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Antibiotics
Special Issues
Epidemiology, Diagnosis and Antimicrobial Treatment of Hospital-Acquired Infections
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Epidemiology, Diagnosis and Antimicrobial Treatment of Hospital-Acquired Infections

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: 15 July 2025 | Viewed by 2897

Special Issue Editors

Prof. Dr. Diamantis Kofteridis

E-Mail Website
Guest Editor
Department of Medicine, University of Crete, Heraklion, Greece
Interests: antimicrobial stewardship; infection control; infectious diseases; medical mycology; infectious diseases in immunocompromised patients
Special Issues, Collections and Topics in MDPI journals
Dr. Petros Ioannou

E-Mail Website
Guest Editor
School of Medicine, University of Crete, Heraklion, Greece
Interests: infectious diseases; internal medicine; HIV/AIDS; infective endocarditis; blood-stream infections
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hospital-acquired infections frequently complicate the course of hospitalized patients and may cause significant morbidity and mortality. The most frequent hospital-acquired infections are those of the bloodstream, the respiratory tract, and the urinary tract. Currently, the field of hospital-acquired infections is rapidly changing due to the growing problem of antimicrobial resistance, which leads to thousands of deaths worldwide, mainly due to infections by methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus, carbapenem-resistant Enterobacterales, extensively-drug resistant and pan-drug resistant Acinetobacter baumannii, and multi-drug resistant Pseudomonas aeruginosa. This often leaves clinicians with few therapeutic options, leading to the revival of older antibiotics and the use of antimicrobial combinations in problematic infectctions caused by these resistant pathogens.

This Special Issue aims to bring together original studies and literature reviews related to the epidemiology, microbiology, diagnosis, treatment, and outcomes of hospital-acquired infections. Studies providing evidence on this topic, as well as on the topic of infection control and antimicrobial stewardship in hospital-acquired infections, are very welcome.

Prof. Dr. Diamantis P. Kofteridis
Dr. Petros Ioannou
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hospital-acquired infection
  • bacteremia
  • bloodstream infection
  • pneumonia
  • ventilator-associated pneumonia
  • urinary tract infection

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Published Papers (3 papers)

