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Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital, 2nd...
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Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital, 2nd Edition

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

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 11178

Special Issue Editor

Dr. Maria Bagattini

E-Mail Website
Guest Editor
Department of Public Health, School of Medicine, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
Interests: healthcare associated infections (HAIs); molecular epidemiology of healthcare-associated infections; epidemiology of antimicrobial resistance; disinfectant tolerance; carbapenem resistant (CR) Acinetobacter baumannii; third generation cephalosporins and carbapenem resistant Enterobacterales
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Antimicrobial resistance (AMR) and healthcare-associated infections (HAIs) are among the biggest global public health challenges of our time. HAIs cause significant morbidity and mortality and incur rising direct and indirect costs. On the basis of the most recent predictive statistical models, worldwide, there were an estimated 4.95 million deaths associated with bacterial AMR in 2019, including 1.27 million deaths attributable to bacterial AMR. Six of the leading pathogens contributing to the burden of AMR in 2019 (third-generation cephalosporin-resistant and fluoroquinolone-resistant Escherichia coli, Methicillin-resistant Staphylococcus aureus, Carbapenem-resistant and third-generation cephalosporin-resistant Klebsiella pneumoniae, Streptococcus pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa)  have been identified as priority pathogens by the WHO, and AMR has been highlighted in the political arena through the Global Action Plan on AMR. The challenge of AMR is closely linked to HAIs; in fact, HAIs in the hospital are often caused by multidrug-resistant bacteria, especially in more vulnerable patients, i.e., premature babies and immunocompromised patients. Interestingly, many bacterial pathogens involved in HAIs have shown the ability to adapt and develop an increased tolerance to biocides. Efflux pumps, mutations driven by selective pressure exerted by antimicrobials and horizontal gene transfer contribute to the development of an increased tolerance to disinfectants. Intervention strategies for addressing the challenge of bacterial AMR fall into different categories, i.e., vaccination, reducing exposure to antibiotics and the development of new antimicrobials, but the principles of infection prevention and control remain the foundation for preventing infections, particularly HAIs, in hospital and a milestone in combating the spread of AMR.

This Special Issue represents the second volume of “Surveillance for antimicrobial resistance and Healthcare-associated infections (HAIs) in hospital”. For this Special Issue, we invite you to submit a manuscript related to all aspects concerning surveillance for AMR and HAIs prevention, detection, control and management.

Dr. Maria Bagattini
Guest Editor

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

  • antimicrobial resistance
  • antibiotic-resistant pathogens
  • disinfectant resistance
  • mechanisms of resistance

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Published Papers (4 papers)

