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Antibiotics
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Challenges and Emerging Strategies to Tackle the Global Burden of...
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Challenges and Emerging Strategies to Tackle the Global Burden of Antimicrobial Resistance

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

Deadline for manuscript submissions: 20 March 2026 | Viewed by 12105

Special Issue Editor

Dr. Tomislav Meštrović

E-Mail Website
Guest Editor
1. University Centre Varaždin, University North, Varazdin, Croatia
2. Institute for Health Metrics and Evaluation (IHME), University of Washington, Seatle, WA, USA
3. Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle, WA, USA
Interests: global burden of AMR; AMR surveillance; diagnostics; treatment; multi-resistant microorganisms; AMR policy; antibiotic stewardship; public health; global health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Antimicrobial resistance (AMR) poses a significant global health threat, with far-reaching implications for health systems and society. Despite the immense disease burden due to resistant microorganisms and urgent need for effective strategies to tackle them, there remains a clear lack of practical clinical research to inform much-needed advances in this field. The emergence of multidrug-resistant pathogens compromises the effectiveness of standard antibiotic treatment regimens, jeopardising in turn medical progress and patient outcomes worldwide.

Therefore, prompt and effective action is essential to address the challenges posed by AMR and develop strategies to mitigate its impact. This Special Issue of the journal "Antibiotics" aims to address this critical issue by focusing on articles covering a range of topics related to AMR. These include novel approaches to AMR diagnostics, surveillance strategies and antimicrobial treatment strategies, but also cover novel approaches to antibiotic stewardship and local/global policy perspectives.

I am pleased to invite submissions of high-quality research-based or review papers addressing the challenges and emerging strategies to tackle the global burden of antimicrobial resistance. The end-goal is to create a timely and highly relevant collection of articles aimed at addressing this pressing topic, which is currently one of the biggest global health concerns the humanity has faced.

Dr. Tomislav Meštrović
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 (AMR)
  • global burden of AMR
  • AMR in the context of public and global health
  • diagnostic and treatment of AMR
  • new approaches to AMR surveillance
  • antibiotic stewardship
  • local and global policy initiatives on AMR
  • prevention of AMR

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Published Papers (4 papers)

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Research

Jump to: Review, Other

8 pages, 770 KB  
Article
Ciprofloxacin Concentrations 100-Fold Lower than the MIC Can Select for Ciprofloxacin Resistance in Neisseria subflava: An In Vitro Study
by Zina Gestels, Saïd Abdellati, Chris Kenyon and Sheeba Santhini Manoharan-Basil
Antibiotics 2024, 13(6), 560; https://doi.org/10.3390/antibiotics13060560 - 14 Jun 2024
Cited by 4 | Viewed by 2012
Abstract
Neisseria gonorrhoeae can acquire antimicrobial resistance (AMR) through horizontal gene transfer (HGT) from other Neisseria spp. such as commensals like Neisseria subflava. Low doses of antimicrobials in food could select for AMR in N. subflava, which could then be transferred to N. [...] Read more.
Neisseria gonorrhoeae can acquire antimicrobial resistance (AMR) through horizontal gene transfer (HGT) from other Neisseria spp. such as commensals like Neisseria subflava. Low doses of antimicrobials in food could select for AMR in N. subflava, which could then be transferred to N. gonorrhoeae. In this study, we aimed to determine the lowest concentration of ciprofloxacin that can induce ciprofloxacin resistance (minimum selection concentration—MSC) in a N. subflava isolate (ID-Co000790/2, a clinical isolate collected from a previous community study conducted at ITM). In this study, Neisseria subflava was serially passaged on gonococcal (GC) medium agar plates containing ciprofloxacin concentrations ranging from 1:100 to 1:10,000 below its ciprofloxacin MIC (0.006 µg/mL) for 6 days. After 6 days of serial passaging at ciprofloxacin concentrations of 1/100th of the MIC, 24 colonies emerged on the plate containing 0.06 µg/mL ciprofloxacin, which corresponds to the EUCAST breakpoint for N. gonorrhoeae. Their ciprofloxacin MICs were between 0.19 to 0.25 µg/mL, and whole genome sequencing revealed a missense mutation T91I in the gyrA gene, which has previously been found to cause reduced susceptibility to fluoroquinolones. The N. subflava MSCde novo was determined to be 0.06 ng/mL (0.00006 µg/mL), which is 100×-fold lower than the ciprofloxacin MIC. The implications of this finding are that the low concentrations of fluoroquinolones found in certain environmental samples, such as soil, river water, and even the food we eat, may be able to select for ciprofloxacin resistance in N. subflava. Full article
(This article belongs to the Special Issue Challenges and Emerging Strategies to Tackle the Global Burden of Antimicrobial Resistance)
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Review

