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Clinically Important Pathogens, Antimicrobial Resistance in ESKAPE Group of Bacteria

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A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 12835

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Special Issue Editors

Prof. Dr. Pavel Bostik

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Guest Editor

Faculty of Medicine and Faculty Hospital, Charles University, Hradec Kralove, Czech Republic
Interests: antibiotic resistance; molecular biology; hospital infections; natural compounds
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Milan Kolar

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Guest Editor

Faculty of Medicine and Dentistry, University Hospital Olomouc, Palacky University, Olomouc, Czech Republic
Interests: bacterial infections; antibiotic therapy; antibiotic resistance
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Clinical medicine today can be characterized by an exponential increase in knowledge in all its disciplines, which brings significant improvements in both the diagnostic and therapeutic fields. However, it is necessary to point out one area which, despite the achieved successes, still represents a serious therapeutic problem. This area includes bacterial infections, the importance of which has been steadily increasing in recent years. The main reasons for this rise can be defined by the following points:

Bacterial infections are often becoming endogenous, i.e., the etiologic agent comes from the human microflora;
Infections by atypical or previously rarely detected microorganisms are on the rise;
Resistance of bacteria to antibacterial drugs (AMR) and the associated risk of antibiotic treatment failure are increasing;
The number of immunocompromised patients is increasing;
Invasive diagnostic and treatment procedures affecting the human microbiome are increasingly used.

AMR is undoubtedly one of the most important healthcare problems. Prevention and at least partial limitation of this problem require an understanding of the emergence and spread of AMR. The basic prerequisite for solving this problem is close interdisciplinary cooperation and implementation of bacterial resistance surveillance, which must include determining the method of selection of multidrug-resistant (MDR) bacteria, pathways, and mechanisms of their spread, including the genetic basis. These data are a necessary prerequisite for determining the basic principles of rational antibiotic therapy and adequate hygienic–epidemiological measures.

This Special Issue is open to articles focusing on clinically important atypical bacterial pathogens and the ESKAPE group of bacteria, including six highly virulent and MDR bacterial pathogens, namely, Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter sp.

The editors believe that the information in this Special Issue will contribute to addressing bacterial infections and related AMR.

Prof. Dr. Pavel Bostik
Prof. Dr. Milan Kolar
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.

Published Papers (5 papers)

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Research

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12 pages, 635 KiB

Open AccessArticle

Impact of SARS-CoV-2 Preventive Measures against Healthcare-Associated Infections from Antibiotic-Resistant ESKAPEE Pathogens: A Two-Center, Natural Quasi-Experimental Study in Greece

by Emmanouil Bolikas, Eirini Astrinaki, Evangelia Panagiotaki, Efsevia Vitsaxaki, Stamatina Saplamidou, Ioannis Drositis, Dimitra Stafylaki, Georgios Chamilos, Achilleas Gikas, Diamantis P. Kofteridis and Evangelos I. Kritsotakis

Antibiotics 2023, 12(7), 1088; https://doi.org/10.3390/antibiotics12071088 - 22 Jun 2023

Cited by 2 | Viewed by 1454

Abstract

The COVID-19 pandemic led to unprecedented stress on healthcare systems worldwide, forming settings of concern for increasing antimicrobial resistance. We investigated the impact of SARS-CoV-2 preventive measures against healthcare-associated infections (HAIs) from antibiotic-resistant bacteria in two tertiary-care hospitals. We compared infection rates between March 2019 and February 2020 (pre-intervention period) and March 2020 and February 2021 (COVID-19 intervention period) from drug-resistant ESKAPEE bacteria (methicillin-resistant Staphylococcus aureus; vancomycin-resistant Enterococci; carbapenem-resistant Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species and Escherichia coli). Over 24 months, 586 drug-resistant ESKAPEE HAIs occurred in 439 patients (0.3% of 179,629 inpatients) with a mean age of 63 years, with 43% being treated in intensive care units (ICUs), and having a 45% inpatient mortality rate. Interrupted time series analysis revealed increasing infection rates before the intervention that were sharply interrupted by abrupt drops for most pathogens and henceforth remained stable in the ICUs but progressively increased in ordinary wards. In the ICUs, the pooled infection rate was 44% lower over the intervention period compared to the pre-intervention period (incidence rate ratio (IRR) 0.56, 95%CI 0.41–0.75, p < 0.001). Pooled infection rates in the wards were slightly higher over the COVID-19 period (IRR 1.12, 95%CI 0.87–1.45, p = 0.368). The findings confirmed the ancillary beneficial impact of the enhanced bundle of transmission-based precautions adopted against SARS-CoV-2 in rapidly constraining antimicrobial-resistant HAIs in two Greek hospitals. Full article

