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) and Northern Greece Society of Medical Biopathology (EIBBE) are affiliated with Antibiotics, and their 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 16.4 days after submission; acceptance to publication is undertaken in 2.8 days (median values for papers published in this journal in the second 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
Antibiotic-Free Hypothermic Storage of Boar Semen at 5 °C with Next-Day On-Farm Cooling: Fertility and Biosafety Under Field Conditions
Antibiotics 2026, 15(5), 490; https://doi.org/10.3390/antibiotics15050490 (registering DOI) - 12 May 2026
Abstract
Background: Antibiotic-free approaches to boar semen preservation are gaining importance to counter emerging antimicrobial resistance. Hypothermic storage at 5 °C, instead of the conventional 17 °C, is a promising strategy to eliminate antibiotics still commonly used in extenders. For practical adoption, the
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Background: Antibiotic-free approaches to boar semen preservation are gaining importance to counter emerging antimicrobial resistance. Hypothermic storage at 5 °C, instead of the conventional 17 °C, is a promising strategy to eliminate antibiotics still commonly used in extenders. For practical adoption, the method must be simple and compatible with on-farm routines. Objective: To assess fertility when cooling was initiated on farm one day after delivery, and to evaluate the robustness of cold-stored semen to temporary warming and subsequent re-cooling, mimicking typical handling on insemination days. Methods: Individual ejaculates (n = 34) from six boars were extended in Androstar® Premium either without antibiotics (5 °C) or with gentamicin (17 °C control). One day after collection, antibiotic-free doses were cooled on farm to 5 °C and used alongside controls in routine insemination of 270 sows. Sperm quality was evaluated by computer-assisted semen analysis and flow cytometry, and bacterial counts were monitored. In a separate test, cold-stored doses were exposed to 20 °C for 60 min and re-cooled to 5 °C. Results: Farrowing rates and litter sizes did not differ between groups (p > 0.05). In antibiotic-free samples after 120 h, bacterial counts were mostly not detectable or low (<102 CFU/mL). Sperm motility and plasma membrane integrity in cold-stored doses remained >80%, comparable to controls (p > 0.05). Temporary warming did not affect sperm quality or bacterial counts. Conclusions: Antibiotic-free semen storage at 5 °C is easy to implement in practice and maintains fertility under field conditions. Broader validation under routine conditions is encouraged in support of the One Health concept.
Full article
Open AccessArticle
Effects of Different Zinc Modulations in Glass Ionomer Cements on Multi-Species Biofilm Formation and Human Tooth Demineralization: An In Vitro Study
by
İpek Ören Bozyer, Khairul Matin, Tijen Pamir, Sema Belli and Yasushi Shimada
Antibiotics 2026, 15(5), 489; https://doi.org/10.3390/antibiotics15050489 (registering DOI) - 12 May 2026
Abstract
Background: Biofilm formation and associated tooth demineralization are key factors influencing the clinical performance of dental materials. Methods: This study compared the antibiofilm and demineralization preventive effects of two zinc-modified glass ionomer cements (Zn-GICs) with a conventional GIC. Disk-shaped specimens of Caredyne Restore
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Background: Biofilm formation and associated tooth demineralization are key factors influencing the clinical performance of dental materials. Methods: This study compared the antibiofilm and demineralization preventive effects of two zinc-modified glass ionomer cements (Zn-GICs) with a conventional GIC. Disk-shaped specimens of Caredyne Restore (CR), ChemFil Rock (CFR), and Ketac Molar (KM) (n = 6) were evaluated in a multi-species biofilm model using an oral biofilm reactor. Early biofilm formation was analyzed by scanning electron microscopy (after 2 h and 4 h), bacterial accumulation and water-insoluble glucan (WIG) production were quantified (after 12 h). For demineralization assessment, restored human enamel and dentin specimens (n = 6) including an additional resin-based control group (Dura Seal, DS) were subjected to a 14-day biofilm challenge and lesion depth was measured using swept-source optical coherence tomography and confocal microscopy. Results: CR showed significantly lower bacterial accumulation and WIG production than the other materials (p < 0.05). CFR demonstrated lower bacterial levels than KM (p < 0.05), whereas no significant differences were observed between CFR and KM in WIG production (p > 0.05). CR produced the shallowest enamel and dentin lesions, whereas DS exhibited the deepest (p < 0.05); however, no statistically significant differences were observed between CFR and KM in lesion depth (p > 0.05). Conclusions: CR demonstrated superior biofilm suppression and reduced demineralization, whereas CFR showed limited differences compared with the conventional GIC.
Full article
(This article belongs to the Special Issue Antimicrobial Activity of Medical Materials, 2nd Edition)
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Open AccessArticle
Acanthamoeba Keratitis: 34-Year Epidemiological Profile
by
Saad H. AlEnezi, Shaimaa Mohammed Alrefaie, Adi Mohammed Al Owaifeer, Hani Basher AlBalawi, Naif Mamdouh Alali, Mohammad Alabduljabbar, Shaker O. Alreshidi, Moustafa S. Magliyah, Entesar A. Altalhi, Shaima Sulaiman Alharbi, Abdulaziz S. Alharthi, Yousef A. Alotaibi and Saad S. Alharbi
Antibiotics 2026, 15(5), 488; https://doi.org/10.3390/antibiotics15050488 (registering DOI) - 12 May 2026
Abstract
Background/Objectives: Acanthamoeba keratitis (AK) is a rare but sight-threatening corneal infection. This study reviews the clinical profile, diagnostic pathways, treatment strategies, and outcomes of AK cases managed over a 34-year period. Methods: We conducted a retrospective analysis of 52
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Background/Objectives: Acanthamoeba keratitis (AK) is a rare but sight-threatening corneal infection. This study reviews the clinical profile, diagnostic pathways, treatment strategies, and outcomes of AK cases managed over a 34-year period. Methods: We conducted a retrospective analysis of 52 microbiologically AK cases from 1983 to 2017. Results: The mean age at presentation was 27.7 ± 9.4 years, with a female predominance (63.5%). The majority (82.7%) were contact lens users, almost exclusively soft lens wearers, with documented risk behaviors such as poor hygiene and sleeping with lenses. 44.2% were initially misdiagnosed as nonspecific microbial keratitis. Common clinical findings included epithelial defects (30.8%), ring infiltrates (44.2%), superficial infiltrates (53.8%), hypopyon (30.8%), and corneal thinning (13.5%). Diagnosis was confirmed by culture/stain in 61.5% of cases, while others required confocal microscopy or corneal biopsy. Co-infections with bacteria were noted in ~20%. Prior to referral, 82.7% of patients had received empirical topical therapy. At KKESH, all received dual anti-Acanthamoeba therapy, and 69.2% underwent surgical intervention, including tectonic PKP (46.2%) and optical PKP (19.2%). Visual acuity improved from a mean logMAR of 1.51 at presentation to 0.87 at last follow-up. Anti-Acanthamoeba therapy was discontinued in 95.9% of patients by the end of follow-up, with steroid use tapering from 61.5% at 3 months to 16.3% at final visit. Conclusions: Acanthamoeba keratitis in Saudi Arabia predominantly affects young female contact lens users and often presents with diagnostic delays and misclassification as herpetic or bacterial keratitis. Despite aggressive medical and surgical therapy, visual outcomes remain suboptimal in many cases.
