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Microorganisms
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Emerging Infectious Diseases and Multidrug Resistance
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Emerging Infectious Diseases and Multidrug Resistance

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Antimicrobial Agents and Resistance".

Deadline for manuscript submissions: closed (30 June 2025) | Viewed by 3100

Special Issue Editor

Dr. Dieter M. Bulach

E-Mail Website
Guest Editor
Microbiological Diagnostic Unit Public Health Laboratory, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC 3000, Australia
Interests: emerging infectious disease; infectious disease; animal diseases; bacterial infection

Special Issue Information

Dear Colleagues,

The emergence and re-emergence of infectious diseases is a global threat. We cannot look beyond COVID-19 as a classic example of a virus-jumping species having a catastrophic impact on an immunologically naïve host population (Homo sapiens). The risk of these cross-species transmission events is increasing in a world dealing with climate change and changing associations between hosts. Of equal concern is global interconnection, raising the prospect of rapid, global spread of some emerging and re-emerging diseases.

Just as the management of antimicrobial resistance (AMR) is seen as a problem that requires not only input from every nation but also cross-sector cooperation (i.e., across human health, animal health, and the environment), emerging infectious diseases require similar engagement, underscoring the importance of developing a global view of One Health now and into the future.

We invite you to submit articles on the epidemiology, diagnosis, and relations between infectious pathogens and multidrug resistance, focusing on recent advances in the aforementioned fields. Original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: new pathogen identification; diagnosis and detection; outbreak investigation and management; infection prevention and control.

Dr. Dieter M. Bulach
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 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. Microorganisms 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 2700 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

  • emerging infectious diseases
  • re-emerging infectious diseases
  • epidemic-prone diseases
  • multidrug resistance
  • infection prevention
  • infection control

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Published Papers (4 papers)