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Research

8 pages, 368 KiB  
Article
Hand Hygiene Practices during the COVID-19 Pandemic in Northern Italy: Assessment of Compliance Rates Measured by Direct Observation and Alcohol-Based Handrub Usage
by Costanza Vicentini, Giulia Libero, Valerio Bordino and Carla Maria Zotti
Antibiotics 2022, 11(11), 1510; https://doi.org/10.3390/antibiotics11111510 - 29 Oct 2022
Cited by 10 | Viewed by 2060
Abstract
Hand hygiene (HH) is among the most effective measures for reducing the transmission of healthcare-associated infections and SARS-CoV-2. We aimed to assess HH practices among healthcare workers (HCWs) of three hub hospitals in Northern Italy during the COVID-19 pandemic, by assessing HH compliance [...] Read more.
Hand hygiene (HH) is among the most effective measures for reducing the transmission of healthcare-associated infections and SARS-CoV-2. We aimed to assess HH practices among healthcare workers (HCWs) of three hub hospitals in Northern Italy during the COVID-19 pandemic, by assessing HH compliance measured by direct observation and alcohol-based handrub usage. An observational study was conducted over a period of three months, between February and April 2021. HH compliance audits were conducted using the WHO My 5 Moments for HH approach. Multivariable logistic regression was used to evaluate independent predictors of HH compliance: ward type, HCW category and HH indication. Spearman correlation was used to investigate the relationship between HH compliance and alcohol-based handrub consumption. In total, 2880 HH opportunities were observed, with an overall compliance of 68%. Significant differences were found in compliance rates across ward types, HCW categories and HH indications. The mean alcohol-based handrub usage among included wards was 41.63 mL/PD. No correlation was identified between compliance rates and alcohol-based handrub consumption (ρ 0.023, p 0.943). This study provided a snapshot of HH practices in a pandemic context, which could be useful as a reference for future studies. Full article
(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital, 2nd Edition)
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13 pages, 791 KiB  
Article
Resveratrol Reverts Tolerance and Restores Susceptibility to Chlorhexidine and Benzalkonium in Gram-Negative Bacteria, Gram-Positive Bacteria and Yeasts
by Antonella Migliaccio, Maria Stabile, Maria Bagattini, Maria Triassi, Rita Berisio, Eliana De Gregorio and Raffaele Zarrilli
Antibiotics 2022, 11(7), 961; https://doi.org/10.3390/antibiotics11070961 - 18 Jul 2022
Cited by 6 | Viewed by 2183
Abstract
The spread of microorganisms causing health-care associated infection (HAI) is contributed to by their intrinsic tolerance to a variety of biocides, used as antiseptics or disinfectants. The natural monomeric stilbenoid resveratrol (RV) is able to modulate the susceptibility to the chlorhexidine digluconate (CHX) [...] Read more.
The spread of microorganisms causing health-care associated infection (HAI) is contributed to by their intrinsic tolerance to a variety of biocides, used as antiseptics or disinfectants. The natural monomeric stilbenoid resveratrol (RV) is able to modulate the susceptibility to the chlorhexidine digluconate (CHX) biocide in Acinetobacter baumannii. In this study, a panel of reference strains and clinical isolates of Gram-negative bacteria, Gram-positive bacteria and yeasts were analyzed for susceptibility to CHX and benzalkonium chloride (BZK) and found to be tolerant to one or both biocides. The carbonyl cyanide m-chlorophenylhydrazine protonophore (CCCP) efflux pump inhibitor reduced the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of CHX and BZK in the majority of strains. RV reduced dose-dependently MIC and MBC of CHX and BZK biocides when used as single agents or in combination in all analyzed strains, but not CHX MIC and MBC in Pseudomonas aeruginosa, Candida albicans, Klebsiella pneumoniae, Stenotrophomonas maltophilia and Burkholderia spp. strains. In conclusion, RV reverts tolerance and restores susceptibility to CHX and BZK in the majority of microorganisms responsible for HAI. These results indicates that the combination of RV, CHX and BZK may represent a useful strategy to maintain susceptibility to biocides in several nosocomial pathogens. Full article
(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital, 2nd Edition)
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12 pages, 254 KiB  
Article
Epidemiology and Burden of Sepsis at Thailand’s Largest University-Based National Tertiary Referral Center during 2019
by Lalita Tancharoen, Prat Pairattanakorn, Visanu Thamlikitkul and Nasikarn Angkasekwinai
Antibiotics 2022, 11(7), 899; https://doi.org/10.3390/antibiotics11070899 - 5 Jul 2022