Full article
(This article belongs to the Special Issue Antimicrobial Treatment and Antibiotic Use in Ophthalmology)
Open AccessArticle
Pet Birds as Potential Reservoirs of Antimicrobial-Resistant Bacteria in Digestive and Respiratory Infections
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Smaranda Crăciun, Maria Carmen Turcu, Cristiana Ştefania Novac, Nicodim Iosif Fiţ, Cosmina Maria Bouari, Sorin Răpuntean, Mălina Lorena Mihu and George Cosmin Nadăş
Antibiotics 2026, 15(5), 487; https://doi.org/10.3390/antibiotics15050487 (registering DOI) - 12 May 2026
Abstract
Background/Objectives: Pet birds are increasingly recognized as potential reservoirs of zoonotic and antimicrobial-resistant bacteria, raising concerns within the One Health framework. However, data on bacterial diversity and resistance profiles in clinically affected ornamental birds remain limited. Methods: This study, conducted over three years
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Background/Objectives: Pet birds are increasingly recognized as potential reservoirs of zoonotic and antimicrobial-resistant bacteria, raising concerns within the One Health framework. However, data on bacterial diversity and resistance profiles in clinically affected ornamental birds remain limited. Methods: This study, conducted over three years (November 2022–March 2026), included 198 pet birds presenting with digestive and respiratory disorders. From these birds, clinical samples were analyzed bacteriologically; resulting isolates were identified by MALDI-TOF mass spectrometry, and antimicrobial susceptibility assessed using the Kirby-Bauer disk diffusion method according to EUCAST and CLSI guidelines. Results: Bacterial growth was detected in 87.9% of cases, yielding 249 distinct isolates. Gram-positive cocci predominated (62.3%), led by Staphylococcus spp. (33.3%) and Enterococcus spp. (9.6%), while Escherichia coli (9.2%) was the primary Gram-negative species. At the genus level, Staphylococcus spp. demonstrated high susceptibility to amikacin (88.5%) but significant resistance to gentamicin (75.6%) and oxytetracycline (63.6%). In contrast, Escherichia spp. isolates were largely resistant, showing only 50% susceptibility to enrofloxacin and 40% to doxycycline, with resistance to tylosin reaching 90%. Overall, 57% of isolates were multidrug-resistant, with Staphylococcus spp. contributing most to this burden. Conclusions: These findings characterize clinically ill pet birds as significant carriers of multidrug-resistant bacteria, highlighting the need for routine diagnostics and improved antimicrobial stewardship in avian medicine.
Full article
(This article belongs to the Special Issue Detection of Bacteria and Antimicrobial Resistance in Clinical Infections)
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Open AccessArticle
Temporal Trends in Carbapenem-Resistant Acinetobacter baumannii Isolation Rates at a Regional Hospital in Central Taiwan, 2020–2024
by
Ying-Ju Chen and Tze-Kiong Er
Antibiotics 2026, 15(5), 486; https://doi.org/10.3390/antibiotics15050486 (registering DOI) - 11 May 2026
Abstract
Background/Objectives: Carbapenem-resistant Acinetobacter baumannii (CRAB) is a priority nosocomial pathogen with limited therapeutic options and high attributable mortality, particularly in intensive care units (ICUs). Whether the pandemic-era rise in institutional CRAB burden resolved, persisted, or stabilized at a sustained high level remains
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Background/Objectives: Carbapenem-resistant Acinetobacter baumannii (CRAB) is a priority nosocomial pathogen with limited therapeutic options and high attributable mortality, particularly in intensive care units (ICUs). Whether the pandemic-era rise in institutional CRAB burden resolved, persisted, or stabilized at a sustained high level remains incompletely characterized at the single-hospital level. Methods: We conducted a retrospective observational study of all non-duplicate clinical A. baumannii complex isolates recovered at a 450-bed regional teaching hospital in central Taiwan between January 2020 and December 2024. Isolates were classified as CRAB based on non-susceptibility (intermediate or resistant) to imipenem or meropenem. Annual and monthly isolation rates, ICU versus non-ICU distribution, and temporal trends were analyzed. Results: Among 582 A. baumannii complex isolates, 340 (58.4%) were classified as CRAB. The annual CRAB isolation rate differed significantly across the study period (p = 0.0099), rising sharply from 44.0% (51/116) in 2020 to 63.9% (76/119) in 2021 and subsequently remaining between 58.3% (60/103) and 63.2% (67/106) through 2024. Monthly isolation rates varied widely (16.7–100.0%) without a consistent seasonal pattern. The proportion of CRAB isolates originating from ICU settings varied year to year, rising from 45.1% (23/51) in 2020 to a peak of 67.4% (58/86) in 2022 and then declining to 49.3% (33/67) in 2024, without a statistically significant overall trend (p = 0.054). Conclusions: These findings suggest that CRAB isolation rates remained at a sustained elevated level after the acute pandemic phase and highlight ICUs as an important focus for institution-level infection prevention and antimicrobial stewardship efforts.
