Multi-Drug Resistant Gram-Negative Infections: Molecular Epidemiology, Microbiological Diagnosis and Antimicrobial Treatment

Dear Colleagues,

Infections caused by gram-negative pathogens have become increasingly prevalent in recent years, representing a serious global threat to public health. Antimicrobial resistance is a worldwide problem and multi-drug resistant organisms (MDRo) are a cause for major concern because of their clinical and economic impact, with high morbidity and mortality rates, higher hospital and antibiotic costs, and longer lengths of stay in hospitals and intensive care units. The majority of the burden is related to healthcare-acquired infections caused by gram-negative multi-drug resistant organisms, including extended-spectrum β-lactamase (ESBL-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Acinetobacter baumannii (CRAB), and MDR Pseudomonas aeruginosa.

Since the 2000s, there has been a steady increase in the rates of these pathogens determined by the rapid spread of resistance mechanisms. The management of MDR gram-negative infections requires a multidisciplinary approach, including innovative strategies for diagnosis, infection control and therapy.

Traditional cultural methods have turn-around times that are considered suboptimal, in particular for severe infections in critical patients. For this reason, rapid diagnostic tests able to detect timely gram-negative organisms and their resistance markers represent an important tool of antimicrobial stewardship. Moreover, the knowledge of resistance mechanisms and of the molecular epidemiology of bacterial isolates plays a crucial role in the understanding of how antimicrobial resistance develops and spreads among strains and between patients. The antimicrobial treatment of MDR gram-negative pathogens is often limited to a few agents with in vitro activity. Some new drugs with promising activity against these organisms have recently been developed (ceftolozane/tazobactam, ceftazidime/avibactam, meropenem/vaborbactam, cefiderocol), increasing the treatment options for infected patients.

We invite authors to send in their manuscripts in the following areas of interest:

• novel in vitro diagnostic tools for MDR gram-negative detection and antimicrobial susceptibility testing;
• molecular epidemiology of gram-negative pathogens and resistance mechanisms;
• evaluation of antimicrobial treatment regimens for MDR gram-negatives infections;
• new drugs against MDR gram-negatives: clinical use, in vitro susceptibility testing and emerging resistance.

Dr. Simone Ambretti
Dr. Paolo Gaibani
Dr. Tommaso Giani
Guest Editors

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