. Dentists were the second-largest group of AB prescribers, surpassed only by general physicians. Amoxicillin (54.2%) was most frequently prescribed, followed by amoxicillin with clavulanic acid (24.5%) and clindamycin (21.0%). Dental patients receiving AB prescriptions were older (mean age: 49.8 years) than the general antibiotic patient population (44.7 years). Interestingly, dental AB prescriptions increased during the COVID-19 pandemic, in contrast to the sharp overall decline in AB prescriptions. Between 2015 and 2019, the proportion of dental antibiotic prescriptions showed a moderate upward tendency, followed by a marked increase during the COVID-19 pandemic and a subsequent decline. In contrast, the number of patients receiving antibiotic prescriptions from other medical disciplines decreased over the same period. One particularly notable finding was the extended use of clindamycin, a reserve AB with known side effects and resistance risks, in dentistry. Conclusions: Dentists are responsible for a significant share of AB prescriptions in Germany. The rise in dental AB prescriptions, particularly the frequent prescription of clindamycin, underscores the need for interventions such as updated clinical guidelines and awareness campaigns concerning AB-related risks and their mitigation directed at dentists. These could focus on microbial culture and sensitivity testing and patient adherence education and control for targeted AB interventions. Emphasizing preventive and alternative anti-infective treatment strategies in dentistry may also help to contain AMR.
Full article
(This article belongs to the Special Issue Managing Appropriate Antibiotic Prescribing and Use in Primary Care)
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Open AccessCommunication
Antimicrobial Susceptibility Testing of the Combination of Aztreonam and Avibactam in NDM-Producing Enterobacterales: A Comparative Evaluation Using the CLSI and EUCAST Methods
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Linda Mei-Wah Chan, Doris Yui Ling Lok, River Chun Wai Wong, Alfred Lok-Hang Lee, Ingrid Yu-Ying Cheung, Christopher Koon-Chi Lai and Viola C. Y. Chow
Antibiotics 2025, 14(7), 675; https://doi.org/10.3390/antibiotics14070675 - 3 Jul 2025
Abstract
Background: The combination of aztreonam (ATM) and avibactam (AVI) presents an important therapeutic option for carbapenem-resistant Enterobacterales, particularly the NDM-producing Enterobacterales. In 2024, both the CLSI and EUCAST published their methods in antimicrobial susceptibility testing for this combination of agents.
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Background: The combination of aztreonam (ATM) and avibactam (AVI) presents an important therapeutic option for carbapenem-resistant Enterobacterales, particularly the NDM-producing Enterobacterales. In 2024, both the CLSI and EUCAST published their methods in antimicrobial susceptibility testing for this combination of agents. Materials and Methods: Forty carbapenem-resistant Enterobacterales isolates, including Escherichia coli (n = 35), Enterobacter cloacae complex (n = 2), Klebsiella pneumoniae complex (n = 2), and Citrobacter freundii complex (n = 1) were included in this study. All isolates harbored the NDM carbapenemase except one, which had no known detected carbapenemases. Four antimicrobial susceptibility testing methods of the combination of ATM and AVI were evaluated on these isolates, including the CLSI broth disk elution (BDE) method, the disk diffusion (DD) method of aztreonam–avibactam (AZA) following the EUCAST breakpoints, the MIC test strip (MTS) method of AZA following the EUCAST breakpoints, and the gradient strip stacking (SS) method. BDE was used as the standard of comparison. Results: Using BDE as the standard of comparison, the AZA DD, AZA MTS, and SS methods had 100% categorical agreement (CA), 0% very major error (VME), and 0% major error (ME). The essential agreement (EA) between the AZA MTS and SS method was 57.5%. Conclusions: The AZA DD, AZA MTS, and the SS methods showed complete concordance with the BDE method. However, the MICs obtained from the AZA MTS and SS were not comparable.