Full article
(This article belongs to the Special Issue Antibiotic Resistance: From the Bench to Patients, 2nd Edition)
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Open AccessArticle
Bayesian Estimation of Vancomycin Exposure and Population Pharmacokinetics in Obese Patients
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Ha-Jin Chun, Hyeon Gyeom Choi, Eun Sook Bang, Jin Ok Kyun, Young Rong Kim, Eun Jin Kim and So Hee Kim
Antibiotics 2026, 15(5), 485; https://doi.org/10.3390/antibiotics15050485 (registering DOI) - 11 May 2026
Abstract
Background/Objectives: This study compared the pharmacokinetic (PK)/pharmacodynamic (PD) targets of vancomycin in obese patients using two Bayesian programs to evaluate the accuracy and bias of these estimates. Additionally, population pharmacokinetics in obese patients were compared with those in the general patient population.
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Background/Objectives: This study compared the pharmacokinetic (PK)/pharmacodynamic (PD) targets of vancomycin in obese patients using two Bayesian programs to evaluate the accuracy and bias of these estimates. Additionally, population pharmacokinetics in obese patients were compared with those in the general patient population. Methods: Medical records of obese adults [body mass index (BMI) ≥ 30 kg/m2] treated with vancomycin at Ajou University Hospital between 2010 and 2017 were retrospectively reviewed. Patients with peak (Cpeak) and trough (Ctrough) concentrations were included. Vancomycin area under the plasma concentration-time curve (AUC) and Ctrough were estimated using Capcil (ver 6.31) and MwPharm (ver 2.3.1.89) software. Accuracy and bias were analyzed, and population PK parameters were evaluated. Results: A total of 149 cases were analyzed. AUC estimates from one-point sampling using Capcil were significantly lower than the reference values, whereas MwPharm produced estimates closer to the reference with higher accuracy and lower bias. Ctrough estimates from one-point sampling showed high accuracy for both programs. Obese patients exhibit lower volume of distribution, higher total body clearance, and shorter elimination half-life than the general patient population. Conclusions: Vancomycin pharmacokinetics differ in obese patients. Bayesian analysis using MwPharm showed AUC and Ctrough estimates that were closer to the reference values and exhibited lower bias than those obtained with Capcil in this dataset. These findings may support more informed dosing decisions for vancomycin in obese patients.
Full article
(This article belongs to the Section Pharmacokinetics and Pharmacodynamics of Drugs)
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Open AccessArticle
Conjugation of Antibiotics to Peptidomimetics Enhances Antimicrobial Spectrum of Activity
by
Joshua Fleming, Nathan James Carey, Yao Cheng, Hao Luo, Tsz Tin Yu, Mark D. P. Willcox, David StC Black, Edgar H. H. Wong and Naresh Kumar
Antibiotics 2026, 15(5), 484; https://doi.org/10.3390/antibiotics15050484 (registering DOI) - 11 May 2026
Abstract
Background/Objectives: Antimicrobial conjugates have attracted considerable interest in addressing the threat of antimicrobial resistance by minimising the likelihood of resistance onset. Antimicrobial peptide mimic–antibiotic conjugates offer a unique strategy to revitalise current clinical agents through increased membrane permeabilisation, prolonging the longevity of traditional
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Background/Objectives: Antimicrobial conjugates have attracted considerable interest in addressing the threat of antimicrobial resistance by minimising the likelihood of resistance onset. Antimicrobial peptide mimic–antibiotic conjugates offer a unique strategy to revitalise current clinical agents through increased membrane permeabilisation, prolonging the longevity of traditional antibiotics while broadening the spectrum of activity of the AMP mimic. Methods: This study explored non-cleavable, enzyme-cleavable, and pH-cleavable linked conjugates between an anthranilamide-based peptide mimic and current clinically available antibiotics to assess the viability of conjugation in enhancing antimicrobial activity as measured through MIC assays. Cleavage studies were conducted to assess the stimulus susceptibility of relevant compounds. Results: Four amide-linked non-cleavable conjugates were synthesised. Of these, a primary amide-linked conjugate between ciprofloxacin and the peptidomimetic had the most significant activity with an MIC of 15.6 µM towards Gram-positive Staphylococcus aureus and Gram-negative Pseudomonas aeruginosa, and an MIC of 7.8 µM towards Gram-negative Escherichia coli. A hydrazone-based pH-sensitive linker system was synthesised and had an MIC of 15.6 µM towards Gram-negative E. coli. Finally, an enzyme-cleavable cephalosporin conjugate system was investigated, which offered a unique method for the specific treatment of resistant bacterial strains. Cleavage studies of this conjugate suggested rapid degradation of the β-lactam ring and release of the subunit. Conclusions: This work presents conjugate systems between peptide mimics and antibiotics as a new, promising strategy to broaden the antimicrobial spectrum of novel antimicrobial agents.
Full article
(This article belongs to the Special Issue Multitalented Synthetic Antimicrobial Compounds: From Design to Effect)
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Open AccessArticle
Virulence and Antimicrobial Resistance Traits of Escherichia coli Retrieved from Fermented Dairy Products During Ramadan in Egypt: Seasonal Public Health Implications
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Fatma Elzhraa, Gabriella Kiskó and Ágnes Belák
Antibiotics 2026, 15(5), 483; https://doi.org/10.3390/antibiotics15050483 (registering DOI) - 9 May 2026
Abstract
Background: Rayeb milk and yogurt provide lasting energy and maintain hydration during fasting. The surge in demand during Ramadan (the holiest month of the year across the Islamic world) increases production to meet consumer needs, potentially compromising strict adherence to safety standards. Data
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Background: Rayeb milk and yogurt provide lasting energy and maintain hydration during fasting. The surge in demand during Ramadan (the holiest month of the year across the Islamic world) increases production to meet consumer needs, potentially compromising strict adherence to safety standards. Data on the prevalence and characterization of Escherichia coli (E. coli) in fermented dairy products during Ramadan, a model of increased batch turnover, remain to be investigated. Objectives: This study aimed to identify the AMR profile and molecularly characterize the AMR and virulence traits of E. coli isolates prevalent in fermented milk products. Methods: A total of 34 E. coli isolates, representing eight distinct serotypes, were recovered from 150 fermented milk samples; rayeb milk (n = 75) and yogurt (n = 75) collected from densely populated towns in the Dakahlia Governorate, Egypt. Results: The most prevalent serotypes were O153:H2, O125:H21, and O119:H6, followed by O111:H2, O26:H11, and O127:H6. The virulence genes stx1 and stx2 were detected in 76.47% of isolates, while eaeA and hlyA were found in O26:H11, O119:H6, and O55:H7 serotypes. In total, 73.53% (25/34) of E. coli isolates were classified as MDR, while 26.47% (9/34) exhibited XDR. Resistance was most prevalent against penicillin, tetracycline, ciprofloxacin, ampicillin, kanamycin, chloramphenicol, and trimethoprim. The kan, dfrA, blaOXA-1, tetA(A), and van(A) AMR genes were positive in 70.59%, 67.65%, 61.76%, 100%, and 47.06% of isolates, respectively. Conclusions: Identified E. coli AMR and virulence panels reflect that production pressure can challenge strict adherence to hygiene control measures and cold-chain maintenance. Subsequently, authorities must enforce proper quality assurance protocols to minimize the risk of food poisoning.
