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Antibiotics
Special Issues
Antibiotic Treatment on Surgical Infections
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Antibiotic Treatment on Surgical Infections

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

Deadline for manuscript submissions: 31 December 2026 | Viewed by 19593

Special Issue Editor

Prof. Dr. Fausto Catena

E-Mail Website
Guest Editor
Department of Emergency Surgery and Trauma, Bufalini Hospital, AUSL Romagna, 47521 Cesena, Italy
Interests: general surgery; colorectal surgery; surgical education; emergency surgery, minimally invasive surgery; intrabdominal infections, peritonitis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Surgical-site infection is an open issue in emergency general surgery. Evidence shows that surgical-site infection is most common in emergency surgery involving organ perforation. Even after improving the development of modern surgical techiques (e.g., a laparoscopic approach instead of laparotomic), hygienic measures, awareness in health-associated infections, and modern antibiotics regimens, the prevention of surgical-site infection would still be a matter of debate. Surgical-site infection is a multifactorial issue, related to patient’s characteristics (such as age, immunological state, comorbidities) and tge environment (such as antibiotic resistance) which can influence the choice of the best antibiotic. Therefore, the main subject of this Special Issue includes the possibility of preventing surgical-site infection according to patient needs, surgical treatment, and specific environment.

Dr. Fausto Catena
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 250 words) can be sent to the Editorial Office for assessment.

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

  • surgical site
  • infection
  • emergency surgery
  • prevention

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Published Papers (5 papers)