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Research

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13 pages, 248 KiB  
Article
An Outbreak of Serratia marcescens in a Cardiothoracic Surgery Unit Associated with an Infected Solution of Pre-Prepared Syringes
by Maria Papagianni, Eleni Mylona, Sofia Kostourou, Chrysoula Kolokotroni, Dimitris Kounatidis, Natalia G. Vallianou and Vasileios Papastamopoulos
Antibiotics 2025, 14(3), 319; https://doi.org/10.3390/antibiotics14030319 - 18 Mar 2025
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Abstract
Background/Objectives: The aim of the present study is to report an outbreak of bloodstream infections caused by Serratia marcescens in patients undergoing postoperational procedures in the Cardiothoracic Department and to describe the epidemiological investigations and control measures undertaken. A cluster of bacteremia due [...] Read more.
Background/Objectives: The aim of the present study is to report an outbreak of bloodstream infections caused by Serratia marcescens in patients undergoing postoperational procedures in the Cardiothoracic Department and to describe the epidemiological investigations and control measures undertaken. A cluster of bacteremia due to Serratia marcescens was identified in blood cultures from postoperative patients in the Cardiothoracic Surgery Department in November 2023. Methods: Active surveillance by the hospital’s prevention and control team was initiated. Interviews with nurses and sanitary personnel and reviews of the most common procedures, such as hand washing, bladder catheterization, and intravenous catheter care, were performed. Culturing samples from hospital personnel, postoperative patients, and the environment, including pressure transducers, tap water, soap, therapeutic solutions, antiseptics, respirators, and various intravenous preparations, were drawn up. Overall, 225 samples were collected, including 149 blood cultures, and these were all sent to the Hospital’s Microbiology Laboratory. Results: Twenty-three out of forty-seven postoperative patients had positive blood cultures for Serratia marcescens. All the postoperative patients involved in the outbreak received cefepime according to antimicrobial susceptibility testing. Three pre-prepared flushing syringes were found to be positive for Serratia marcescens as well. The Cardiothoracic Department was kept under surveillance with hand hygiene measures, infusion preparation, medical device use, and cleaning procedures reviewed by the infection’s prevention and control team. Conclusions: Undoubtedly, nosocomial outbreaks represent an important health issue regarding morbidity, mortality, and costs. Timely interventions by the hospital’s infection prevention and control team may be life-saving under these circumstances. Full article
(This article belongs to the Special Issue Epidemiology, Diagnosis and Antimicrobial Treatment of Hospital-Acquired Infections)
12 pages, 545 KiB  
Article
Evaluation of the Use of Preventive Antibiotic Therapy in Patients Undergoing One-Step Prosthetic Revision Surgery with Low Preoperative Infectious Risk
by Leonardo Motta, Giacomo Stroffolini, Stefania Marocco, Giulia Bertoli, Gianluca Piovan, Lorenzo Povegliano, Claudio Zorzi and Federico Gobbi
Antibiotics 2025, 14(3), 224; https://doi.org/10.3390/antibiotics14030224 - 21 Feb 2025
Viewed by 290
Abstract
Introduction: The prosthetic knee infection (PKI) rate in most centers ranges from 0.5 to 2% for knee replacements, depending on risk factors. Current PKI definitions may miss the identification of both early and late complications. There is no consensus on preventive or early [...] Read more.
Introduction: The prosthetic knee infection (PKI) rate in most centers ranges from 0.5 to 2% for knee replacements, depending on risk factors. Current PKI definitions may miss the identification of both early and late complications. There is no consensus on preventive or early empiric antibiotic therapy (EEAT) in the one-step exchange strategy for low-risk patients pending microbiology results. The aim of the study was to evaluate the potential role of EEAT in patients with comorbidities in preventing PKI and to evaluate differences in septic failure at 3, 6 and 9 months after prosthetic revision between patients undergoing EEAT and patients not undergoing EEAT. Methods: All adult patients undergoing one-step knee revision surgery at IRCCS Sacro-Cuore Don Calabria Negrar, from January 2018 to February 2021, were retrospectively included in a cohort observational study. Patients on antibiotic therapy before surgery or with preoperative ascertained PKI were excluded. Demographic characteristics, Charlson score, comorbidities, inflammatory markers, microbiological tests, imaging, infectious disease risk score and EEAT data were collected. Any postoperative complication or modification of antibiotic therapy at 14, 30, 90, 180 and 270 days after surgery was collected. Results: A total of 227 patients were included: 114 comorbid low-risk patients received EEAT after surgery, pending microbiological results; while 113 non-comorbid low-risk patients did not receive any antibiotic therapy in the postoperative period. Among the EEAT group, 16 were diagnosed with PKI, compared with 10 in the untreated group. Regarding septic failure during the 9-month follow-up after revision surgery, we registered nine cases in the EEAT arm and four in the untreated arm. In three out of nine cases treated with EEAT who had a post-revision septic failure, the causative microorganism was not successfully empirically targeted by EEAT; in the untreated group, two out of four cases had a post-revision septic failure, despite the targeted treatment of intraoperatively identified causative microorganisms. Conclusions: According to our results, EEAT after revision surgery in patients with comorbidities, who are at higher risk of infection, did not prevent prosthetic knee infections. There was also no evidence of a reduction in subsequent septic failure within nine months of revision surgery between groups. More accurate risk-defining scores are needed to identify patients at risk of PKI complications. Full article
(This article belongs to the Special Issue Epidemiology, Diagnosis and Antimicrobial Treatment of Hospital-Acquired Infections)
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Review

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11 pages, 624 KiB  
Review
Ewingella americana Infections in Humans—A Narrative Review
by Petros Ioannou, Stella Baliou and Diamantis Kofteridis
Antibiotics 2024, 13(6), 559; https://doi.org/10.3390/antibiotics13060559 - 14 Jun 2024
Viewed by 1800
Abstract
Ewingella americana is a Gram-negative rod that belongs to the order Enterobacterales and the family Yersiniaceae and was first identified in 1983 from 10 clinical strains in the United States of America. The present study aimed to identify all the published cases of [...] Read more.
Ewingella americana is a Gram-negative rod that belongs to the order Enterobacterales and the family Yersiniaceae and was first identified in 1983 from 10 clinical strains in the United States of America. The present study aimed to identify all the published cases of E. americana in the literature, describe the epidemiological, clinical, and microbiological characteristics, and provide data regarding its antimicrobial resistance, treatment, and outcomes. A narrative review was performed based on a PubMed and Scopus databases search. In total, 16 studies provided data on 19 patients with infections by E. americana. The median age of the patients was 55 years, and 47.4% were male. The most common infections were those of the bloodstream, the respiratory tract, and the peritoneal cavity. Antimicrobial resistance to cephalosporins, aminoglycosides, and the combination of trimethoprim with sulfamethoxazole was minimal, and these were the most commonly used antimicrobials for treating these infections. No included study provided information on the genetic or molecular mechanism of this pathogen’s antimicrobial resistance. The overall mortality was minimal, with only one patient with bacteremia succumbing to the infection. Further studies are needed to better understand this microorganism, its pathogenic potential in humans, and the genetic and molecular mechanisms underlying its antimicrobial resistance, for which very little evidence exists to date. Full article
(This article belongs to the Special Issue Epidemiology, Diagnosis and Antimicrobial Treatment of Hospital-Acquired Infections)
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