Full article
(This article belongs to the Special Issue Microbial Resistance Surveillance and Management in Food Systems)
Open AccessReview
Infective Endocarditis: A Contemporary Review of Epidemiology, Diagnosis, and Management
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Angela Ishak, Yusuf Kamran Qadeer, Mousa Mahmoud AlRawashdeh, Bing Yue, Muzamil Khawaja, Markus Strauss and Chayakrit Krittanawong
Antibiotics 2026, 15(5), 482; https://doi.org/10.3390/antibiotics15050482 (registering DOI) - 9 May 2026
Abstract
Infective endocarditis (IE) is an uncommon but life-threatening condition characterized by infection and inflammation of the endocardial surface of the heart, most commonly affecting native or prosthetic valves. Recent data indicate in-hospital mortality rates ranging from 15% to 25%, with evidence of increasing
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Infective endocarditis (IE) is an uncommon but life-threatening condition characterized by infection and inflammation of the endocardial surface of the heart, most commonly affecting native or prosthetic valves. Recent data indicate in-hospital mortality rates ranging from 15% to 25%, with evidence of increasing mortality even in high-income countries. Beyond its fatal potential, IE poses a major public health burden, accounting for over 1.7 million disability-adjusted life years (DALYs) globally in 2019. This review aims to discuss recent advancements in the diagnosis and management of IE given the shifting epidemiology and pathogen profile of the disease. There is a rising incidence of healthcare-associated IE and an expanding population of vulnerable patients, including the elderly and those with prosthetic material or indwelling catheters. Diagnostic capabilities have rapidly advanced with the adoption of modalities such as 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), cardiac CT, and cardiac magnetic resonance (CMR), particularly in patients with prosthetic valve endocarditis or culture-negative presentations. Additionally, the expanding indications for surgical intervention and increasing antimicrobial resistance have added complexity to management decisions. These developments underscore the need for a comprehensive review to support healthcare providers in navigating the modern diagnostic and therapeutic landscape of IE.
Full article
(This article belongs to the Special Issue Advances in Infective Endocarditis Research: From Bench to Bedside)
Open AccessArticle
Microbiological Patterns in Periprosthetic Knee Infections over a Decade: Analysis of Resistance Patterns, Temporal Trends, and Patient Residence
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Marcos González-Alonso, Alfonso Lajara-Heredia, Adrián Guerra-González, Vega Villar-Suárez and Jaime Antonio Sánchez-Lázaro
Antibiotics 2026, 15(5), 481; https://doi.org/10.3390/antibiotics15050481 (registering DOI) - 9 May 2026
Abstract
Background: Infection following total knee arthroplasty (TKA) is a challenging complication. Optimal empirical antibiotic therapy and surgical management hinge on up-to-date knowledge of local pathogen distribution and resistance patterns. However, few studies have examined whether geographical factors, specifically rural versus urban residence, influence
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Background: Infection following total knee arthroplasty (TKA) is a challenging complication. Optimal empirical antibiotic therapy and surgical management hinge on up-to-date knowledge of local pathogen distribution and resistance patterns. However, few studies have examined whether geographical factors, specifically rural versus urban residence, influence the microbiology or clinical outcomes of periprosthetic joint infection (PJI) within integrated healthcare systems. The goal of this study was to assess the temporal evolution of bacterial species and antimicrobial resistance in knee PJI over an 11-year period. As a secondary objective, we wanted to evaluate the potential impact of patient residence on microbiological trends and treatment success. Methods: We conducted a retrospective analysis of all patients diagnosed with knee PJI who underwent surgical treatment between 2013 and 2023 at our center. Infections were classified as acute postoperative, acute hematogenous, or chronic. Patient residence was categorized as rural (<5000 inhabitants) or urban. Temporal trends were modeled using Poisson regression, and comparisons between subgroups were performed using Fisher’s exact test and Student’s t-test. Results: A total of 98 patients were analyzed, with 99 microorganisms identified. Gram-positive organisms predominated (72.3%), with Staphylococcus aureus (33.3%) and Coagulase-negative Staphylococci (CoNS) (29.3%) as the most frequent isolates. Resistance to vancomycin was not detected in S. aureus isolates. However, CoNS demonstrated high resistance to fluoroquinolones (55.2%) and rifampicin (20.7%). No significant annual shifts were observed for Gram-positive (IRR = 0.94; 95% CI: 0.86–1.03; p = 0.413) or Gram-negative cases (IRR = 0.75; 95% CI: 0.53–1.05; p = 0.086). Comparing rural versus urban populations, no differences were found in microbiological profiles (Fisher’s exact test, all p > 0.05). Furthermore, clinical treatment success rates were comparable (Rural 69.4% vs. Urban 63.0%, p = 0.500), despite a significantly higher prevalence of diabetes mellitus in rural patients (34.7% vs. 10.2%, p = 0.007). Conclusions: The microbiological landscape of knee PJI has remained stable, with no emergence of multidrug-resistant S. aureus. In our setting, standardized management protocols appeared to be equally effective regardless of patient residence. However, given the single-center nature and sample size of this study, broader multicenter validation is required before these findings can be generalized.
