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Hospital-Acquired Infections: Evolving Threats and Epidemiological Insights
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Hospital-Acquired Infections: Evolving Threats and Epidemiological Insights

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: 25 August 2026 | Viewed by 2433

Special Issue Editor

Dr. Amir Nutman

E-Mail Website
Guest Editor
1. Wolfson Medical Center, Holon, Israel
2. School of Public Health, Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
Interests: infectious diseases; infection control and prevention; antibiotic resistance; healthcare epidemiology

Special Issue Information

Dear Colleagues,

Hospital-acquired infections are a major global challenge, significantly impacting patient outcomes and clinical care across healthcare systems. This Special Issue aims to present cutting-edge research and practical insights into the evolving epidemiology and clinical impact of HAIs. We invite submissions that utilize hospital-based data, evaluate infection prevention strategies, or apply novel and interdisciplinary approaches to reduce transmission and improve patient safety at the point of care.

We particularly welcome studies that inform clinical decision-making, track resistance mechanisms, and support outbreak response. Clinical investigations into the role of antimicrobial stewardship, infection control practices, and healthcare infrastructure in shaping HAI outcomes are also encouraged.

The Special Issue seeks to connect global epidemiological trends with clinical implications across diverse care settings. By combining data-driven epidemiology with clinical practice, the collection aims to support evidence-based strategies that improve patient care and reduce complications.

Dr. Amir Nutman
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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly 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 2600 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

  • hospital-acquired infections
  • healthcare-associated infections
  • antimicrobial resistance
  • multidrug-resistant organisms (MDRO)
  • infection prevention and control
  • outbreak investigation
  • patient safety
  • healthcare epidemiology