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19 pages, 1066 KB  
Review
Current Knowledge on CRISPR Strategies Against Antimicrobial-Resistant Bacteria
by Carlos de la Fuente Tagarro, Diego Martín-González, Andrea De Lucas, Sergio Bordel and Fernando Santos-Beneit
Antibiotics 2024, 13(12), 1141; https://doi.org/10.3390/antibiotics13121141 - 27 Nov 2024
Cited by 3 | Viewed by 3750
Abstract
CRISPR/Cas systems have emerged as valuable tools to approach the problem of antimicrobial resistance by either sensitizing or lysing resistant bacteria or by aiding in antibiotic development, with successful applications across diverse organisms, including bacteria and fungi. CRISPR/Cas systems can target plasmids or [...] Read more.
CRISPR/Cas systems have emerged as valuable tools to approach the problem of antimicrobial resistance by either sensitizing or lysing resistant bacteria or by aiding in antibiotic development, with successful applications across diverse organisms, including bacteria and fungi. CRISPR/Cas systems can target plasmids or the bacterial chromosome of AMR-bacteria, and it is especially necessary to have an efficient entry into the target cells, which can be achieved through nanoparticles or bacteriophages. Regarding antibiotic development and production, though the use of CRISPR/Cas in this field is still modest, there is an untapped reservoir of bacterial and fungal natural products, with over 95% yet to be characterized. In Streptomyces, a key antibiotic-producing bacterial genus, CRISPR/Cas has been successfully used to activate silent biosynthetic gene clusters, leading to the discovery of new antibiotics. CRISPR/Cas is also applicable to non-model bacteria and different species of fungi, making it a versatile tool for natural products discovery. Moreover, CRISPR/Cas-based studies offer insights into metabolic regulation and biosynthetic pathways in both bacteria and fungi, highlighting its utility in understanding genetic regulation and improving industrial strains. In this work, we review ongoing innovations on ways to treat antimicrobial resistances and on antibiotic discovery using CRISPR/Cas platforms, highlighting the role of bacteria and fungi in these processes. Full article
(This article belongs to the Special Issue Challenges and Emerging Strategies to Tackle the Global Burden of Antimicrobial Resistance)
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32 pages, 6288 KB  
Review
A Decade of Antimicrobial Resistance in Human and Animal Campylobacter spp. Isolates
by Rita Barata, Maria José Saavedra and Gonçalo Almeida
Antibiotics 2024, 13(9), 904; https://doi.org/10.3390/antibiotics13090904 - 21 Sep 2024
Cited by 8 | Viewed by 5076
Abstract
Objectives: Campylobacter spp. remain a leading cause of bacterial gastroenteritis worldwide, with resistance to antibiotics posing significant challenges to treatment and public health. This study examines profiles in antimicrobial resistance (AMR) for Campylobacter isolates from human and animal sources over the past [...] Read more.
Objectives: Campylobacter spp. remain a leading cause of bacterial gastroenteritis worldwide, with resistance to antibiotics posing significant challenges to treatment and public health. This study examines profiles in antimicrobial resistance (AMR) for Campylobacter isolates from human and animal sources over the past decade. Methods: We conducted a comprehensive review of resistance data from studies spanning ten years, analyzing profiles in resistance to key antibiotics, ciprofloxacin (CIP), tetracycline (TET), erythromycin (ERY), chloramphenicol (CHL), and gentamicin (GEN). Data were collated from various regions to assess global and regional patterns of resistance. Results: The analysis reveals a concerning trend of increasing resistance patterns, particularly to CIP and TET, across multiple regions. While resistance to CHL and GEN remains relatively low, the high prevalence of CIP resistance has significantly compromised treatment options for campylobacteriosis. Discrepancies in resistance patterns were observed between human and animal isolates, with variations across different continents and countries. Notably, resistance to ERY and CHL showed regional variability, reflecting potential differences in antimicrobial usage and management practices. Conclusions: The findings underscore the ongoing challenge of AMR in Campylobacter, highlighting the need for continued surveillance and research. The rising resistance prevalence, coupled with discrepancies in resistance patterns between human and animal isolates, emphasize the importance of a One Health approach to address AMR. Enhanced monitoring, novel treatment strategies, and global cooperation are crucial for mitigating the impact of resistance and ensuring the effective management of Campylobacter-related infections. Full article
(This article belongs to the Special Issue Challenges and Emerging Strategies to Tackle the Global Burden of Antimicrobial Resistance)
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Other

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30 pages, 4428 KB  
Systematic Review
Prevalence and Antimicrobial Resistance of Enterobacteriaceae in Wild Birds Across Europe: A Systematic Review
by Daiana-Ionela Cocoș, Eugenia Dumitrescu, Florin Muselin, Diana Brezovan, János Degi, Oana-Maria Boldura and Romeo T. Cristina
Antibiotics 2025, 14(9), 905; https://doi.org/10.3390/antibiotics14090905 - 8 Sep 2025
Viewed by 428
Abstract
Wild birds are increasingly recognized as reservoirs and vectors of antimicrobial-resistant (AMR) Enterobacteriaceae, but comprehensive assessments across Europe remain limited. AMR represents a growing threat to global health under the One Health framework. Background/Objectives: This review aimed to evaluate the occurrence, diversity, [...] Read more.
Wild birds are increasingly recognized as reservoirs and vectors of antimicrobial-resistant (AMR) Enterobacteriaceae, but comprehensive assessments across Europe remain limited. AMR represents a growing threat to global health under the One Health framework. Background/Objectives: This review aimed to evaluate the occurrence, diversity, and resistance patterns of Enterobacteriaceae in wild birds across Europe (1969–2025), and to identify ecological and methodological trends. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we searched PubMed and Web of Science until July 2025. Inclusion criteria targeted studies reporting Enterobacteriaceae isolation and/or AMR in free-living European birds. Data were synthesized thematically by bacterial species, avian order, resistance profile, and country. Risk of bias was assessed based on sampling, reporting, and diagnostic clarity. Results: Eighty studies met the inclusion criteria, covering over 18,000 wild birds from 25 countries. Escherichia coli and Salmonella enterica were most reported, often exhibiting resistance to β-lactams, fluoroquinolones, and tetracyclines. AMR was detected in birds from both urban and natural areas. Study designs varied widely, with inconsistent methods for bacterial identification and susceptibility testing. Conclusions: Wild birds in Europe carry resistant Enterobacteriaceae, including strains with clinically relevant resistance profiles. These findings support their inclusion in One Health AMR surveillance and highlight the need for harmonized protocols, expanded molecular tools, and ecological integration. Full article
(This article belongs to the Special Issue Challenges and Emerging Strategies to Tackle the Global Burden of Antimicrobial Resistance)
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