Full article
(This article belongs to the Special Issue Periprosthetic Joint Infection: Understanding the Epidemiology, Pathogenesis, Diagnosis and Treatment Options)
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Open AccessBrief Report
Isolation of a Methicillin-Resistant Staphylococcus pseudintermedius Strain from a Domestic Dog with Vulvovaginitis: A Potential Public Health Concern?
by
Lorenzo Pace, Valeria Rondinone, Laura Del Sambro, Viviana Manzulli, Stefano Castellana, Luigina Serrecchia, Angelica Bianco, Beatrice Maffei, Leonardo Marino, Antonio Petrella and Domenico Galante
Antibiotics 2026, 15(5), 480; https://doi.org/10.3390/antibiotics15050480 (registering DOI) - 9 May 2026
Abstract
Background: Staphylococcus pseudintermedius is a major opportunistic pathogen of dogs and the primary cause of canine pyoderma and other infections. The global emergence of methicillin-resistant S. pseudintermedius (MRSP) represents a significant challenge in veterinary medicine due to its frequent multidrug-resistant phenotype and
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Background: Staphylococcus pseudintermedius is a major opportunistic pathogen of dogs and the primary cause of canine pyoderma and other infections. The global emergence of methicillin-resistant S. pseudintermedius (MRSP) represents a significant challenge in veterinary medicine due to its frequent multidrug-resistant phenotype and limited therapeutic options. Methods: We describe the phenotypic and genomic characterization of an MRSP isolate recovered from a vaginal swab of an 11-year-old dog diagnosed with vulvovaginitis in southern Italy. Antimicrobial susceptibility testing was performed using broth microdilution according to CLSI VET01S guidelines. Whole-genome sequencing was conducted to determine sequence type and antimicrobial resistance determinants. Results: The isolate was identified as S. pseudintermedius by MALDI-TOF MS and confirmed by genomic analysis. Multilocus sequence typing assigned the strain to sequence type ST2333. Phenotypically, the isolate exhibited multidrug resistance, including resistance to β-lactams, macrolides, lincosamides, tetracyclines, aminoglycosides, fluoroquinolones, and trimethoprim–sulfamethoxazole, while remaining susceptible to amikacin, rifampicin, florfenicol, and vancomycin. Whole-genome sequencing confirmed the presence of mecA and additional resistance determinants consistent with the observed phenotype. Conclusions: This report suggests the possible occurrence of an MDR MRSP ST2333 lineage in southern Italy and highlights the importance of combined phenotypic and genomic surveillance to support antimicrobial stewardship in veterinary medicine within a One Health framework.
Full article
(This article belongs to the Special Issue Epidemiology of Antimicrobial-Resistant Pathogens in Animals: A One Health Perspective)
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Open AccessArticle
Contrasting In Vitro Activity of Nitroxoline Against Multidrug-Resistant Escherichia coli and Klebsiella pneumoniae Isolates from Outpatients
by
Dominik Maleš, Zvonimir Barišić, Darko Kero and Merica Carev
Antibiotics 2026, 15(5), 479; https://doi.org/10.3390/antibiotics15050479 - 8 May 2026
Abstract
Background/Objectives: Antimicrobial resistance is a major public health concern, particularly among multidrug-resistant (MDR) Enterobacterales. Nitroxoline is an older antibiotic with a unique mechanism of action that has not been widely used in recent decades. This study aimed to evaluate the in vitro
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Background/Objectives: Antimicrobial resistance is a major public health concern, particularly among multidrug-resistant (MDR) Enterobacterales. Nitroxoline is an older antibiotic with a unique mechanism of action that has not been widely used in recent decades. This study aimed to evaluate the in vitro activity of nitroxoline against Extended-Spectrum Beta-Lactamase (ESBL)-producing Escherichia coli (E. coli) and MDR Klebsiella pneumoniae (K. pneumoniae) isolated from urine samples of outpatients in Split-Dalmatia County, Croatia. Methods: Nitroxoline susceptibility was assessed using disk diffusion for E. coli (n = 26) and broth microdilution for K. pneumoniae (n = 33). Results: ESBL-producing E. coli isolates showed high susceptibility to nitroxoline, with 25 (96.2%) classified as susceptible. In contrast, K. pneumoniae isolates exhibited high minimum inhibitory concentration (MIC) values (range 16–128 mg/L; median 32 mg/L), indicating limited activity. Conclusions: Nitroxoline demonstrated strong in vitro activity against ESBL-producing E. coli but limited activity against MDR K. pneumoniae. Interpretation of the findings for K. pneumoniae is constrained by the lack of established clinical breakpoints.
Full article
(This article belongs to the Section Mechanism and Evolution of Antibiotic Resistance)
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Open AccessReview
Combating Antibacterial Resistance: The Integrative Role of Artificial Intelligence in Bio-Based Product Development
by
Renuka Gudepu, Swapna Sirikonda, Ravinaik Banoth, Praveen Kumar Annagowni, Swati Dahariya and Aditya Velidandi
Antibiotics 2026, 15(5), 478; https://doi.org/10.3390/antibiotics15050478 - 8 May 2026
Abstract
The escalating crisis of antimicrobial resistance claims nearly 5 million lives annually. Resistant infections now account for 4.95 million deaths worldwide and economic losses projected to reach $300 billion by 2030. Despite this urgent threat, traditional antibiotic discovery has declined precipitously. New chemical
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The escalating crisis of antimicrobial resistance claims nearly 5 million lives annually. Resistant infections now account for 4.95 million deaths worldwide and economic losses projected to reach $300 billion by 2030. Despite this urgent threat, traditional antibiotic discovery has declined precipitously. New chemical entity approvals have fallen by over 50%, while existing therapeutics are rapidly rendered obsolete by sophisticated bacterial resistance mechanisms including extended-spectrum β-lactamases, carbapenemases, and multidrug efflux pumps. Bio-based products have historically provided humanity’s most transformative antibiotics, yet conventional discovery pipelines face insurmountable bottlenecks. A total of 99.9% of environmental microbes remain unculturable. Biosynthetic gene clusters are predominantly silent under laboratory conditions, and dereplication efforts achieve only 2 to 5% annotation rates. This review presents a comprehensive examination of how artificial intelligence (AI) is revolutionizing bio-based product-based antibacterial discovery. We analyze AI-driven genome mining tools that have identified over 170,000 biosynthetic gene clusters across bacterial genomes, deep learning architectures achieving 88.5% bioactivity prediction accuracy, and generative models delivering experimental hit rates exceeding 50%—representing 50- to 90-fold improvements over traditional screening. Through validated case studies spanning in silico prediction to in vivo efficacy, we demonstrate that AI integration is not merely accelerating discovery but fundamentally transforming our capacity to access nature’s previously inaccessible chemical diversity in the fight against antimicrobial resistance.