(This article belongs to the Special Issue Clinically Important Pathogens, Antimicrobial Resistance in ESKAPE Group of Bacteria)

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12 pages, 1172 KiB

Open AccessArticle

Analysis of Bacterial Pathogens Causing Complicating HAP in Patients with Secondary Peritonitis

by Josef Chudáček, Petr Špička, Milan Kolar, Martin Stašek, Štefan Kolcún, Dušan Klos, Kristýna Hricová, Patrik Mlynarcik, Vendula Pudová, Olga Klementová and Rostislav Horáček

Antibiotics 2023, 12(3), 527; https://doi.org/10.3390/antibiotics12030527 - 06 Mar 2023

Viewed by 1421

Abstract

Background: Diffuse peritonitis is an acute abdominal condition characterized by high mortality. The main treatment modality is surgery, requiring a subsequent prolonged hospital stay. These patients are, among other things, at risk of developing hospital-acquired pneumonia (HAP), which considerably worsens their treatment outcomes. This study aimed to extend the existing knowledge by providing more detailed microbiological characteristics of complicating HAP in patients with secondary peritonitis, including the identification of isolated bacterial pathogens and their potential sources. Methods: The 2015–2019 retrospective study comprised all patients with an intraoperatively confirmed diagnosis of secondary diffuse peritonitis who were classified in accordance with the quick Sepsis Related Organ Failure Assessment scoring system. Results: HAP developed in 15% of patients. The 90-day mortality rates were 53% and 24% in patients with and without HAP; respectively. The most frequent pathogens responsible for HAP were Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae complex and Enterococcus faecalis. Multidrug resistance to antibiotics was found in 38% of bacterial pathogens. Clonal spread of these bacterial pathogens among patients was not detected. Rather, the endogenous characteristic of HAP was confirmed. Conclusions: The initial antibiotic therapy of complicating HAP in patients with secondary peritonitis must be effective mainly against enterobacteria, including strains with the production of ESBL and AmpC beta-lactamases, Pseudomonas aeruginosa and Enterococcus faecalis. The study further highlighted the importance of monitoring the respiratory tract bacterial microflora in patients with secondary peritonitis. The results should be used for initial antibiotic treatment of complicating HAP instances. Full article

(This article belongs to the Special Issue Clinically Important Pathogens, Antimicrobial Resistance in ESKAPE Group of Bacteria)

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Review

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20 pages, 1547 KiB

Open AccessReview

The Major Facilitator Superfamily and Antimicrobial Resistance Efflux Pumps of the ESKAPEE Pathogen Staphylococcus aureus

by Jerusha Stephen, Fathima Salam, Manjusha Lekshmi, Sanath H. Kumar and Manuel F. Varela

Antibiotics 2023, 12(2), 343; https://doi.org/10.3390/antibiotics12020343 - 07 Feb 2023

Cited by 10 | Viewed by 5403

Abstract

The ESKAPEE bacterial pathogen Staphylococcus aureus has posed a serious public health concern for centuries. Throughout its evolutionary course, S. aureus has developed strains with resistance to antimicrobial agents. The bacterial pathogen has acquired multidrug resistance, causing, in many cases, untreatable infectious diseases and raising serious public safety and healthcare concerns. Amongst the various mechanisms for antimicrobial resistance, integral membrane proteins that serve as secondary active transporters from the major facilitator superfamily constitute a chief system of multidrug resistance. These MFS transporters actively export structurally different antimicrobial agents from the cells of S. aureus. This review article discusses the S. aureus-specific MFS multidrug efflux pump systems from a molecular mechanistic perspective, paying particular attention to structure–function relationships, modulation of antimicrobial resistance mediated by MFS drug efflux pumps, and direction for future investigation. Full article