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(This article belongs to the Special Issue Present and Future of Antibiotic Treatment for Carbapenem-Resistant Enterobacteriaceae)
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Open AccessReview
Potential Future Applications of Postbiotics in the Context of Ensuring Food Safety and Human Health Improvement
by
Zorica Tomičić, Ljubiša Šarić and Ružica Tomičić
Antibiotics 2025, 14(7), 674; https://doi.org/10.3390/antibiotics14070674 - 3 Jul 2025
Abstract
Postbiotics are defined as non-viable metabolites or compounds produced by probiotic microorganisms with significant impact on human health. The growing interest in postbiotics is supported by numerous studies due to their additional benefits over probiotics that show positive outcomes for specific conditions, as
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Postbiotics are defined as non-viable metabolites or compounds produced by probiotic microorganisms with significant impact on human health. The growing interest in postbiotics is supported by numerous studies due to their additional benefits over probiotics that show positive outcomes for specific conditions, as well as their application as biopreservatives in the food industry. Their potential in functional foods and therapeutic applications is increasingly recognized as they exhibit stability, safety, and diverse biological activities. As for their most important biological roles, postbiotics have been shown to have effective anti-inflammatory, antimicrobial, antioxidant, and anticancer properties, in addition to reducing food allergies. The application of postbiotics in functional foods contributes to improving intestinal health and reducing the risk of foodborne diseases. The concept of postbiotics is relatively new in the food industry. They offer a promising alternative to conventional food preservatives due to their ability to inhibit pathogenic bacteria and extend shelf life. Considering the diversity of postbiotic compounds and their significant biological activities, this review presents and discusses the mechanisms of action and future trends in their application in the food industry and their impact on human health. Increasing research and development in the production and formulation of postbiotics will play a key role in the upward trajectory of the market.
Full article
(This article belongs to the Special Issue Bioactive Natural Products in Antimicrobial Resistance Management)
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Open AccessSystematic Review
Multidrug-Resistant Tuberculosis in Central Asia and Predominant Beijing Lineage, Challenges in Diagnosis, Treatment Barriers, and Infection Control Strategies: An Integrative Review
by
Ulan Kozhamkulov, Sholpan Iglikova, Anar Rakisheva and Joseph Almazan
Antibiotics 2025, 14(7), 673; https://doi.org/10.3390/antibiotics14070673 - 2 Jul 2025
Abstract
Background: Multidrug-resistant tuberculosis (MDR-TB) remains a significant public health threat in Central Asia, where rising resistance to first-line anti-TB drugs challenges control efforts. As of 2024, the World Health Organization (WHO) reports that over 2.5% of new TB cases and 18% of
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Background: Multidrug-resistant tuberculosis (MDR-TB) remains a significant public health threat in Central Asia, where rising resistance to first-line anti-TB drugs challenges control efforts. As of 2024, the World Health Organization (WHO) reports that over 2.5% of new TB cases and 18% of previously treated cases are resistant to first-line TB drugs worldwide. Objectives: This integrative review synthesizes current evidence on MDR-TB in Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan, with a focus on infection control, diagnostic advancements, and evolving treatment strategies. Methods: A comprehensive literature search was conducted across five electronic databases: PubMed, Scopus, Web of Science, Embase, World Health Organization (WHO) Global Tuberculosis Database, and ClinicalTrials.gov. A total of 29 articles from Central Asian countries met the inclusion criteria. Results: Four main themes were identified: “genetic variability and resistance patterns of MDR-TB strains”; “barriers to effective treatment”; “diagnostic tools”, and “infection control strategies”. Conclusions: This review underscores the importance of comprehensive, multifactorial approaches in addressing drug-resistant TB in the region. The implementation of early diagnosis and all-oral treatment regimens has improved adherence in recent studies.
Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Drug-Resistant Mycobacterium tuberculosis)
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Open AccessArticle
Evaluation of a Hub-and-Spoke Model to Enhance Healthcare Professionals’ Practice of Antimicrobial Stewardship (AMS) Programmes in the Volta Region of Ghana
by
Mairead McErlean, Eneyi Kpokiri, Preet Panesar, Emily E. Cooper, Jonathan Jato, Emmanuel Orman, Hayford Odoi, Araba Hutton-Nyameaye, Samuel O. Somuah, Isaac Folitse, Thelma A. Aku, Inemesit O. Ben, Melissa Farragher, Leila Hail, Cornelius C. Dodoo and Yogini H. Jani
Antibiotics 2025, 14(7), 672; https://doi.org/10.3390/antibiotics14070672 - 2 Jul 2025
Abstract
Background: Antimicrobial resistance (AMR) poses a critical global health challenge, particularly in resource-limited settings. A hub-and-spoke model, decentralising expertise and distributing resources to peripheral facilities, has been proposed as a strategy to enhance the antimicrobial stewardship (AMS) capacity in low- and middle-income
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Background: Antimicrobial resistance (AMR) poses a critical global health challenge, particularly in resource-limited settings. A hub-and-spoke model, decentralising expertise and distributing resources to peripheral facilities, has been proposed as a strategy to enhance the antimicrobial stewardship (AMS) capacity in low- and middle-income countries. Aim: This study sought to understand healthcare professionals’ experiences of a hub-and-spoke AMS model in the Volta Region of Ghana and its influence on clinical practice, leadership, and collaborative endeavours to address AMR. Methods: A qualitative descriptive design was adopted. In-depth interviews were conducted with 11 healthcare professionals who participated in the AMS program. Thematic analysis was used to identify key themes related to the knowledge and skills that were gained, clinical and leadership practice changes, capacity building, and challenges. Results: Participants reported an increased awareness of AMR, particularly regarding the scale and clinical implications of antimicrobial misuse. The clinical practice improvements included more judicious prescribing and enhanced adherence to infection prevention and control measures. Many respondents highlighted stronger leadership skills and a commitment to capacity building through AMS committees, multidisciplinary collaboration, and cross-organisational knowledge exchange. Despite resource constraints and logistical hurdles, participants expressed optimism, citing data-driven approaches such as point prevalence surveys to track progress and inform policy. Engagement with hospital management and public outreach were viewed as essential to sustaining AMS efforts and curbing over-the-counter antibiotic misuse. Conclusions: The hub-and-spoke model caused observable improvements in AMS knowledge, clinical practice, and leadership capacity among healthcare professionals in Ghana. While challenges remain, particularly in securing sustainable resources and shifting community behaviours, these findings underscore the potential of network-based programs to catalyse systemic changes in tackling AMR. Future research should explore long-term outcomes and strategies for embedding AMS practices more deeply within healthcare systems and communities.