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Research

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15 pages, 1274 KB  
Article
Pathogen Profiling in Reverse Total Shoulder Arthroplasty: Virulence Traits of Clinical Isolates Before and After Intraoperative Povidone–Iodine Irrigation
by Enrico Bellato, Fabio Longo, Francesca Menotti, Rebecca Mariani, Lucrezia Massobrio, Valentina Bartolotti, Helena Villavicencio, Narcisa Mandras, Alessandro Bondi, Antonio Curtoni, Filippo Castoldi, Giuliana Banche and Valeria Allizond
Antibiotics 2026, 15(2), 129; https://doi.org/10.3390/antibiotics15020129 - 28 Jan 2026
Viewed by 729
Abstract
Background/Objectives: Reverse total shoulder arthroplasty (RTSA), a commonly performed procedure in elderly patients with osteoarthritis, is frequently complicated by postoperative infections—primarily caused by Cutibacterium acnes and coagulase-negative staphylococci (CoNS)—which remain a major clinical challenge. While standard antiseptic skin protocols can reduce the [...] Read more.
Background/Objectives: Reverse total shoulder arthroplasty (RTSA), a commonly performed procedure in elderly patients with osteoarthritis, is frequently complicated by postoperative infections—primarily caused by Cutibacterium acnes and coagulase-negative staphylococci (CoNS)—which remain a major clinical challenge. While standard antiseptic skin protocols can reduce the bacterial load at the surgical site, they often fail to achieve complete eradication, particularly with C. acnes, a resident species of the shoulder microbiome. Recent evidence indicates that intraoperative povidone–iodine irrigation is effective in significantly decreasing microbial burden; however, a thorough characterization of the virulence factors of the isolated strains remains essential. Methods: A total of 187 clinical strains isolated immediately after RTSA were characterized with respect to their antibiotic resistance profiles and biofilm-forming capacity, and the impact of intraoperative povidone–iodine irrigation on the reduction in bacteria that express these virulence traits was evaluated. Results: Of the 120 C. acnes isolates, 97.67% were susceptible to the tested antimicrobial agents, while only 3.33% exhibited resistance, specifically to clindamycin. In contrast, 53% of CoNS isolates were classified as susceptible, whereas the remaining 47% demonstrated multidrug resistance. Biofilm production was detected in 24% (29/120) of C. acnes and 39% (25/64) of CoNS isolates, with a statistically significant reduction observed after irrigation only for C. acnes. No association was found between biofilm formation and clindamycin resistance in C. acnes, likely due to the low number of resistant isolates. Conversely, among CoNS, a correlation was observed, with the 17.2% of biofilm-producing strains also exhibiting resistance to antimicrobial agents. Conclusions: Notwithstanding the presence of these virulence factors, povidone–iodine irrigation proved effective in substantially reducing the number of bacterial isolates recovered at the surgical site without selecting for strains with enhanced pathogenicity. Notably, the majority of resistant bacteria were detected prior to intraoperative irrigation. This intraoperative procedure may be a key approach to reducing prosthetic joint infections frequently caused by more virulent pathogens, which are unlikely to be selected following this disinfection strategy. Full article
(This article belongs to the Special Issue Antibiotic Treatment on Surgical Infections)
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12 pages, 219 KB  
Article
Fosfomycin in Complicated Intra-Abdominal Infections in an Intensive Care Setting: Does It Improve the Outcome? A Retrospective Observational Study
by Giovanni Genga, Federico Ragni, Maria Carolina Benvenuto, Elisabetta Svizzeretto, Andrea Tommasi, Giuseppe Vittorio Luigi De Socio, Daniela Francisci and Carlo Pallotto
Antibiotics 2025, 14(11), 1104; https://doi.org/10.3390/antibiotics14111104 - 2 Nov 2025
Viewed by 975
Abstract
Background: Intra-abdominal infection (IAI) is a challenging condition that needs both medical and surgical treatment and it is still associated with high morbidity and mortality rates. Fosfomycin is approved for use in combination therapy for IAIs. The aim of this study was [...] Read more.
Background: Intra-abdominal infection (IAI) is a challenging condition that needs both medical and surgical treatment and it is still associated with high morbidity and mortality rates. Fosfomycin is approved for use in combination therapy for IAIs. The aim of this study was to evaluate the impact of intravenous fosfomycin addition in a combination regimen for IAI treatment in an intensive care setting. Methods: We performed a retrospective, observational, monocentric study. We enrolled patients admitted to the ICU with IAIs from April 2022 to June 2024. Patients were divided into two groups: Group A, standard treatment; and Group B, combination therapy including fosfomycin. Primary endpoints were clinical response at 7 days and in-hospital mortality; moreover, a risk factor analysis for mortality was also performed. Results: In total, 104 patients were enrolled, 85 in Group A, and 19 in Group B. Groups were homogenous in regard to demographics, but clinical condition was slightly worst in Group B. Source control < 24 h was performed in 69.6% and 33.3% cases in Group A and Group B, respectively (p = 0.017). Clinical response on day 7 (81.2% vs. 73.7%, p = 0.675) and in-hospital mortality (27.1% vs. 47.2%, p = 0.145) were comparable. Univariate and multivariate analysis highlighted Charlson Comorbidity Index (CCI) (p = 0.04) and septic shock (p = 0.029) as risk factors, and effective empirical therapy (p = 0.04) as the protective factor; fosfomycin was not directly associated with outcome improvement. Conclusions: The outcome was comparable between groups; clinicians preferred to administer a combination regimen including fosfomycin in patients with statistically significant greater severity of illness and without early source control. Full article
(This article belongs to the Special Issue Antibiotic Treatment on Surgical Infections)
12 pages, 846 KB  
Article
Antimicrobial Consumption from 2017 to 2021 in East Trinidad and Tobago: A Study in the English-Speaking Caribbean
by Rajeev P. Nagassar, Narin Jalim, Arianne Mitchell, Ashley Harrinanan, Anisa Mohammed, Darren K. Dookeeram, Danini Marin, Lucia Giangreco, Paola Lichtenberger and Gustavo H. Marin
Antibiotics 2023, 12(3), 466; https://doi.org/10.3390/antibiotics12030466 - 25 Feb 2023
Cited by 4 | Viewed by 3814
Abstract
An antimicrobial consumption (AMC) study was performed in Trinidad and Tobago at the Eastern Regional Health Authority (ERHA). A retrospective, cross-sectional survey was conducted from 1 November 2021 to 30 March 2022. Dosage and package types of amoxicillin, azithromycin, co-amoxiclav, cefuroxime, ciprofloxacin, levofloxacin, [...] Read more.
An antimicrobial consumption (AMC) study was performed in Trinidad and Tobago at the Eastern Regional Health Authority (ERHA). A retrospective, cross-sectional survey was conducted from 1 November 2021 to 30 March 2022. Dosage and package types of amoxicillin, azithromycin, co-amoxiclav, cefuroxime, ciprofloxacin, levofloxacin, moxifloxacin, nitrofurantoin and co-trimoxazole were investigated. Consumption was measured using the World Health Organization’s Antimicrobial Resistance and Consumption Surveillance System methodology version 1.0, as defined daily doses (DDD) per 1000 population per day (DID). They were also analyzed using the ‘Access’, ‘Watch’ and ‘Reserve’ classifications. In the ERHA, AMC ranged from 6.9 DID to 4.6 DID. With regards to intravenous formulations, the ‘Watch’ group displayed increased consumption, from 0.160 DID in 2017 to 0.238 DID in 2019, followed by a subsequent drop in consumption with the onset of the COVID-19 pandemic. Oral co-amoxiclav, oral cefuroxime, oral azithromycin and oral co-trimoxazole were the most highly consumed antibiotics. The hospital started off as the higher consumer of antibiotics, but this changed to the community. The consumption of ‘Watch’ group antibiotics increased from 2017 to 2021, with a drop in consumption of ‘Access’ antibiotics and at the onset of COVID-19. Consumption of oral azithromycin was higher in 2021 than 2020. Full article
(This article belongs to the Special Issue Antibiotic Treatment on Surgical Infections)
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11 pages, 1385 KB  
Article
Infection-Related Ventilator-Associated Complications in Critically Ill Patients with Trauma: A Retrospective Analysis
by Emanuele Russo, Marta Velia Antonini, Andrea Sica, Cristian Dell’Amore, Costanza Martino, Emiliano Gamberini, Luca Bissoni, Alessandro Circelli, Giuliano Bolondi, Domenico Pietro Santonastaso, Francesco Cristini, Luigi Raumer, Fausto Catena and Vanni Agnoletti
Antibiotics 2023, 12(1), 176; https://doi.org/10.3390/antibiotics12010176 - 15 Jan 2023
Cited by 10 | Viewed by 4668
Abstract
Background: Trauma is a leading cause of death and disability. Patients with trauma undergoing invasive mechanical ventilation (IMV) are at risk for ventilator-associated events (VAEs) potentially associated with a longer duration of IMV and increased stay in the intensive care unit (ICU). Methods: [...] Read more.
Background: Trauma is a leading cause of death and disability. Patients with trauma undergoing invasive mechanical ventilation (IMV) are at risk for ventilator-associated events (VAEs) potentially associated with a longer duration of IMV and increased stay in the intensive care unit (ICU). Methods: We conducted a retrospective cohort study aimed to evaluate the incidence of infection-related ventilator-associated complications (IVACs), possible ventilator-associated pneumonia (PVAP), and their characteristics among patients experiencing severe trauma that required ICU admission and IMV for at least four days. We also determined pathogens implicated in PVAP episodes and characterized the use of antimicrobial therapy. Results: In total, 88 adult patients were included in the main analysis. In this study, we observed that 29.5% of patients developed a respiratory infection during ICU stay. Among them, five patients (19.2%) suffered from respiratory infections due to multi-drug resistant bacteria. Patients who developed IVAC/PVAP presented lower total GCS (median value, 7; (IQR, 9) vs. 12.5, (IQR, 8); p = 0.068) than those who did not develop IVAC/PVAP. Conclusions: We observed that less than one-third of trauma patients fulfilling criteria for ventilator associated events developed a respiratory infection during the ICU stay. Full article
(This article belongs to the Special Issue Antibiotic Treatment on Surgical Infections)
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Review

