Epidemiology and Genomics of Antimicrobial Resistance of Difficult-to-Treat Pathogens

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Mechanism and Evolution of Antibiotic Resistance".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 713

Special Issue Editor


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Guest Editor
1. Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
2. Microbiology, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
Interests: epidemiology of bacterial and fungal infections; antimicrobial resistance
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Special Issue Information

Dear Colleagues,

Antimicrobial resistance (AMR) poses a significant global health threat, particularly with difficult-to-treat pathogens resistant to multiple or all available antibiotics. A multidisciplinary approach combining surveillance, molecular studies, and public health interventions is essential to combat this growing challenge. Epidemiology and genomics play crucial roles in understanding the spread, evolution, and mechanisms of AMR in these pathogens. Epidemiological studies can help to track the incidence, prevalence, and transmission dynamics of multi-drug-resistant organisms (MDRos) across different countries. They provide insights into risk factors, reservoirs, and the impact of antimicrobial stewardship policies. Genomics, on the other hand, allows for a deeper understanding of the genetic determinants of resistance, including mutations, horizontal gene transfer, and mobile genetic elements such as plasmids and transposons. Whole-genome sequencing (WGS) and metagenomics have revolutionized AMR research, enabling the identification of resistance genes, the tracking of outbreaks, and the characterization of pathogen evolution. Integrating epidemiological data with genomic analyses enhances our ability to predict resistance trends, develop rapid diagnostic tools, and inform targeted interventions.

This Special Issue welcomes the submission of manuscripts that further explore the epidemiology and genomics of AMR in difficult-to-treat pathogens, focusing on key bacterial species and resistance mechanisms.

Dr. Simone Ambretti
Guest Editor

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Keywords

  • antimicrobial resistance
  • difficult-to-treat pathogens
  • epidemiology
  • genomics
  • MRSA
  • VRE
  • ESBL
  • CRE
  • CRAB
  • MDR pseudomonas aeruginosa

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Published Papers (1 paper)

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Research

13 pages, 292 KiB  
Article
Molecular Detection of Multiple Antimicrobial Resistance Genes in Helicobacter pylori-Positive Gastric Samples from Patients Undergoing Upper Gastrointestinal Endoscopy with Gastric Biopsy in Algarve, Portugal
by Francisco Cortez Nunes, Catarina Aguieiras, Mauro Calhindro, Ricardo Louro, Bruno Peixe, Patrícia Queirós, Pedro Castelo-Branco and Teresa Letra Mateus
Antibiotics 2025, 14(8), 780; https://doi.org/10.3390/antibiotics14080780 - 1 Aug 2025
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Abstract
Background/Objectives: Helicobacter pylori (H. pylori) is a common gastric pathogen linked to gastritis, gastroduodenal ulcers, and gastric cancer. Rising antimicrobial resistance (AMR) poses challenges for effective treatment and has prompted the WHO to classify H. pylori as a high-priority pathogen. [...] Read more.
Background/Objectives: Helicobacter pylori (H. pylori) is a common gastric pathogen linked to gastritis, gastroduodenal ulcers, and gastric cancer. Rising antimicrobial resistance (AMR) poses challenges for effective treatment and has prompted the WHO to classify H. pylori as a high-priority pathogen. This study aimed to detect the prevalence of AMR genes in H. pylori-positive gastric samples from patients in Algarve, Portugal, where regional data is scarce. Methods: Eighteen H. pylori-positive gastric biopsy samples from patients undergoing upper gastrointestinal endoscopy were analyzed. PCR and sequencing were used to identify genes associated with resistance to amoxicillin (Pbp1A), metronidazole (rdxA, frxA), tetracycline (16S rRNA mutation) and clarithromycin (23S rRNA). Sequence identity and homologies were verified using tBLASTx and the Comprehensive Antibiotic Resistance Database (CARD). Results: Out of the 18 H. pylori-positive samples, 16 (88.9%) contained at least one AMR gene. The most frequent genes were rdxA (83.3%) and frxA (66.7%) for metronidazole resistance, and the 16S rRNA mutation (66.7%) for tetracycline. Resistance to amoxicillin and clarithromycin was detected in 27.8% and 16.7% of cases, respectively. Most samples (72.2%) had multiple resistance genes. A significantly strong association was found between female sex and the presence of the rdxA gene (p = 0.043). Conclusions: The study reveals a high prevalence of H. pylori resistance genes in Algarve, particularly against metronidazole and tetracycline. These findings highlight the need for local surveillance and tailored treatment strategies. Further research with larger populations is warranted to assess regional resistance patterns and improve eradication efforts. Full article
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