Infections in the Critically Ill: Multi-Drug Resistance and Emerging Frontiers in ICU Infectious Diseases

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: 31 March 2027 | Viewed by 182

Special Issue Editors


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Guest Editor
Department of Internal Medicine, University General Hospital of Patras, Department of Medicine, University of Patras, 26504 Rio, Greece
Interests: internal medicine; infectious diseases; sepsis; HIV; COVID-19; antimicrobial resistance; infections in obstetrics and gynaecology

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Guest Editor Assistant
Department of Internal Medicine, University General Hospital of Patras, Department of Medicine, University of Patras, 26504 Rio, Greece
Interests: internal medicine; infectious diseases; sepsis; HIV; COVID-19

Special Issue Information

Dear Colleagues,

Infections in critically ill patients remain a leading cause of morbidity and mortality in the intensive care unit (ICU), increasingly shaped by multidrug-resistant organisms (MDROs), complex host physiology, and frequent exposure to broad-spectrum antimicrobials. Improving outcomes requires an integrated approach that combines rapid and accurate diagnosis, continuous resistance monitoring and ICU-acquired infection surveillance, robust infection prevention and control, and stewardship-driven antimicrobial management, including PK/PD optimization, timely source control, and structured reassessment for de-escalation.

This Special Issue, entitled “Infections in the Critically Ill: Multi-Drug Resistance and Emerging Frontiers in ICU Infectious Diseases”, will present recent research addressing contemporary challenges in ICU infectious diseases.

Topics of interest:

  1. ICU infection diagnosis: specimen collection and sampling strategies, rapid diagnostics, and diagnostic stewardship;
  2. MDRO epidemiology in the ICU: resistance trends, surveillance approaches, and early outbreak detection;
  3. Biomarkers and clinical decision tools for diagnosis, risk stratification, and treatment monitoring;
  4. Infection prevention and control: device-associated infections, bundles, isolation/cohorting strategies, and environmental measures;
  5. Emerging infections in the ICU: viral infections and other evolving threats in critical care;
  6. Antimicrobial stewardship in critical care: practical frameworks, audit/feedback, guideline implementation, and outcomes;
  7. Artificial intelligence and digital tools in ICU infection care: decision support, prediction/early warning, and workflow integration.

Dr. Karolina Akinosoglou
Guest Editor

Dr. Eleni Polyzou
Guest Editor Assistant

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Keywords

  • multidrug-resistant organisms (MDROs)
  • rapid diagnostics
  • ICU surveillance
  • infection prevention and control
  • antimicrobial stewardship

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Published Papers (1 paper)

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Review

26 pages, 2030 KB  
Review
Infectious Risks Associated with Biologic Therapies in Autoimmune, Rheumatologic and Dermatologic Diseases: A Narrative Review
by Stefania Capuccio, Francesco Romano, Joan R. Rello, Antonios Katsounas and Jordi Rello
Microorganisms 2026, 14(6), 1250; https://doi.org/10.3390/microorganisms14061250 - 2 Jun 2026
Abstract
Biologic and targeted synthetic therapies have substantially improved the management of autoimmune diseases (ADs), achieving unprecedented disease control. However, by modulating key immune pathways, these agents increase susceptibility to a wide spectrum of infections. This narrative review synthesizes current evidence on infectious risks [...] Read more.
Biologic and targeted synthetic therapies have substantially improved the management of autoimmune diseases (ADs), achieving unprecedented disease control. However, by modulating key immune pathways, these agents increase susceptibility to a wide spectrum of infections. This narrative review synthesizes current evidence on infectious risks associated with biologic DMARDs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) in AD, characterizing infection profiles across different drug classes, identifying patient- and treatment-related risk factors, and providing evidence-based recommendations for screening, prevention, and management. A comprehensive literature search was conducted through March 2026, across PubMed, Embase, and the Cochrane Library, using predefined search terms combining biologic and targeted synthetic drug classes with infection-related outcomes. Evidence from major international registries (BSRBR-RA, DANBIO, RABBIT) and society guidelines (ACR, EULAR, IDSA) was prioritized. Among bDMARDs, TNF-α inhibitors (TNF-α i) and rituximab were associated with the highest rates of serious infections, whereas IL-17 and IL-23 inhibitors demonstrated comparatively lower infectious risk profiles. Steroids, older age, and prior serious infections emerged as the most consistent patient-related risk modifiers. Unlike prior reviews focused on single diseases or drug classes, this work provides an integrated, cross-disciplinary risk stratification framework. bDMARDs and tsDMARDs remain among the most innovative treatments available for effective management of ADs, with favorable benefit–risk profiles when accompanied by systematic prevention strategies. Universal pre-treatment screening for tuberculosis and viral hepatitis, risk-stratified parasitic screening, evidence-based vaccination, and selective antimicrobial prophylaxis can mitigate infectious complications. Full article
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