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Antibiotics
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Infections and Sepsis in the Intensive Care Unit
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Infections and Sepsis in the Intensive Care Unit

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

Deadline for manuscript submissions: 31 December 2024 | Viewed by 6083

Special Issue Editors

Dr. Mariachiara Ippolito

E-Mail Website
Guest Editor
Department of Surgical, Oncological and Oral Science (Di.Chir.On.S), University of Palermo, 90127 Palermo, Italy
Interests: intensive care; anaesthesiology; sepsis; infections; antimicrobial therapy
Dr. Andrea Cortegiani

E-Mail Website
Guest Editor
Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, 90127 Palermo, Italy
Interests: intensive care; anaesthesiology; sepsis; infections; antimicrobial therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,
  • Understanding the challenges of infections and sepsis management is a priority for healthcare professionals involved in critical care and infectious diseases. Critically ill patients require constant attention, and ongoing research is pivotal for an evidence-based approach. This Special Issue aims to cover topics such as antibiotic resistance, empirical and targeted antibiotic therapy, and the evolving role of technology in septic patient care;
  • Readers of this Special Issue, including researchers, healthcare professionals, and policymakers, will be able to find research addressing the crucial role of antibiotics in the prevention and treatment of infections in high-risk environments like the ICU and critical care.

Dr. Mariachiara Ippolito
Dr. Andrea Cortegiani
Guest Editors

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

  • antibiotics
  • infections
  • sepsis
  • septic shock
  • ICU

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Published Papers (4 papers)

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Research

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9 pages, 622 KiB  
Article
Evaluation of T2 Magnetic Resonance (T2MR®) Technology for the Early Detection of ESKAPEc Pathogens in Septic Patients
by Celestino Bonura, Domenico Graceffa, Salvatore Distefano, Simona De Grazia, Oscar Guzman, Brian Bohn, Mariachiara Ippolito, Salvatore Campanella, Angelica Ancona, Marta Caputo, Pietro Mirasola, Cesira Palmeri, Santi Maurizio Raineri, Antonino Giarratano, Giovanni Maurizio Giammanco and Andrea Cortegiani
Antibiotics 2024, 13(9), 885; https://doi.org/10.3390/antibiotics13090885 - 14 Sep 2024
Viewed by 985
Abstract
Bloodstream infections (BSIs) and sepsis are a major cause of morbidity and mortality. Appropriate early antibiotic therapy is crucial for improving the survival of patients with sepsis and septic shock. T2 magnetic resonance (T2MR®) technology may enable fast and sensitive detection [...] Read more.
Bloodstream infections (BSIs) and sepsis are a major cause of morbidity and mortality. Appropriate early antibiotic therapy is crucial for improving the survival of patients with sepsis and septic shock. T2 magnetic resonance (T2MR®) technology may enable fast and sensitive detection of ESKAPEc pathogens directly from whole-blood samples. We aimed to evaluate concordance between the T2Bacteria® Panel and standard blood culture and its impact on antibiotic therapy decisions. We conducted a single-centre retrospective study on patients with sepsis-induced hypotension or septic shock admitted to general, post-operative/neurosurgical, and cardiothoracic Intensive Care Units who were tested with the T2Bacteria® Panel from January 2021 to December 2022. Eighty-five consecutively admitted patients were included, for a total of 85 paired tests. A total of 48 ESKAPEc pathogens were identified by the T2Bacteria® Panel. The concordance rate between the T2Bacteria® Panel and blood cultures was 81% (69/85), with 20 concordant-positive and 49 concordant-negative cases. For the 25 microorganisms grown from accompanying blood cultures, blood pathogen coverage by the T2Bacteria® Panel was 88%. In this cohort of severely ill septic patients, the T2Bacteria® Panel was highly concordant and was able to detect more ESKAPEc pathogens, with a significantly shorter turn-around time compared to conventional blood cultures. The T2Bacteria® Panel also significantly impacted decisions on antibiotic therapy. Full article
(This article belongs to the Special Issue Infections and Sepsis in the Intensive Care Unit)
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12 pages, 243 KiB  
Article
Impact of a Bundle of Interventions on Quality-of-Care Indicators for Staphylococcus aureus Bacteraemia: A Single-Centre, Quasi-Experimental, Before–After Study
by Giacomo Casalini, Cristina Pagani, Andrea Giacomelli, Laura Galimberti, Laura Milazzo, Massimo Coen, Serena Reato, Beatrice Caloni, Stefania Caronni, Simone Pagano, Samuel Lazzarin, Anna Lisa Ridolfo, Sara Giordana Rimoldi, Andrea Gori and Spinello Antinori
Antibiotics 2024, 13(7), 646; https://doi.org/10.3390/antibiotics13070646 - 12 Jul 2024
Viewed by 889
Abstract
Staphylococcus aureus bacteraemia (SAB) is a life-threatening bloodstream infection. Improved adherence to quality-of-care indicators (QCIs) can significantly enhance patient outcomes. This quasi-experimental study evaluated the impact of a bundle of interventions on QCI adherence in adult patients with SAB. Additionally, a molecular rapid [...] Read more.
Staphylococcus aureus bacteraemia (SAB) is a life-threatening bloodstream infection. Improved adherence to quality-of-care indicators (QCIs) can significantly enhance patient outcomes. This quasi-experimental study evaluated the impact of a bundle of interventions on QCI adherence in adult patients with SAB. Additionally, a molecular rapid diagnostic test (mRDT) for S. aureus and methicillin resistance was introduced during weekdays. We compared pre-intervention (January–December 2022) and post-intervention (May 2023–April 2024) data on QCI adherence and time to appropriate treatment. A total of 56 and 40 SAB episodes were included in the pre- and post-intervention periods, respectively. Full QCI adherence significantly increased from 28.6% to 67.5% in the post-intervention period (p < 0.001). The mRDT diagnosed SAB in eight cases (26.6%), but the time to achieve appropriate target therapy did not improve in the post-intervention period (54 h (IQR 30–74) vs. 72 h (IQR 51–83), p = 0.131). The thirty-day mortality rate was comparable between the two periods (17.9% vs. 12.5%, p = 0.476). This study demonstrates that a bundle of interventions can substantially improve adherence to SAB management QCIs. Full article
(This article belongs to the Special Issue Infections and Sepsis in the Intensive Care Unit)
13 pages, 525 KiB  
Article
Impact of Appropriate Empirical Antibiotic Treatment on the Clinical Response of Septic Patients in Intensive Care Unit: A Single-Center Observational Study
by Mateo Tićac, Tanja Grubić Kezele and Marina Bubonja Šonje
Antibiotics 2024, 13(6), 569; https://doi.org/10.3390/antibiotics13060569 - 19 Jun 2024
Viewed by 1753
Abstract
The appropriate antibiotic treatment of patients with bacterial sepsis in the intensive care unit (ICU) remains a challenge. Considering that current international guidelines recommend 7 days of antibiotic therapy as sufficient for most severe infections, our primary outcome was a comparison of clinical [...] Read more.
The appropriate antibiotic treatment of patients with bacterial sepsis in the intensive care unit (ICU) remains a challenge. Considering that current international guidelines recommend 7 days of antibiotic therapy as sufficient for most severe infections, our primary outcome was a comparison of clinical response to initial empirical therapy on day 7 and mortality between two groups of septic patients—with appropriate (AEAT) and inappropriate (IEAT) empirical antibiotic therapy according to the in vitro sensitivity of bacteria detected in a blood culture (BC). Adult patients admitted to the ICU between 2020 and 2023, who were diagnosed with sepsis according to the Sequential Organ Failure Assessment (SOFA) score ≥ 2 in association with a suspected or documented infection, were selected for the study. Of the 418 patients, 149 (35.6%) died within 7 days. Although the AEAT group had a lower mortality rate (30.3% vs. 34.2%) and better clinical improvement (52.8% vs. 47.4%) on day 7 after starting empirical antibiotic therapy, there was no significant difference. A causative organism was isolated from BCs in 30% of septic patients, with gram-negative bacteria (GNB) predominating in 60% of cases, and multidrug-resistant (MDR) or extensively drug-resistant (XDR) bacteria predominantly detected in the BCs of the IEAT group. Although the AEAT group had slightly worse clinical characteristics at the onset of sepsis than the IEAT group, the AEAT group showed faster improvement on days 7 and 14 of sepsis. In this retrospective cross-sectional study, the AEAT group was associated with better clinical response at day 7 after sepsis onset and lower mortality, but without a significant difference. Comorbidities and the type of bacterial pathogen should also be taken into account as they can also contribute to the prediction of the final outcome. These results demonstrate the importance of daily assessment of clinical factors to more accurately predict the clinical outcome of a septic patient. Full article
(This article belongs to the Special Issue Infections and Sepsis in the Intensive Care Unit)
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Review

