Antimicrobial Resistance during and after COVID-19

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Diagnostic Microbiology and Infectious Disease".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 2268

Special Issue Editors


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Guest Editor
Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
Interests: infectious diseases; sepsis; antimicrobial resistance; COVID-19

Special Issue Information

Dear Colleagues, 

The aim of the Special Issue is to explore how the SARS-CoV-2 pandemic has influenced and how it will impact antimicrobial resistance trends worldwide. The management of patients with COVID-19, at the beginning of the pandemic, was shaped by ambiguity and a lack of specific treatments, potentially leading to greater empiric antimicrobial use. At the same time, extreme pressure on healthcare systems and intensive care units may have compromised infection control measures, despite adherence to COVID-19 precautions. Non-pharmaceutical interventions, a decrease in other viral illnesses, bacterial and fungal co-infections, and alterations in immune responses, as well as environmental factors, could have affected the rates of antimicrobial-resistant bacteria in the community and in hospitals. Nevertheless, during the last few years, there have been many technological breakthroughs in the molecular diagnosis of pathogens and resistance genes from biological samples, improving diagnostic accuracy and reliability. With this Special Issue, we would like to explore the impact of the COVID-19 pandemic on antibacterial resistance, antimicrobial use, nosocomial infections and infection control and discuss methods and strategies to improve policies and practices in the aftermath of the pandemic.

Dr. Eirini Christaki
Dr. Georgios Nikolopoulos
Guest Editors

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Keywords

  • microbe
  • antimicrobial resistance
  • pandemic
  • COVID-19
  • SARS-CoV-2
  • infection control
  • nosocomial infection
  • antibiotics
  • antimicrobial use

Published Papers (1 paper)

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Research

13 pages, 298 KiB  
Article
A Retrospective Study of Staphylococcus aureus Bacteremia in a Tertiary Hospital and Factors Associated with Mortality
by Petros Ioannou, Maria Zacharioudaki, Despoina Spentzouri, Antonia Koutoulakou, Konstantinos Kitsos-Kalyvianakis, Christoforos Chontos, Stamatis Karakonstantis, Sofia Maraki, George Samonis and Diamantis P. Kofteridis
Diagnostics 2023, 13(11), 1975; https://doi.org/10.3390/diagnostics13111975 - 5 Jun 2023
Cited by 1 | Viewed by 1638
Abstract
Staphylococcus aureus bacteremia (SAB) is a severe infection frequently associated with significant morbidity and mortality. Recent studies have shown that SAB mortality has decreased during the last decades. However, about 25% of patients suffering from the disease will ultimately die. Hence, there is [...] Read more.
Staphylococcus aureus bacteremia (SAB) is a severe infection frequently associated with significant morbidity and mortality. Recent studies have shown that SAB mortality has decreased during the last decades. However, about 25% of patients suffering from the disease will ultimately die. Hence, there is an urgent need for more timely and efficient treatment of patients with SAB. The aim of the present study was to retrospectively evaluate a cohort of SAB patients hospitalized in a tertiary hospital and to identify factors independently associated with mortality. All 256 SAB patients hospitalized from January 2005 to December 2021 in the University Hospital of Heraklion, Greece, were evaluated. Their median age was 72 years, while 101 (39.5%) were female. Most SAB patients were cared for in medical wards (80.5%). The infection was community-acquired in 49.5%. Among all strains 37.9% were methicillin-resistant S. aureus (MRSA), however, definite treatment with an antistaphylococcal penicillin was given only in 22% of patients. Only 14.4% of patients had a repeat blood culture after the initiation of antimicrobial treatment. Infective endocarditis was present in 8%. In-hospital mortality has reached 15.9%. Female gender, older age, higher McCabe score, previous antimicrobial use, presence of a central venous catheter, neutropenia, severe sepsis, septic shock, and MRSA SAB were positively associated with in-hospital mortality, while monomicrobial bacteremia was negatively associated. The multivariate logistic regression model identified only severe sepsis (p = 0.05, odds ratio = 12.294) and septic shock (p = 0.007, odds ratio 57.18) to be independently positively associated with in-hospital mortality. The evaluation revealed high rates of inappropriate empirical antimicrobial treatment and non-adherence to guidelines, as shown, by the lack of repeat blood cultures. These data underline the urgent need for interventions with antimicrobial stewardship, increased involvement of infectious diseases physicians, educational sessions, and creation and implementation of local guidelines for improvement of the necessary steps for timely and efficient SAB treatment. Optimization of diagnostic techniques is needed to overcome challenges such as heteroresistance that may affect treatment. Clinicians should be aware of the factors associated with mortality in patients with SAB to identify those who are at a higher risk and optimize medical management. Full article
(This article belongs to the Special Issue Antimicrobial Resistance during and after COVID-19)
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