Full article
Open AccessArticle
Antibacterial and Antibiofilm Potential of Thymol–Benzimidazolium–Chalcone Hybrids Against Clinical MRSA Strains: Insights from Gene Expression Profiling and Molecular Docking
by
Salim Yakut, Hakan Ünver, Akın Yiğin, Mehmet Çimentepe, Fadile Yıldız Zeyrek, Özge Öztürk Çimentepe and Metin Yildirim
Antibiotics 2026, 15(5), 477; https://doi.org/10.3390/antibiotics15050477 - 8 May 2026
Abstract
Background/Objectives: Four novel thymol–benzimidazolium–chalcone hybrids were designed based on a molecular hybridization strategy that integrates bioactive scaffolds known for their antimicrobial and antioxidant properties. This approach aims to enhance biological activity through synergistic effects and multi-target interactions, as supported by previous studies on
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Background/Objectives: Four novel thymol–benzimidazolium–chalcone hybrids were designed based on a molecular hybridization strategy that integrates bioactive scaffolds known for their antimicrobial and antioxidant properties. This approach aims to enhance biological activity through synergistic effects and multi-target interactions, as supported by previous studies on phenolic and benzimidazole derivatives. The inclusion of both antioxidant and antibacterial evaluations was motivated by the well-established role of oxidative stress in bacterial pathogenicity and resistance mechanisms. Methods: Their antibacterial potential was initially screened using the disk diffusion method and subsequently evaluated by determining MIC and MBC values against eight clinical Staphylococcus aureus isolates. Results: Among the tested compounds, compound 3a emerged as the most potent derivative, exhibiting MIC values ranging from 0.25 to 1 µg/mL. Morphological analysis confirmed significant disruption of bacterial cell integrity, and further investigation demonstrated strong antibiofilm activity accompanied by downregulation of key biofilm- and resistance-associated genes (icaA, dltB, and mepA). Molecular docking studies were performed against selected target proteins, including 1MWT, 3VSL, 3ZG5 (sortase A), and 2ZCS, which are associated with bacterial cell wall biosynthesis, DNA replication, virulence, and metabolic pathways. Compound 3a exhibited the highest binding affinity, with a docking score of −11.953 kcal/mol against 2ZCS. Conclusions: Overall, these findings highlight the potential of thymol-based benzimidazolium–chalcone hybrids as promising multifunctional agents with combined antibacterial, antibiofilm, and antioxidant properties.
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(This article belongs to the Special Issue Antimicrobial Resistance in Bacterial Pathogens: Surveillance, Mechanisms, and Diagnostics)
Open AccessArticle
Association of a Hospital-Wide Integrated Stewardship Intervention with Hospital-Acquired Multidrug-Resistant Organism Infection Incidence Density: A Large-Scale Interrupted Time-Series Study
by
Shan Zheng, Li Yang, Cong Shi, Chuan Xu and Li Tan
Antibiotics 2026, 15(5), 476; https://doi.org/10.3390/antibiotics15050476 - 7 May 2026
Abstract
Background: Hospital-acquired multidrug-resistant organism (HA-MDRO) infections remain a major patient-safety threat linked to antimicrobial exposure, but long-term hospital-level evidence on whether integrated stewardship can reduce HA-MDRO burden remains limited. Methods: We conducted a quasi-experimental interrupted time-series study at a large multi-campus
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Background: Hospital-acquired multidrug-resistant organism (HA-MDRO) infections remain a major patient-safety threat linked to antimicrobial exposure, but long-term hospital-level evidence on whether integrated stewardship can reduce HA-MDRO burden remains limited. Methods: We conducted a quasi-experimental interrupted time-series study at a large multi-campus tertiary teaching hospital in China. A hospital-wide integrated intervention combining diagnostic stewardship and antimicrobial prescribing stewardship was implemented on 1 November 2021. Monthly aggregated hospital data from July 2018 to December 2024, including 2,145,489 hospitalizations, were analyzed. The primary outcome was HA-MDRO infection incidence density per 1000 patient-days. Results: HA-MDRO incidence density decreased immediately at the start of the COVID period (IRR = 0.246; p < 0.001) and then increased over time (IRR per month = 1.074; p < 0.001). After intervention implementation, the post-intervention trend declined significantly relative to the COVID-period trajectory (IRR per month = 0.938; p < 0.001). Microbiological testing increased immediately and continued to rise (OR = 1.381 and 1.016 per month, respectively), whereas restricted antibiotic use declined after implementation (OR = 0.979 per month; all p < 0.05). The control outcome showed no consistent post-intervention change. Counterfactual analysis estimated that 15,274 HA-MDRO cases were averted over follow-up. Conclusions: A hospital-wide integrated stewardship intervention was associated with reversal of the increasing HA-MDRO trajectory observed during the COVID period, together with improved microbiological testing and reduced restricted antibiotic use. These findings support the value of integrating diagnostic and prescribing stewardship in high-volume tertiary hospital settings.
