Multi-Drug Resistant Gram-Negative Infections: Molecular Epidemiology, Microbiological Diagnosis, and Antimicrobial Treatment, 2nd Edition

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

Deadline for manuscript submissions: 31 August 2026 | Viewed by 1421

Special Issue Editor

Special Issue Information

Dear Colleagues,

Multi-drug resistant (MDR) Gram-negative bacilli (BNG) represent a serious threat among antimicrobials resistances. MDR-GNB are resistant to multiple antimicrobial molecules, thus reducing the antimicrobial options available for treating infections sustained by these microorganisms. Among them, extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriales (CRE), carbapenem-resistant Acinetobacter baumannii (CRAB), and MDR Pseudomonas aeruginos represent the most urgent threat for which there is an imminent need for novel antimicrobial treatment strategies. To counteract the paucity of the antimicrobial molecules for the treatment of infections due to MDR-GNB, multidisciplinary approaches are required. In this context, innovative strategies for diagnosis, infection control and antimicrobial stewardship are the key factors. In this Special Issue, we invite authors to send in their manuscripts on the following areas of interest:

  • Novel in vitro diagnostic tools for MDR-GNB detection and antimicrobial susceptibility testing;
  • The molecular epidemiology of Gram-negative pathogens and resistance mechanisms;
  • The evaluation of antimicrobial treatment regimens for MDR-GNB;
  • New drugs against MDR-GNB: clinical use, in vitro susceptibility testing and emerging resistance.
  • Pharmacodynamics/pharmacokinetics (PK/PD) parameter to optimise antimicrobial treatments for MDR-GNB

Dr. Paolo Gaibani
Guest Editor

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Keywords

  • pharmacodynamics/pharmacokinetics (PK/PD)
  • enterobacterales
  • carbapenemase
  • novel molecules
  • antimicrobial resistance

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Related Special Issue

Published Papers (2 papers)

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Research

14 pages, 821 KB  
Article
Correlation Between Antimicrobial Consumption and Resistance in Klebsiella pneumoniae During the COVID-19 Pandemic Using Dynamic Regression Models: A Quasi-Experimental Epidemiological Time-Series Study
by Paul Laffont-Lozes, Florian Salipante, Paul Loubet, Catherine Dunyach-Remy, Jean-Philippe Lavigne, Albert Sotto and Romaric Larcher
Antibiotics 2025, 14(10), 1020; https://doi.org/10.3390/antibiotics14101020 - 14 Oct 2025
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Abstract
Background/Objectives: The COVID-19 pandemic has been reported to impact antimicrobial consumption (AMC) and antimicrobial resistance (AMR) worldwide. We aimed to assess this correlation in Klebsiella pneumoniae before and during the COVID-19 pandemic and to estimate the burden of each antibiotic. Methods: [...] Read more.
Background/Objectives: The COVID-19 pandemic has been reported to impact antimicrobial consumption (AMC) and antimicrobial resistance (AMR) worldwide. We aimed to assess this correlation in Klebsiella pneumoniae before and during the COVID-19 pandemic and to estimate the burden of each antibiotic. Methods: We collected data on AMC of penicillins and beta-lactamase inhibitors (PBIs), anti-pseudomonal activity penicillins and beta-lactamase inhibitors (AAPBIs), cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, and AMR in K. pneumoniae strains. The correlation between AMC and AMR was studied using dynamic regression models. Results: Overall, AMC of AAPBIs and fourth-generation cephalosporin increased, while fluoroquinolone consumption and AMR in the 2862 K. pneumoniae strains analyzed decreased. However, during the first year of the pandemic, we reported an increase in AMC and AMR. We found that 46% to 48% of the increase in cephalosporin, AAPBI, and fluoroquinolone resistance was explained by increased cephalosporin and fluoroquinolone consumption, 55% of the increase in PBI resistance was explained by increased PBI, cephalosporin, and fluoroquinolone consumption, and 58% of the increase in aminoglycoside resistance was explained by increased aminoglycoside consumption. Conclusions: During the COVID-19 pandemic, the increase in AMR in K. pneumoniae was correlated with the increase in AMC of several antibiotics, mainly cephalosporins and especially fluoroquinolones. Full article
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14 pages, 1389 KB  
Article
Lack of Association Between qacE and qacE∆1 Gene Variants and Sodium Hypochlorite Resistance in Clinical Isolates of ESBL- and Carbapenemase-Producing Klebsiella spp. and Enterobacter spp., from Gaborone, Botswana
by Pearl Ntshonga, Tlhalefo Dudu Ntereke, Tshiamo Zankere, Daniel Paul Morse, Garesego Koto, Irene Gobe and Giacomo Maria Paganotti
Antibiotics 2025, 14(7), 662; https://doi.org/10.3390/antibiotics14070662 - 30 Jun 2025
Viewed by 707
Abstract
Background: The qacE gene and its variant, qacE∆1, have been associated with resistance to antimicrobials and biocides. This poses a threat to infection prevention, control and treatment. Several studies investigated this relationship with conflicting results. The aim of this research was [...] Read more.
Background: The qacE gene and its variant, qacE∆1, have been associated with resistance to antimicrobials and biocides. This poses a threat to infection prevention, control and treatment. Several studies investigated this relationship with conflicting results. The aim of this research was to determine the prevalence of qacE and qacE∆1 in clinical extended spectrum β-lactamase- (ESBL) and carbapenemase-producing Klebsiella spp. and Enterobacter spp. and elucidate the association of these genes with resistance to sodium hypochlorite. Methods: This study included 216 isolates of ESBL- and carbapenemase-producing multidrug-resistant (MDR) Klebsiella spp. and Enterobacter spp. These isolates were identified by VITEK-2 analyser. The MIC and MBC of sodium hypochlorite were determined using the microbroth serial-dilution method. PCR was used to detect gene variants. A regression analysis investigated any association between qacE genotypes, MIC and MBC, as well as antimicrobial drug resistance profiles. Results: Overall, there was a high prevalence of qacE and qacE∆1 variants (84.7%; 95% CI, 79.2–89.2). There was a high prevalence of qacE∆1 (80.6%; 95% CI, 74.6–85.6) as compared to qacE (15.3%, 95% CI, 10.8–20.8). The MIC50 and MIC90 of the isolates ranged between 7031 mg/L and 9375 mg/L and 14,060 mg/L and 18,750 mg/L, respectively, while the MBC ranged from 48,750 mg/L to 18,750 mg/L. There was no association between qacE genotypes and high MIC and MBC as well as antimicrobial drug resistance. Conclusions: The MIC and MBC of sodium hypochlorite are higher than what is currently used for disinfection in Botswana. There is a high prevalence of qacE and qacE∆1; however, these genes do not seem to be associated with resistance to sodium hypochlorite. Full article
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