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13 pages, 286 KB  
Review
Implementation Strategies for Preventing Healthcare-Associated Infections across the Surgical Pathway: An Italian Multisociety Document
by Massimo Sartelli, Stefano Bartoli, Felice Borghi, Stefano Busani, Andrea Carsetti, Fausto Catena, Nicola Cillara, Federico Coccolini, Andrea Cortegiani, Francesco Cortese, Elisa Fabbri, Domitilla Foghetti, Francesco Forfori, Antonino Giarratano, Francesco Maria Labricciosa, Pierluigi Marini, Claudio Mastroianni, Angelo Pan, Daniela Pasero, Marco Scatizzi, Bruno Viaggi and Maria Luisa Moroadd Show full author list remove Hide full author list
Antibiotics 2023, 12(3), 521; https://doi.org/10.3390/antibiotics12030521 - 6 Mar 2023
Cited by 16 | Viewed by 7847
Abstract
Healthcare-associated infections (HAIs) result in significant patient morbidity and can prolong the duration of the hospital stay, causing high supplementary costs in addition to those already sustained due to the patient’s underlying disease. Moreover, bacteria are becoming increasingly resistant to antibiotics, making HAI [...] Read more.
Healthcare-associated infections (HAIs) result in significant patient morbidity and can prolong the duration of the hospital stay, causing high supplementary costs in addition to those already sustained due to the patient’s underlying disease. Moreover, bacteria are becoming increasingly resistant to antibiotics, making HAI prevention even more important nowadays. The public health consequences of antimicrobial resistance should be constrained by prevention and control actions, which must be a priority for all health systems of the world at all levels of care. As many HAIs are preventable, they may be considered an important indicator of the quality of patient care and represent an important patient safety issue in healthcare. To share implementation strategies for preventing HAIs in the surgical setting and in all healthcare facilities, an Italian multi-society document was published online in November 2022. This article represents an evidence-based summary of the document. Full article
(This article belongs to the Special Issue Antibiotic Treatment on Surgical Infections)
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