Full article
(This article belongs to the Special Issue Antibiotics Stewardship in Low and Middle-Income Countries)
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Open AccessArticle
Synthetic Human Lactoferrin Peptide hLF(1-11) Shows Antifungal Activity and Synergism with Fluconazole and Anidulafungin Towards Candida albicans and Various Non-Albicans Candida Species, Including Candidozyma auris
by
Carlo Brouwer, Youp van der Linden, Maria Rios Carrasco, Saleh Alwasel, Tarad Abalkhail, Fatimah O. Al-Otibi, Teun Boekhout and Mick M. Welling
Antibiotics 2025, 14(7), 671; https://doi.org/10.3390/antibiotics14070671 - 2 Jul 2025
Abstract
Introduction: Candidozyma auris (Cz. auris) has emerged globally, and diseases caused by it are associated with a mortality rate of 30–72%. This yeast is often multidrug-resistant and challenging to treat. A synthetic peptide, consisting of 11 amino acids of human lactoferrin
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Introduction: Candidozyma auris (Cz. auris) has emerged globally, and diseases caused by it are associated with a mortality rate of 30–72%. This yeast is often multidrug-resistant and challenging to treat. A synthetic peptide, consisting of 11 amino acids of human lactoferrin (hLF1-11), offers a new therapy that is active against Candida albicans, non-albicans Candida yeasts, as well as Cz. auris. The current study examined the susceptibility of clinically relevant Candida species to hLF(1-11) in vitro and investigated the synergistic interaction of this peptide with fluconazole (FLU) and anidulafungin (ANI). Methods: Susceptibility of the yeasts to hLF(1-11) was tested with a microdilution method to determine minimum inhibitory concentrations (MICs). A total of 59 strains belonging to 16 species of Candida or Candidozyma were tested. The treatment cohort included 20 strains of Cz. auris originating from six different countries. Results: Mean MIC values of all susceptible strains ranged from 16.66 ± 6.46 μg/mL to 45.83 ± 10.21 μg/mL. There were no statistical differences in the susceptibility of hLF(1-11) for Cz. auris across geographic origins. In the combinatory tests, drugs acting together, the fractional inhibitory concentration indexes [FIC] < 1.0, showed a synergistic or additive effect on the efficacy of FLU and ANI when used in combination with hLF(1-11). [FIC] indexes 1–2 were interpreted as intermediate. MIC values in combinatory use were 1–2 titer steps lower than when used alone. Conclusions: hLF(1-11) inhibits the growth of yeasts that belong to the genus Candida, including Cz. auris. The combinatory use may be further investigated to treat infections caused by resistant yeasts.