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15 pages, 574 KiB  
Review
Antimicrobial Stewardship: A Correct Management to Reduce Sepsis in NICU Settings
by Veronica Notarbartolo, Bintu Ayla Badiane, Vincenzo Insinga and Mario Giuffrè
Antibiotics 2024, 13(6), 520; https://doi.org/10.3390/antibiotics13060520 - 3 Jun 2024
Cited by 3 | Viewed by 1880
Abstract
The discovery of antimicrobial drugs has led to a significant increase in survival from infections; however, they are very often prescribed and administered, even when their use is not necessary and appropriate. Newborns are particularly exposed to infections due to the poor effectiveness [...] Read more.
The discovery of antimicrobial drugs has led to a significant increase in survival from infections; however, they are very often prescribed and administered, even when their use is not necessary and appropriate. Newborns are particularly exposed to infections due to the poor effectiveness and the immaturity of their immune systems. For this reason, in Neonatal Intensive Care Units (NICUs), the use of antimicrobial drugs is often decisive and life-saving, and it must be started promptly to ensure its effectiveness in consideration of the possible rapid evolution of the infection towards sepsis. Nevertheless, the misuse of antibiotics in the neonatal period leads not only to an increase in the development and wide spreading of antimicrobial resistance (AMR) but it is also associated with various short-term (e.g., alterations of the microbiota) and long-term (e.g., increased risk of allergic disease and obesity) effects. It appears fundamental to use antibiotics only when strictly necessary; specific decision-making algorithms and electronic calculators can help limit the use of unnecessary antibiotic drugs. The aim of this narrative review is to summarize the right balance between the risks and benefits of antimicrobial therapy in NICUs; for this purpose, specific Antimicrobial Stewardship Programs (ASPs) in neonatal care and the creation of a specific antimicrobial stewardship team are requested. Full article
(This article belongs to the Special Issue Infections and Sepsis in the Intensive Care Unit)
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