(This article belongs to the Special Issue Clinically Important Pathogens, Antimicrobial Resistance in ESKAPE Group of Bacteria)

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Other

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9 pages, 9207 KiB

Open AccessCase Report

A Rare Case of Osteomyelitis of an Ankle Caused by Mycobacterium chelonae

by Lenka Ryskova, Rudolf Kukla, Radka Bolehovska, Libor Prokes, Milan Vajda, Tomas Kucera, Ivo Pavlik, Pavel Bostik and Pavel Ryska

Antibiotics 2023, 12(1), 97; https://doi.org/10.3390/antibiotics12010097 - 06 Jan 2023

Viewed by 2020

Abstract

Mycobacterium chelonae, a rapidly growing nontuberculous mycobacterium, is usually described as a causative agent of soft tissue infections (postsurgical, posttraumatic, posttransplantation, postinjection, catheter infection, etc.), but only rarely as a cause of osteomyelitis. The authors describe a case report of a 72-year-old man with osteomyelitis of the talus. Initially, the infection was assessed as a soft tissue infection, without any osteolytic changes on the X-ray. After cultivation with subsequent targeted molecular typing of the rpoB gene, M. chelonae was identified from the affected tissue. The bone involvement was subsequently detected on MRI and confirmed histologically with findings of the granulomatous tissue and acid-fast bacilli. The patient was initially treated intravenously with a combination of tigecycline, amikacin, and moxifloxacin for 4 weeks, after which the oral combination of doxycycline and moxifloxacin continued. Identification of the infecting pathogen using molecular typing thus helped to establish the correct diagnosis and represents a rarely described case of osteomyelitis caused by M. chelonae. Full article

(This article belongs to the Special Issue Clinically Important Pathogens, Antimicrobial Resistance in ESKAPE Group of Bacteria)

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8 pages, 1162 KiB

Open AccessCase Report

Dual Infection of an Open Fracture Caused by Mycobacterium setense and Clostridium celerecrescens

by Lenka Ryskova, Jan Zahradnicek, Rudolf Kukla, Radka Bolehovska, Milan Vajda, Ivo Pavlik, Pavel Bostik and Pavel Ryska

Antibiotics 2022, 11(9), 1254; https://doi.org/10.3390/antibiotics11091254 - 15 Sep 2022

Cited by 1 | Viewed by 1454

Abstract

Infections caused by Mycobacterium setense or Clostridium celerecrescens are extremely rare. In this report, for the first time a dual infection with these two pathogens is described. An 18-year-old female suffered multiple injuries, including an open comminuted fracture of the right humeral diaphysis after falling from a fifth-floor balcony in January 2019. Five months after the accident, a fistula appeared in the scar, reaching the bone tissue. M. setense and C. celerecrescens were cultured from sinus swabs and subsequently from perioperative samples. The patient was initially treated with a combination of intravenous antibiotics (ATBs): imipenem, amikacin, and ciprofloxacin. One month after the fracture fixation with a titanium nail, C. celerecrescens was again detected; therefore, metronidazole was added to the therapy. A triple combination of oral (PO) ATBs (trimethoprim–sulfamethoxazole, moxifloxacin, and metronidazole) followed, 8 weeks after the initial intravenous therapy. C. celerecrescens was cultured again two times, most recently in November 2019, when surgical debridement was supplemented by the topical administration of cancellous bone impregnated with vancomycin. Signs of bone healing were found at follow-ups and ATB treatment was finished in March 2020 after a total of 9 months of therapy. To this day, there have been no signs of reinfection. This case thus illustrates the need for a combination of systemic and individualized local therapy in the treatment of complicated cases of dual infections with rare pathogens. Full article

(This article belongs to the Special Issue Clinically Important Pathogens, Antimicrobial Resistance in ESKAPE Group of Bacteria)

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