Full article
(This article belongs to the Special Issue Bioactive Peptides and Their Antibiotic Activity)
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Open AccessReview
Extraintestinal Manifestations of Clostridioides difficile Infections: An Overview
by
Konstantinos Mpakogiannis, Fotios S. Fousekis, Stylianos Elemes, Evangelos Mantellos, Eirini Christaki and Konstantinos H. Katsanos
Antibiotics 2025, 14(7), 670; https://doi.org/10.3390/antibiotics14070670 - 2 Jul 2025
Abstract
Introduction: Clostridioides difficile (C. difficile) is primarily associated with colonic disease, including pseudomembranous colitis. However, in rare instances, it may cause extraintestinal infectious and non-infectious manifestations, particularly in immunocompromised patients or those with significant underlying conditions. Search Methods: A literature review
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Introduction: Clostridioides difficile (C. difficile) is primarily associated with colonic disease, including pseudomembranous colitis. However, in rare instances, it may cause extraintestinal infectious and non-infectious manifestations, particularly in immunocompromised patients or those with significant underlying conditions. Search Methods: A literature review was performed using PubMed, Embase, and Researchgate databases up to 15 February 2025. The following search strings were used: “extraintestinal manifestations”, “extracolonic manifestations”, “extraintestinal infections”, “extracolonic infections”, “Clostridium difficile”, and “Clostridioides difficile”. Results: Extraintestinal manifestations of C. difficile appear to represent fewer than 1% of all reported infections. The most frequently reported infectious complications include bacteremia and abdominopelvic infections and abscesses, often involving polymicrobial cultures, with the isolation of C. difficile alongside microorganisms typically found in the normal intestinal microbiota. Rare non-infectious cases, such as reactive arthritis, have also been described. The underlying pathogenetic mechanism is believed to involve disruption of the intestinal barrier and translocation of bacteria or toxins to sterile sites. Conclusions: Though rare, extraintestinal C. difficile manifestations pose important clinical challenges. Better understanding of their mechanisms is essential for early recognition and appropriate management. Further research is warranted to define potential mechanisms and therapeutic approaches.
Full article
(This article belongs to the Special Issue Emerging Topics in Clostridioides difficile Infection: A One Health Problem)
Open AccessArticle
Antimicrobial Resistance in the Aconcagua River, Chile: Prevalence and Characterization of Resistant Bacteria in a Watershed Under High Anthropogenic Contamination Pressure
by
Nicolás González-Rojas, Diego Lira-Velásquez, Richard Covarrubia-López, Johan Plaza-Sepúlveda, José M. Munita, Mauricio J. Carter and Jorge Olivares-Pacheco
Antibiotics 2025, 14(7), 669; https://doi.org/10.3390/antibiotics14070669 - 2 Jul 2025
Abstract
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Background: Antimicrobial resistance (AMR) is a growing global health concern, driven in part by the environmental release of antimicrobial-resistant bacteria (ARB) and antimicrobial resistance genes (ARGs). Aquatic systems, particularly those exposed to urban, agricultural, and industrial activity, are recognized as hotspots for
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Background: Antimicrobial resistance (AMR) is a growing global health concern, driven in part by the environmental release of antimicrobial-resistant bacteria (ARB) and antimicrobial resistance genes (ARGs). Aquatic systems, particularly those exposed to urban, agricultural, and industrial activity, are recognized as hotspots for AMR evolution and transmission. In Chile, the Aconcagua River—subject to multiple anthropogenic pressures—offers a representative model for studying the environmental dimensions of AMR. Methods: Thirteen surface water samples were collected along the Aconcagua River basin in a single-day campaign to avoid temporal bias. Samples were filtered through 0.22 μm membranes and cultured on MacConkey agar, either unsupplemented or supplemented with ceftazidime (CAZ) or ciprofloxacin (CIP). Isolates were purified and identified using MALDI-TOF mass spectrometry. Antibiotic susceptibility was evaluated using the Kirby–Bauer disk diffusion method in accordance with CLSI guidelines. Carbapenemase activity was assessed using the Blue-Carba test, and PCR was employed for the detection of the blaVIM, blaKPC, blaNDM, and blaIMP genes. Results: A total of 104 bacterial morphotypes were isolated; 80 were identified at the species level, 5 were identified at the genus level, and 19 could not be taxonomically assigned using MALDI-TOF. Pseudomonas (40 isolates) and Aeromonas (25) were the predominant genera. No growth was observed on CIP plates, while 24 isolates were recovered from CAZ-supplemented media, 87.5% of which were resistant to aztreonam. Five isolates exhibited resistance to carbapenems; two tested positive for carbapenemase activity and carried the blaVIM gene. Conclusions: Our results confirm the presence of clinically significant resistance mechanisms, including blaVIM, in environmental Pseudomonas spp. from the Aconcagua River. These findings highlight the need for environmental AMR surveillance and reinforce the importance of adopting a One Health approach to antimicrobial stewardship and wastewater regulation.