Cited by 3 | Viewed by 2303
Abstract
Data specific to the epidemiology and burden of sepsis in low- and middle-income countries are limited. This study aimed to determine the epidemiology and burden of adult patients with sepsis at Siriraj Hospital during 2019. Randomly selected adult patients who had blood cultures [...] Read more.
Data specific to the epidemiology and burden of sepsis in low- and middle-income countries are limited. This study aimed to determine the epidemiology and burden of adult patients with sepsis at Siriraj Hospital during 2019. Randomly selected adult patients who had blood cultures performed at our center during January–December 2019 were enrolled. A Quick Sepsis-related Organ Failure Assessment (qSOFA) score was used to determine the presence of sepsis. Demographic data and clinical outcome data were collected, and the annual incidence of sepsis or septic shock and death was estimated. Of the 987 subjects who had blood cultures performed, 798 had infections, 341 had sepsis, and 104 had septic shock. The prevalence of sepsis or septic shock was 34.9% among blood cultured patients, and 42.7% among those with infections. The prevalence of septic shock was 30.5% among subjects with sepsis. Approximately 63% of sepsis subjects were hospital-acquired infections. The factors independently associated with 28-day mortality in sepsis were receiving an immunosuppressive agent (adjusted odds ratio [aOR]: 2.37, 95% confidence interval [CI]: 1.27–4.45; p = 0.007), septic shock (aOR: 2.88, 95% CI: 1.71–4.87; p < 0.001), and proven infection (aOR: 2.88, 95% CI: 1.55–5.36; p = 0.001). Receiving appropriate, definitive antibiotic therapy (ABT) was independently associated with lower mortality in sepsis (aOR: 0.50, 95% CI: 0.27–0.93; p = 0.028) and septic shock subjects (aOR: 0.21, 95% CI: 0.06–0.72; p = 0.013). Achievement of mean arterial pressure (MAP) ≥ 65 mmHg (aOR: 0.09, 95% CI: 0.01–0.77; p = 0.028) and urine output ≥ 0.5 mL/kg/h (aOR: 0.15, 95% CI: 0.04–0.51; p = 0.006) were independently associated with lower mortality in septic shock patients. The incidence and mortality of sepsis remains high. Appropriate choice of definitive ABT and achievement of MAP and urine output goals may lower mortality in patients with sepsis or septic shock. Full article
(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital, 2nd Edition)
10 pages, 560 KiB  
Article
An Observational Study of MDR Hospital-Acquired Infections and Antibiotic Use during COVID-19 Pandemic: A Call for Antimicrobial Stewardship Programs
by Nour Shbaklo, Silvia Corcione, Costanza Vicentini, Susanna Giordano, Denise Fiorentino, Gabriele Bianco, Francesco Cattel, Rossana Cavallo, Carla Maria Zotti and Francesco Giuseppe De Rosa
Antibiotics 2022, 11(5), 695; https://doi.org/10.3390/antibiotics11050695 - 20 May 2022
Cited by 27 | Viewed by 3879
Abstract
The pandemic caused by the COVID-19 virus has required major adjustments to healthcare systems, especially to infection control and antimicrobial stewardship. The objective of this study was to describe the incidence of multidrug-resistant (MDR) hospital-acquired infections (HAIs) and antibiotic consumption during the three [...] Read more.
The pandemic caused by the COVID-19 virus has required major adjustments to healthcare systems, especially to infection control and antimicrobial stewardship. The objective of this study was to describe the incidence of multidrug-resistant (MDR) hospital-acquired infections (HAIs) and antibiotic consumption during the three waves of COVID-19 and to compare it to the period before the outbreak at Molinette Hospital, located in the City of Health and Sciences, a 1200-bed teaching hospital with surgical, medical, and intensive care units. We demonstrated an increase in MDR infections: particularly in K. pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp), A. baumannii, and MRSA. Fluoroquinolone use showed a significant increasing trend in the pre-COVID period but saw a significant reduction in the COVID period. The use of fourth- and fifth-generation cephalosporins and piperacillin–tazobactam increased at the beginning of the COVID period. Our findings support the need for restoring stewardship and infection control practices, specifically source control, hygiene, and management of invasive devices. In addition, our data reveal the need for improved microbiological diagnosis to guide appropriate treatment and prompt infection control during pandemics. Despite the infection control practices in place during the COVID-19 pandemic, invasive procedures in critically ill patients and poor source control still increase the risk of HAIs caused by MDR organisms. Full article
(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital, 2nd Edition)
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