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(This article belongs to the Special Issue Antibiotic Stewardship Implementation Strategies)
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Open AccessArticle
Antibiotic Resistance Profiles of Escherichia coli Recovered from Mesenteric Lymph Nodes of Free-Ranging Game Ungulates in Western Romania
by
Răzvan-Tudor Pătrînjan, Adriana Morar, Cristina Mirabela Gașpar, Sebastian-Alexandru Popa, Alexandra Ban-Cucerzan, Bianca Ghițan, Daiana-Ionela Cocoș and Kálmán Imre
Antibiotics 2026, 15(5), 475; https://doi.org/10.3390/antibiotics15050475 - 7 May 2026
Abstract
Background/Objectives: The emergence of antimicrobial resistance (AMR) within a One Health framework highlights the role of wildlife as environmental reservoirs. Because wild game is an increasingly important meat source, hygienic handling during evisceration is critical to prevent carcass contamination from internal tissues such
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Background/Objectives: The emergence of antimicrobial resistance (AMR) within a One Health framework highlights the role of wildlife as environmental reservoirs. Because wild game is an increasingly important meat source, hygienic handling during evisceration is critical to prevent carcass contamination from internal tissues such as mesenteric lymph nodes (MLNs). This study aimed to investigate the occurrence and antibiotic resistance (AR) profiles of Escherichia coli isolated from the MLNs of hunted wild ungulates in western Romania to better understand microbiological hazards along the game meat supply chain. Methods: MLN samples were aseptically collected from 103 legally hunted wild boars (Sus scrofa, n = 78) and cervids (Capreolus capreolus and Cervus elaphus, n = 25) across two hunting grounds. E. coli isolation was performed utilizing selective Tryptone Bile X-Glucuronide agar. Subsequent biochemical identification and phenotypic antimicrobial susceptibility testing were conducted using the automated VITEK® 2 system. Results: The overall E. coli isolation rate was 72.8% (75/103). Analyzed by host species, the bacterium was recovered from 79.4% of the sampled wild boars (62/78) and 52.0% of the cervids (13/25). Phenotypic resistance to at least one antibiotic agent was observed in 25.3% (19/75) of the isolates, most frequently against cephalosporins (cefalexin, 21.3%) and penicillins (ampicillin, 24.0%). Multidrug resistance (MDR) was identified in 20.0% (15/75) of the isolates. Conclusions: The detection of MDR E. coli phenotypes within the MLNs of free-ranging game indicates the penetration of clinically relevant resistance mechanisms into sylvatic environments. These findings underscore the potential risk of internal carcass contamination during field evisceration, highlighting the critical need for strict hygiene practices to ensure game meat safety.
Full article
(This article belongs to the Special Issue Antibiotic Resistance and Antimicrobial Stewardship in Veterinary Medicine)
Open AccessArticle
The Efficacy and Safety of Eravacycline in the Management of Infections: A Single-Center Experience
by
Narendran Koomanan, Yvonne Peijun Zhou and Andrea Lay Hoon Kwa
Antibiotics 2026, 15(5), 474; https://doi.org/10.3390/antibiotics15050474 - 7 May 2026
Abstract
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Background/Objectives: Eravacycline is a fluorocycline antibiotic increasingly used for drug-resistant or difficult-to-treat infections, including off-label indications, with limited real-world clinical data. This study aimed to characterize the effectiveness, safety, and overall risk-benefit profile of eravacycline using an adapted Desirability of Outcome Ranking
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Background/Objectives: Eravacycline is a fluorocycline antibiotic increasingly used for drug-resistant or difficult-to-treat infections, including off-label indications, with limited real-world clinical data. This study aimed to characterize the effectiveness, safety, and overall risk-benefit profile of eravacycline using an adapted Desirability of Outcome Ranking (DOOR) framework. Methods: We conducted a retrospective, single-center observational study of adult patients who received ≥48 h of eravacycline at an academic medical center between May 2022 and October 2023. Clinical response was assessed at the end of therapy, alongside 30-day all-cause mortality. Treatment-emergent adverse events (TEAEs) were recorded and normalized per 100 eravacycline-days. An adapted DOOR framework integrated efficacy, toxicity and mortality into an ordinal composite outcome, with analyses stratified by pathogen and site of infection. Results: A total of 140 patients contributed 151 eravacycline courses. Intra-abdominal (41.7%) and lower respiratory tract infections (27.8%) were the most common indications. Treatment success was observed in 69.5% of courses, while 30-day all-cause mortality was 23.6%. TEAEs occurred in 52.3% of courses and frequently led to eravacycline discontinuation. Exposure-normalized TEAE rates were highest in shorter courses, with gastrointestinal intolerance predominating early, while hepatoxicity and coagulation abnormalities were more frequent with intermediate treatment durations. DOOR analysis demonstrated highly desirable outcomes in 48.3% of courses, with more favorable profiles observed in carbapenem-resistant Enterobacterales (CRE), vancomycin-resistant Enterococci (VRE) and nontuberculous mycobacteria (NTM) infections. Bloodstream infections were associated with less desirable outcomes. Conclusions: Eravacycline demonstrated meaningful real-world activity across complex infections but was limited by frequent toxicity. The DOOR framework provided a patient-centered context for organism- and site-specific risk-benefit assessment.
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Open AccessArticle
Comparative Phenotypic and PCR-Based Methicillin Resistance Characterization of Clinical Canine Staphylococcus pseudintermedius
by
Patrik Mag, Enikő Fehér, Eszter Kaszab, Dóra Máté, Noémi Tarpataki and Ákos Jerzsele
Antibiotics 2026, 15(5), 473; https://doi.org/10.3390/antibiotics15050473 - 7 May 2026
Abstract
Background: Antimicrobial resistance in Staphylococcus pseudintermedius is an increasing concern in small animal medicine, particularly due to methicillin-resistant strains and associated multidrug resistance. This study aimed to characterize antimicrobial susceptibility patterns in clinical canine isolates, determine the prevalence of methicillin resistance, and assess
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Background: Antimicrobial resistance in Staphylococcus pseudintermedius is an increasing concern in small animal medicine, particularly due to methicillin-resistant strains and associated multidrug resistance. This study aimed to characterize antimicrobial susceptibility patterns in clinical canine isolates, determine the prevalence of methicillin resistance, and assess the presence of mecA and mecC genes. Methods: A total of 243 clinical isolates from canine skin samples collected in Hungary between 2023 and 2025 were analyzed. Minimum inhibitory concentrations (MICs) for 24 antimicrobial agents were determined using broth microdilution in accordance with CLSI guidelines. Isolates were classified as methicillin-resistant or susceptible based on oxacillin MIC values. PCR assays targeting mecA and mecC were performed on oxacillin-resistant isolates. Results: Of the 243 isolates, 47 (19.3%) were methicillin-resistant. High resistance rates were observed for β-lactams, tetracyclines, macrolides, and lincosamides, while rifampicin, amikacin and florfenicol retained good to excellent activity. Methicillin-resistant isolates exhibited substantially higher resistance across multiple antimicrobial classes. Overall, 50.6% of all isolates were classified as multidrug-resistant (MDR) and 17.3% as extensively drug-resistant (XDR), while no pandrug-resistant (PDR) isolates were detected; all methicillin-resistant isolates were at least MDR. The mecA gene was detected in 80.9% of oxacillin-resistant isolates, while mecC was not identified. Conclusions: Methicillin resistance in canine S. pseudintermedius is closely associated with multidrug resistance, limiting therapeutic options. However, selected agents, including rifampicin, amikacin and florfenicol, retained in vitro activity. Partial discordance between phenotypic resistance and mecA detection highlights the importance of combined phenotypic and molecular approaches. These findings have direct implications for empirical antimicrobial therapy and support targeted treatment strategies, while emphasizing the importance of antimicrobial stewardship in small animal practice.