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Open AccessArticle
Transcriptomic Analysis of Biofilm Formation Inhibition by PDIA Iminosugar in Staphylococcus aureus
by
Anna Tomusiak-Plebanek, Łucja Kozień, Estelle Gallienne, Maciej Florczyk, Sławomir Ciesielski, Piotr Heczko and Magdalena Strus
Antibiotics 2025, 14(7), 668; https://doi.org/10.3390/antibiotics14070668 - 1 Jul 2025
Abstract
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Background: Iminosugars are natural or synthetic sugar analogues with a very broad spectrum of activities, including those against the most prominent bacterial pathogens, like P. aeruginosa or S. aureus. In a series of studies, we have demonstrated that one of the synthetic iminosugars,
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Background: Iminosugars are natural or synthetic sugar analogues with a very broad spectrum of activities, including those against the most prominent bacterial pathogens, like P. aeruginosa or S. aureus. In a series of studies, we have demonstrated that one of the synthetic iminosugars, PDIA (beta-1-C-propyl-1,4-dideoxy-1,4-imino-L-arabinitol), possesses the ability to suppress biofilm production by different pathogenic bacteria without inhibiting their growth. Thereby, PDIA is able to influence experimental skin infection caused by S. aureus. Methods: To elucidate molecular mechanisms by which PDIA impedes biofilm formation by S. aureus, a transcriptomic study was performed in which a biofilm-producing S. aureus strain was grown in the presence of PDIA for 24 and 48 h in comparison to a control without the iminosugar. The RNA was then isolated, converted into cDNA, sequenced, and data analysis was performed. Results: It appeared that PDIA caused the down-regulation of many bacteriophage genes responsible for the processes of bacterial cell lysis, and some genes responsible for cell wall degradation were also down-regulated. Among the 25 most upregulated genes were those representing the phosphotransferase system (PTS), which is required for carbohydrate uptake and control of carbon metabolism. The ranking of the most significant down-regulated genes after 24 h exposure to PDIA shows that they predominantly coded for both the synthesis and lysis of the peptidoglycan. Conclusions: We have shown here that the influence of PDIA on the expression of S. aureus genes is broad and affects many genes encoding metabolism and ribosomes.
Full article

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Open AccessArticle
Genomic and Functional Characterization of Multidrug-Resistant E. coli: Insights into Resistome, Virulome, and Signaling Systems
by
Vijaya Bharathi Srinivasan, Naveenraj Rajasekar, Karthikeyan Krishnan, Mahesh Kumar, Chankit Giri, Balvinder Singh and Govindan Rajamohan
Antibiotics 2025, 14(7), 667; https://doi.org/10.3390/antibiotics14070667 - 30 Jun 2025
Abstract
Introduction: Genetic plasticity and adaptive camouflage in critical pathogens have contributed to the global surge in multidrug-resistant (MDR) infections, posing a serious threat to public health and therapeutic efficacy. Antimicrobial resistance, now a leading cause of global mortality, demands urgent action through diagnostics,
[...] Read more.
Introduction: Genetic plasticity and adaptive camouflage in critical pathogens have contributed to the global surge in multidrug-resistant (MDR) infections, posing a serious threat to public health and therapeutic efficacy. Antimicrobial resistance, now a leading cause of global mortality, demands urgent action through diagnostics, vaccines, and therapeutics. In India, the Indian Council of Medical Research’s surveillance network identifies Escherichia coli as a major cause of urinary tract infections, with increasing prevalence in human gut microbiomes, highlighting its significance across One Health domains. Methods: Whole-genome sequencing of E. coli strain ECG015, isolated from a human gut sample, was performed using the Illumina NextSeq platform. Results: Genomic analysis revealed multiple antibiotic resistance genes, virulence factors, and efflux pump components. Phylogenomic comparisons showed close relatedness to pathovars from both human and animal origins. Notably the genome encoded protein tyrosine kinases (Etk/Ptk and Wzc) and displayed variations in the envelope stress-responsive CpxAR two-component system. Promoter analysis identified putative CpxR-binding sites upstream of genes involved in resistance, efflux, protein kinases, and the MazEF toxin–antitoxin module, suggesting a potential regulatory role of CpxAR in stress response and persistence. Conclusions: This study presents a comprehensive genomic profile of E. coli ECG015, a gut-derived isolate exhibiting clinically significant resistance traits. For the first time, it implicates the CpxAR two-component system as a potential central regulator coordinating antimicrobial resistance, stress kinase signaling, and programmed cell death. These findings lay the groundwork for future functional studies aimed at targeting stress-response pathways as novel intervention strategies against antimicrobial resistance.
Full article
(This article belongs to the Special Issue Genomic Analysis of Drug-Resistant Pathogens)

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