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Therapeutic Strategies for Complicated Hospital-Acquired Infections in the Era of Antimicrobial Resistance

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A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 30 November 2026 | Viewed by 683

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Editors

Dr. Andreas G. Tsantes

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Guest Editor

1. Laboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece
2. Department of Microbiology, 'Saint Savvas' Oncology Hospital, 11635 Athens, Greece
Interests: antimicrobial resistance; hospital-acquired infections; clinical microbiology; translational therapeutic strategies
Special Issues, Collections and Topics in MDPI journals

Dr. Rozeta Sokou

E-Mail Website
Guest Editor

Neonatal Department, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
Interests: neonatal and pediatric infections; antimicrobial resistance; hospital-acquired infections; clinical outcomes in vulnerable populations
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hospital-acquired infections (HAIs) remain a major cause of morbidity and mortality worldwide, particularly when they present as complicated infections in critically ill, immunocompromised, or surgically treated patients, including adults, pediatric and neonatal populations, as well as pregnant women. The increasing prevalence of antimicrobial resistance (AMR) among nosocomial pathogens has further limited therapeutic options, posing significant challenges to effective clinical management.

This Special Issue aims to provide a comprehensive overview of contemporary therapeutic strategies for complicated hospital-acquired infections in the era of antimicrobial resistance, with a primary focus on bacterial pathogens, followed by resistant fungal infections. Emphasis is placed on multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacteria commonly implicated in HAIs, including Enterobacterales, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus spp., and Staphylococcus aureus. Particular attention will be given to novel antibiotics, optimized combination therapies, pharmacokinetic/pharmacodynamic considerations, and individualized treatment approaches in high-risk clinical settings such as intensive care units, oncology wards, transplant units, neonatal and pediatric care units, and obstetric settings.

In addition, the Special Issue will address the growing burden of invasive fungal infections caused by resistant or difficult-to-treat species, including non-albicans Candida, Candida auris, and Aspergillus species, with special consideration of vulnerable populations such as neonates, children, and pregnant patients. Therapeutic challenges related to antifungal resistance, emerging antifungal agents, combination antifungal therapy, and stewardship strategies will be critically discussed.

By integrating microbiological, pharmacological, and clinical perspectives, this Special Issue seeks to bridge the gap between resistance mechanisms and real-world therapeutic decision-making across all age groups and special populations. Contributions focusing on antimicrobial stewardship, clinical outcomes, and translational research are particularly encouraged. Overall, this collection aims to support clinicians and researchers in optimizing the management of complicated HAIs within the broader framework of antimicrobial resistance.

Topics of Interest

Complicated hospital-acquired infections in adult, pediatric, neonatal, and obstetric populations;
Multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacterial pathogens;
Therapeutic management of HAIs caused by Enterobacterales, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus spp., and Staphylococcus aureus;
Novel antibiotics and antibiotic combinations;
Pharmacokinetic/pharmacodynamic optimization in critically ill patients;
Biofilm-associated hospital-acquired infections;
Antimicrobial stewardship strategies in hospital settings;
Real-world clinical outcomes and treatment optimization;
Invasive fungal infections in hospitalized patients;
Antifungal resistance and emerging antifungal agents;
Combination antifungal therapies;
Mixed bacterial–fungal hospital-acquired infections.

Types of Articles

Original Research Articles
Narrative Reviews
Systematic Reviews and Meta-Analyses
Brief Communications

Dr. Andreas G. Tsantes
Dr. Rozeta Sokou
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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized 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 infections
antimicrobial resistance
multidrug-resistant pathogens
novel antibiotics
antimicrobial stewardship
invasive fungal infections

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Published Papers (1 paper)

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Research

11 pages, 482 KB

Open AccessArticle

Molecular Identification and Phenotypic Antimicrobial Resistance of Acinetobacter spp. from an Equine University Clinic in Germany

by Sabita Diana Stöckle, Anais Sauerwein, Elisabeth Mueller and Heidrun Gehlen

Antibiotics 2026, 15(6), 558; https://doi.org/10.3390/antibiotics15060558 - 30 May 2026

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Abstract

Background: While equine patient-mediated introduction of A. baumannii into hospital settings has been documented, its environmental dissemination and the risk of hospital-acquired surgical site infection remain poorly understood. Objective: Therefore, this descriptive observational study examined (a) the environmental distribution of Acinetobacter spp. in an equine university hospital, (b) the impact of the implementation of new hygiene protocols, (c) the specification of resistance patterns, and (d) the evaluation of the presence of Acinetobacter spp. in hospital-acquired wound infections. Methods: During three sampling periods, environmental samples of the stables, the treatment, and surgery areas were collected before and after cleaning and disinfection. After sampling period 1 (December 2021), the cleaning routines were optimized by reviewing the cleaning and disinfection process, as well as including further surfaces in the cleaning schedule for January 2022). This was followed by a second (February 2022) and a third (June 2022) sampling period. During sampling periods 1 and 2, 76 surfaces were sampled; in sampling period 3, only 21 critical surfaces were examined. Samples were cultured on selective agar plates and incubated at 37 °C, with bacterial growth evaluated after 24–48 h. Wound swabs were enriched in broth before culturing. Bacteria were identified using MALDI-TOF mass spectrometry. During the first sampling period, antibiotic susceptibility testing was performed using broth microdilution according to CLSI-vet standards. Results: During each sampling period, Acinetobacter spp. was detected in at least one sample in each of the different areas; however, there was a reduced detection rate from sampling period 1 throughout sampling period 3. The isolates were highly resistant against beta-lactam and macrolide antibiotics but mostly sensitive to fluroquinolones (enrofloxacin, 2.2% resistance; marbofloxacin, 0.0% resistance), aminoglycosides (gentamicin, 6.5% resistance; kanamycin, 8.7% resistance), and tetracyclines. Acinetobacter spp. was not detected in surgical site infections. Conclusions: Environmental persistence of Acinetobacter spp. in an equine clinical setting does not necessarily translate into surgical site infections. Through prudent antibiotic use, the antibiotic susceptibility of the isolates may be perceived. Full article

(This article belongs to the Special Issue Therapeutic Strategies for Complicated Hospital-Acquired Infections in the Era of Antimicrobial Resistance)

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