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(This article belongs to the Special Issue Antimicrobial Resistance Genes: Spread and Evolution, 2nd Edition)
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Open AccessArticle
Preoperative Bacteriuria and Antimicrobial Resistance in Men Undergoing Urethral Stricture Surgery
by
Mikołaj Frankiewicz, Łukasz Białek, Adam Kaftan, Marta Rydzińska, Jakub Dobruch, Michał Skrzypczyk and Marcin Matuszewski
Antibiotics 2026, 15(5), 472; https://doi.org/10.3390/antibiotics15050472 - 6 May 2026
Abstract
Background/Objectives: Perioperative antibiotics are standard in urethral stricture surgery, but timely uncontaminated preoperative urine cultures are not always available, and empiric regimens are often selected before current susceptibility data are known. We aimed to characterize preoperative bacteriuria and antimicrobial resistance in men
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Background/Objectives: Perioperative antibiotics are standard in urethral stricture surgery, but timely uncontaminated preoperative urine cultures are not always available, and empiric regimens are often selected before current susceptibility data are known. We aimed to characterize preoperative bacteriuria and antimicrobial resistance in men undergoing urethral stricture surgery and to assess associations with recorded clinical variables. Methods: We retrospectively analyzed 304 men undergoing urethral stricture surgery at two referral centers, representing the subset of the surgical population for whom a complete preoperative microbiology report, including antimicrobial susceptibility data when culture-positive organisms were recovered, was retrievable from the institutional microbiology laboratory information systems. Clinical contributors were assigned by structured chart review. The primary microbiologic endpoint was preoperative bacteriuria, defined by final local laboratory interpretation of the urine culture. Urine culture was requested at admission and repeated within 24 h before surgery if missing or non-diagnostic. MDR was defined as resistance to three or more clinically relevant antimicrobial classes, excluding expected intrinsic resistance patterns. Results: Among patients with retrievable complete preoperative microbiology data, urine cultures were positive in 164/304 patients (53.9%). The most frequent recorded contributors were iatrogenic exposure (119; 39.1%), prior endoscopic treatment (71; 23.4%), and trauma (64; 21.1%); 108/304 patients (35.5%) had more than one contributor. Among culture-positive patients, MDR occurred in 18/164 (11.0%). On exploratory multivariable analysis, suprapubic catheter status was independently associated with culture positivity (adjusted OR 4.41, 95% CI 2.47–7.87; p < 0.001), whereas PFUI was not significant after adjustment. Conclusions: In this analytic cohort, preoperative bacteriuria was common, and suprapubic catheter status was the strongest independent correlate of urine culture positivity. The observed MDR burden supports recent preoperative urine culture acquisition and stewardship-based perioperative antibiotic selection.
Full article
(This article belongs to the Special Issue Antibiotic Prophylaxis and Stewardship in Surgical Infection)
Open AccessArticle
In Vitro Antifungal and Wound-Healing Potential of Ferulago cassia and Ferulago silaifolia Essential Oils in Skin Candidiasis
by
Carolina Furtado, Manuel González-Vázquez, Ceyda Sibel Kılıç, Lígia Salgueiro and Mónica Zuzarte
Antibiotics 2026, 15(5), 471; https://doi.org/10.3390/antibiotics15050471 - 6 May 2026
Abstract
Background/Objectives: Skin candidiasis is a key contributor to chronic, non-healing wounds, largely due to persistent microbial infections. Candida species can colonize the skin, form protective biofilms, and interfere with enzyme activity, leading to extracellular matrix degradation, changes in pigmentation, and impaired wound healing.
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Background/Objectives: Skin candidiasis is a key contributor to chronic, non-healing wounds, largely due to persistent microbial infections. Candida species can colonize the skin, form protective biofilms, and interfere with enzyme activity, leading to extracellular matrix degradation, changes in pigmentation, and impaired wound healing. The rising prevalence of antifungal resistance challenges its management, underscoring the need for more effective antifungal therapies. Therefore, this study aimed to assess the antifungal effects and wound-healing potential of essential oils (EOs) from Ferulago spp. Methods: The antifungal activity of the EOs from five Ferulago species was evaluated against Candida spp. and Cryptococcus neoformans. The most active EOs were further investigated for their effects on C. albicans virulence factors, including germ tube formation, as well as biofilm formation and disruption. These effects were assessed using microscopic observation, XTT reduction assay, and crystal violet and safranin stainings. The wound-healing potential of the EOs was evaluated using the scratch-wound assay on fibroblasts and keratinocytes. Additionally, the effect on tyrosinase and elastase activity, was also investigated. Results:F. silaifolia and F. cassia essential oils showed fungicidal activity against Candida spp. and Cryptococcus neoformans. F. silaifolia displayed greater potency, with lower MIC and MLC values. Both oils inhibited key C. albicans virulence factors at sub-MIC concentrations. F. silaifolia EO was more effective in preventing biofilm formation whereas F. cassia EO showed notable tyrosinase inhibitory effect. Conclusions: These findings align with traditional uses and suggest that F. silaifolia and F. cassia EOs exhibit antifungal activity alongside properties associated with wound healing, supporting their potential as topical antifungal agents and thereby justifying further investigation.
Full article
(This article belongs to the Special Issue Rethinking Mild Infections: The Role of Natural Products in Antimicrobial Stewardship)
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