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

8 pages, 692 KB  
Article
Multiplex Lateral Flow Immunochromatographic Assay Is an Effective Method to Detect Carbapenemases in Non-Susceptible Acinetobacter baumannii
by Ilay Pinto, Talya Finn, Svetlana Paikin and Jonathan Lellouche
J. Clin. Med. 2026, 15(9), 3232; https://doi.org/10.3390/jcm15093232 - 23 Apr 2026
Viewed by 276
Abstract
Objectives: This study evaluated the diagnostic performance of the lateral flow immunochromatographic assay (RESIST-ACINETO, Coris BioConcept) for the rapid detection of the major carbapenemases in Acinetobacter baumannii. Methods: Blood culture isolates collected between 2014 and 2024 with meropenem MIC ≥ 4 mg/L [...] Read more.
Objectives: This study evaluated the diagnostic performance of the lateral flow immunochromatographic assay (RESIST-ACINETO, Coris BioConcept) for the rapid detection of the major carbapenemases in Acinetobacter baumannii. Methods: Blood culture isolates collected between 2014 and 2024 with meropenem MIC ≥ 4 mg/L were retrieved, re-identified by MALDI-TOF MS, and susceptibility was confirmed by broth microdilution. Carbapenemase genes (blaOXA-23, blaOXA-40, blaNDM) were detected using multiplex PCR, which served as the reference standard. All isolates were tested using the RESIST ACINETO assay, and diagnostic accuracy parameters were calculated. Results: A total of 114 isolates were recovered and confirmed as A. baumannii. Among 93 carbapenem-non-susceptible isolates, 97.8% (91/93) were correctly identified by the assay. The test showed 99.1% sensitivity and 99.1% specificity, with most positive results appearing within 3–10 min. Two discrepant results were observed (one false positive, one false negative), while all meropenem-susceptible isolates tested negative. Conclusions: The RESIST ACINETO assay provides rapid, accurate detection of carbapenemases in A. baumannii, significantly reducing turnaround time compared with conventional workflows. Its performance supports integration into routine diagnostics to enhance timely resistance confirmation and infection-control interventions. Full article
(This article belongs to the Special Issue Hospital-Acquired Infections: Evolving Threats and Epidemiological Insights)
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13 pages, 843 KB  
Article
The Impact of Early Empirical Antibiotic Therapy on the Mortality of Bacteremia Patients with Klebsiella Infection: A Retrospective Cohort Study
by Alaa Atamna, Tanya Babich, Amar Nahhas, Anan Zreik, Abed Agbaria, Shahd Dahamsheh, Mouhammad Haj Yahya, Haim Ben-Zvi and Jihad Bishara
J. Clin. Med. 2026, 15(1), 337; https://doi.org/10.3390/jcm15010337 - 2 Jan 2026
Viewed by 665
Abstract
Background: Klebsiella species are a leading cause of Gram-negative bacteremia associated with nosocomial infections. They exhibit higher antimicrobial resistance compared to other Enterobacterales, emphasizing their role as a “sentinel organism”. While the impact of inappropriate empiric therapy has been studied, data specific [...] Read more.
Background: Klebsiella species are a leading cause of Gram-negative bacteremia associated with nosocomial infections. They exhibit higher antimicrobial resistance compared to other Enterobacterales, emphasizing their role as a “sentinel organism”. While the impact of inappropriate empiric therapy has been studied, data specific to Klebsiella bacteremia are limited due to small sample sizes. This study aims to provide high-resolution data on Klebsiella bacteremia and assess the impact of appropriate empirical therapy on clinical outcomes. Methods: We conducted a retrospective study of patients with Klebsiella bacteremia hospitalized at Beilinson Hospital between 2012 and 2022. Patients were categorized into two groups based on the appropriateness of empiric therapy. The primary outcome was 30-day all-cause mortality; subgroup analyses evaluated mortality in ESBL bacteremia treated with either carbapenems or piperacillin-tazobactam, and carbapenems versus aminoglycosides. Propensity score weighting and inverse probability treatment-weighted models were used to adjust for confounding. Results: Among 1132 patients, 79% received appropriate empirical therapy. This therapy was associated with reduced 30-day mortality (OR = 0.59, 95% CI: 0.46–0.76) and a shorter hospital stay (median 7 vs. 11 days, p < 0.001). Other significant risk factors for mortality included a higher Charlson comorbidity score (OR = 1.06), assistance with ADL (OR = 2.16), prior hospitalization (OR = 1.31), and a higher SOFA score (OR = 1.32). No significant mortality differences were observed in ESBL subgroups treated with carbapenems versus piperacillin-tazobactam (p = 0.2) or carbapenems versus aminoglycosides (p = 0.9). Conclusions: Early appropriate empirical therapy significantly reduces 30-day mortality in Klebsiella bacteremia. These findings highlight the importance of timely, appropriate empirical therapy and suggest choosing less broad-spectrum therapy. However, the lack of molecular data on resistance mechanisms limits the ability to assess strain-specific outcomes and may affect generalizability. Despite this, the study offers valuable insights for optimizing empirical therapy and advancing antimicrobial stewardship in the era of rising resistance. Full article
(This article belongs to the Special Issue Hospital-Acquired Infections: Evolving Threats and Epidemiological Insights)
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11 pages, 229 KB  
Article
The Impact of Obesity on Clostridioides difficile Infection Outcomes: A Retrospective Cohort Study
by Alaa Atamna, Manar Khalaila, Tanya Babich, Anan Zriek, Haim Ben Zvi, Gida Ayada, Avishay Elis, Jihad Bishara and Amir Nutman
J. Clin. Med. 2025, 14(15), 5459; https://doi.org/10.3390/jcm14155459 - 3 Aug 2025
Viewed by 997
Abstract
Background: Studies have demonstrated a positive correlation between high body mass index (BMI) and an increased risk of Clostridioides difficile infection (CDI), independent of antibiotic usage or healthcare exposures. Aim: To compare the outcomes of obese (BMI ≥ 30 kg/m2) and [...] Read more.
Background: Studies have demonstrated a positive correlation between high body mass index (BMI) and an increased risk of Clostridioides difficile infection (CDI), independent of antibiotic usage or healthcare exposures. Aim: To compare the outcomes of obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2) hospitalized patients with CDI. Methods: This retrospective cohort study included patients with CDI hospitalized in Beilinson hospital between January 2013 and January 2020. The primary outcome was 90-day all-cause mortality. Secondary outcomes included 30-day mortality, colectomy, intensive care unit (ICU) admission and length of hospital stay (LOS). Multivariate analysis was performed to identify the risk factors independently associated with 90-day mortality. Results: The study included 889 patients: 131 (15%) obese and 758 (85%) non-obese. The obese group was younger (median age 65 years vs. 73 years (p < 0.01)) and with a higher rate of diabetes mellitus (57/131 (44%) vs. 180/758 (24%) (p < 0.01)). The 90-day mortality was lower in the obese group: 19/131 (15%) vs. 170/752 (23%) (p = 0.04). The 30-day mortality was 8/131 (6%) vs. 96/757 (13%) (p = 0.03). ICU admission was 9/131 (7%) vs. 23/758 (3%) (p = 0.03), and median LOS was 19 vs. 12 days (p < 0.01) in obese and non-obese groups, respectively. In the multivariable analysis, after adjustment for age, Charlson’s comorbidity index ≥3, assistance in activities of daily living, treatment with proton pump inhibitors and severity of illness, obesity was not a significant risk factor for 90-day mortality (OR = 0.65, 95% CI: 0.38–1.01; p = 0.1). Conclusions: In this study, obesity was not significantly associated with 90-day mortality after adjustment for other risk factors; however, ICU admission was higher and LOS longer in this group. Full article
(This article belongs to the Special Issue Hospital-Acquired Infections: Evolving Threats and Epidemiological Insights)
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