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Antibiotics
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The Issue of Multidrug-Resistant Pathogens in Nosocomial Infections, 2nd Edition
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The Issue of Multidrug-Resistant Pathogens in Nosocomial Infections, 2nd Edition

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

Deadline for manuscript submissions: 31 December 2025 | Viewed by 1863

Special Issue Editor

Dr. Alberto Enrico Maraolo

E-Mail Website
Guest Editor
Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
Interests: One Health; drug resistance; microbiome
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Although the COVID-19 pandemic has demonstrated how emerging and re-emerging pathogens represent an existential menace to humankind, the issue of antimicrobial resistance (AMR) looms as the perennial threat of this century.

The main setting where AMR unfolds is obviously the nosocomial setting.

In many countries, there are alarming rates of multidrug-resistant (MDR), extensively drug-resistant (XDR), or difficult-to-treat (DTR) pathogens among both Gram-negative and Gram-positive bacteria.

The robust knowledge of epidemiology, resistance mechanisms, and available therapeutic options against superbugs is crucial to guarantee the best management of patients affected by invasive infections produced by these pathogens.

This Special Issues aims to collect reviews and original articles addressing these topics to offer new insights from different viewpoints: epidemiological, aetiological, diagnostic, prognostic, and therapeutic.

Dr. Alberto Enrico Maraolo
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
  • MDR
  • XDR
  • DTR
  • nosocomial infections

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Related Special Issue

Published Papers (2 papers)

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Research

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10 pages, 434 KiB  
Article
Combating Metallo-β-Lactamase-Producing Pseudomonas aeruginosa: The Fractional Inhibitory Concentration Index as a Tool to Evaluate Antibiotic Synergy
by Guido Granata, Carolina Venditti, Claudia Rotondo, Valentina Dimartino, Silvia D’Arezzo, Assunta Gallo, Gabriella Parisi, Alessandro Capone, Carla Fontana and Stefania Cicalini
Antibiotics 2025, 14(2), 210; https://doi.org/10.3390/antibiotics14020210 - 19 Feb 2025
Viewed by 848
Abstract
Background: Multi-drug-resistant Gram-negative bacteria producing metallo-β-lactamase are an increasing concern. Here, we described three cases of infection due to difficult-to-treat and drug-resistant P. aeruginosa producing metallo-β-lactamases, which were successfully treated with antibiotic combination of cefiderocol plus imipenem–relebactam, and reported on the molecular [...] Read more.
Background: Multi-drug-resistant Gram-negative bacteria producing metallo-β-lactamase are an increasing concern. Here, we described three cases of infection due to difficult-to-treat and drug-resistant P. aeruginosa producing metallo-β-lactamases, which were successfully treated with antibiotic combination of cefiderocol plus imipenem–relebactam, and reported on the molecular and epidemiological features of the isolates and the in vitro synergistic effects of different antibiotic combinations guiding antibiotic treatment. Patients and methods: Three P. aeruginosa strains were isolated from respiratory or blood cultures of three different patients. Minimum inhibitory concentrations breakpoints were interpreted according to EUCAST recommendations. Next-generation sequencing data were used for in silico identification of resistance genes and sequence types and for core genome multi-locus sequence typing analysis. The fractional inhibitory concentration index was performed as a measure of synergy of cefiderocol plus imipenem and imipenem–relebactam. Results: The three isolates exhibited different multi-drug-resistant and molecular profiles carrying blaIMP-13 (imipenemase metallo-β-lactamase-13) (isolates named Pse-1 and Pse-3) and blaVIM-2 (Verona integron-encoded metallo-β-lactamase-2) (isolate Pse-2). Typing showed that the isolates did not cluster and belonged to different sequence types. The E-test method showed the presence of synergy of cefiderocol in combination with imipenem–relebactam in the two P. aeruginosa isolates producing IMP-13 (Pse-1 and Pse-3). No synergy was observed in the isolate producing VIM-2 (Pse-2). Conclusions: Cefiderocol in association with imipenem–relebactam exhibited a synergistic effect against IMP-producing P. aeruginosa isolates. Further studies with a range of drugs and an expanded number of isolates are required to ascertain potential novel synergistic associations and the clinical utility of the fractional inhibitory concentration index. Full article
(This article belongs to the Special Issue The Issue of Multidrug-Resistant Pathogens in Nosocomial Infections, 2nd Edition)
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Review

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15 pages, 550 KiB  
Review
Delftia acidovorans Infections in Immunocompetent and Immunocompromised Hosts: A Case Report and Systematic Literature Review
by Vincenzo Scaglione, Lucia Federica Stefanelli, Maria Mazzitelli, Leda Cattarin, Loreta De Giorgi, Elena Naso, Alberto Enrico Maraolo, Annamaria Cattelan and Federico Nalesso
Antibiotics 2025, 14(4), 365; https://doi.org/10.3390/antibiotics14040365 - 1 Apr 2025
Viewed by 456
Abstract
Delftia acidovorans (D. acidovorans) is a non-fermentative, aerobic, Gram-negative bacillus typically found in environmental sources such as soil and water. Although considered an opportunistic pathogen, it has been implicated in both immunocompromised and immunocompetent individuals. This study presents a case of [...] Read more.
Delftia acidovorans (D. acidovorans) is a non-fermentative, aerobic, Gram-negative bacillus typically found in environmental sources such as soil and water. Although considered an opportunistic pathogen, it has been implicated in both immunocompromised and immunocompetent individuals. This study presents a case of persistent cathether-related bacteraemia in a 61-year-old haemodialysis patient and offers a systematic literature review of similar cases. The patient, affected by end-stage kidney disease and dependent on a central venous catheter (CVC), presented with septic shock. Blood cultures confirmed D. acidovorans, resistant to aminoglycosides but sensitive to cephalosporins, piperacillin/tazobactam, and fluoroquinolones. Despite appropriate antibiotic therapy, bacteraemia persisted, prompting the use of taurolidine lock therapy when catheter removal was initially unfeasible. Blood cultures cleared after nine days, and the catheter was later replaced. A systematic review following PRISMA guidelines identified 21 additional cases of D. acidovorans bacteraemia. Most (76.2%) occurred in immunocompromised patients, particularly those with malignancies, chronic haemodialysis, or indwelling devices. Infections in immunocompetent individuals were typically associated with intravenous drug use or environmental exposure. Mortality was approximately 19%. Aminoglycoside resistance was consistent across most cases, while susceptibility to piperacillin/tazobactam, cephalosporins, and carbapenems was generally preserved. Given its resistance profile and ability to form biofilms, D. acidovorans poses a management challenge, particularly in catheter-associated infections. Rapid identification and targeted antimicrobial therapy are crucial. Adjunctive measures such as taurolidine lock therapy can be beneficial when device removal is not immediately possible. Full article
(This article belongs to the Special Issue The Issue of Multidrug-Resistant Pathogens in Nosocomial Infections, 2nd Edition)
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