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Research

13 pages, 426 KiB  
Article
Comparison of Clinical Characteristics and Outcomes Between MRSA and MSSA Infections Among Patients in Intensive Care Units
by Gustavo Andrés Urriago-Osorio, Heiler Lozada-Ramos, Jorge Enrique Daza-Arana, Paola Andrea Ruiz-Jiménez, Giovanna Patricia Rivas-Tafurt and Diana Marcela Bonilla-Bonilla
Microorganisms 2025, 13(7), 1519; https://doi.org/10.3390/microorganisms13071519 - 29 Jun 2025
Viewed by 330
Abstract
Staphylococcus aureus infections are an important cause of morbidity and mortality among patients in intensive care units (ICUs), particularly those with multiple comorbidities and critical conditions. Methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) strains differ in resistance, clinical behavior, and prognoses, [...] Read more.
Staphylococcus aureus infections are an important cause of morbidity and mortality among patients in intensive care units (ICUs), particularly those with multiple comorbidities and critical conditions. Methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) strains differ in resistance, clinical behavior, and prognoses, making it important to understand their effects on clinical outcomes. Comparing clinical outcomes of MRSA and MSSA infections is important. This retrospective cohort study analyzed ICU patients with confirmed S. aureus infections at a quaternary care hospital. Demographic, clinical, and comorbidity data were collected. Poisson regression was used to analyze 7-day mortality and identify adjusted risk factors. Seven-day mortality was higher in patients with MSSA than MRSA infections, with an adjusted relative risk for MRSA of 0.380 (95% confidence interval: 0.15–0.95; p = 0.039). Independent risk factors for mortality included lack of an infectious disease consultation, vascular comorbidities, such as peripheral vascular disease and cerebrovascular events, chronic kidney disease, and inotropic support requirement. Patients with MRSA infections required significantly longer ventilatory support (mean 43.5 days vs. 13 days for MSSA; p = 0.019). Staphylococcus aureus infections in ICU patients were associated with poor outcomes, particularly in patients without infectious disease consultation and those with vascular comorbidities. Mortality differences between MRSA and MSSA highlight the importance of appropriate empiric therapy and standardized protocols incorporating infectious disease consultation to improve outcomes in critically ill patients. Full article
(This article belongs to the Special Issue Emerging Infectious Diseases and Multidrug Resistance)
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13 pages, 842 KiB  
Article
Minimum Inhibitory Concentration Increase in Clostridioides difficile Isolates from Patients with Recurrence: Results from a Retrospective Single-Centre Cohort Study
by Pietro Valsecchi, Erika Asperges, Marta Corbella, Greta Banfi, Marcello Maffezzoni, Nicolò Amarasinghe, Riccardo Drago, Flavia Virga, Filippo Costanzo, Francesca Calabretta, Paolo Sacchi, Patrizia Cambieri, Antonio Di Sabatino, Fausto Baldanti and Raffaele Bruno
Microorganisms 2025, 13(7), 1515; https://doi.org/10.3390/microorganisms13071515 - 28 Jun 2025
Viewed by 340
Abstract
Antimicrobial susceptibility testing (AST) is not routinely performed for C. difficile infection (CDI); however, reports of antimicrobial resistance to various antibiotics have increased. This study aimed to assess the rate of antimicrobial resistance to four antimicrobials (vancomycin, metronidazole, tigecycline, and ciprofloxacin) to assess [...] Read more.
Antimicrobial susceptibility testing (AST) is not routinely performed for C. difficile infection (CDI); however, reports of antimicrobial resistance to various antibiotics have increased. This study aimed to assess the rate of antimicrobial resistance to four antimicrobials (vancomycin, metronidazole, tigecycline, and ciprofloxacin) to assess risk factors for antimicrobial resistance and evaluate MIC variation in patients with recurrence. Data from consecutive patients with CDI admitted to our institution between 1 January 2022 and 30 April 2023 were collected. We performed AST with gradient diffusion and NAAT to evaluate the presumptive presence of R027/NAP1 and toxin production genes. Antimicrobial susceptibility testing was performed on 108 available isolates. We did not find any resistance to vancomycin (median MIC 0.5 μg/mL), metronidazole (median MIC 1 μg/mL), and tigecycline (median MIC 0.016 μg/mL), while resistance to ciprofloxacin was detected in all the samples. Among the recurrent isolates, 37.5% displayed a 2-fold MIC increase for vancomycin, 75% for metronidazole, and 37.5% for tigecycline. After stratifying clinical outcomes according to vancomycin MIC, patients with higher MIC experienced increased 28-day mortality (p value 0.009). Our results were concordant with European surveillance data. MIC increase in all tested antibiotics in patients with CDI warrants further research since decreased susceptibility has been associated with clinical failure. Full article
(This article belongs to the Special Issue Emerging Infectious Diseases and Multidrug Resistance)
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15 pages, 9730 KiB  
Article
Investigation of the Structure and Functional Activity of the YqeK Protein in Streptococcus pyogenes with High Efficiency in Hydrolyzing Ap4A
by Kai Yang, Suhua Hu, Yao Yao, Kaijie Li, Zunbao Wang, Xinyu Wang, Dan Ma, Mingfang Bi and Xiaobing Mo
Microorganisms 2025, 13(2), 230; https://doi.org/10.3390/microorganisms13020230 - 22 Jan 2025
Viewed by 1027
Abstract
Streptococcus pyogenes is an important zoonotic Gram-positive bacterium that appears in chains, without spores or flagella, and belongs to the beta-hemolytic streptococci. It can be transmitted through droplets or contact, with the preferred antibiotics being penicillin, erythromycin, or cephalosporins. However, the misuse [...] Read more.
Streptococcus pyogenes is an important zoonotic Gram-positive bacterium that appears in chains, without spores or flagella, and belongs to the beta-hemolytic streptococci. It can be transmitted through droplets or contact, with the preferred antibiotics being penicillin, erythromycin, or cephalosporins. However, the misuse of these drugs has led to antibiotic resistance, posing a significant threat to both human and animal health. Studying resistance genes encoding proteins is crucial for mitigating the emergence of resistant strains and improving treatment outcomes. Interestingly, a dinucleotide known as diadenosine tetraphosphate (Ap4A) exists in Streptococcus pyogenes; its accumulation in response to various stress signals can inhibit bacterial pathogenicity and enhance antibiotic susceptibility. Our research focuses on the Sp-yqeK protein, which we have identified as a hydrolase that symmetrically cleaves Ap4A. The Sp-yqeK protein effectively cleaves Ap4A, producing adenosine diphosphate (ADP) molecules. Results indicate that this enzyme exhibits optimal activity at pH 7.0 and a temperature of 45 °C. Furthermore, we determined the crystal structure of the Sp-yqeK, Mg2+, and ADP complex at a resolution of 2.0 Å, providing insights into the interactions crucial for catalytic efficiency between Sp-yqeK and ADP. This complex reveals unique folding characteristics of the HD domain superfamily proteins, accommodating both ADP and Mg2+. These components are securely embedded into the polar cavity of the yqeK protein through conserved residues (His29, Lys62, His91, His117, Asp135, Leu172, Phe180, and Thr183), highlighting the residues responsible for Ap4A hydrolysis and Mg2+ binding. Our research offers a deeper understanding of the hydrolysis mechanism of Ap4A and the specificity of Sp-yqeK, providing structural insights that may support future studies on antibiotic resistance in Streptococcus pyogenes and other Gram-positive bacteria. Full article
(This article belongs to the Special Issue Emerging Infectious Diseases and Multidrug Resistance)
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12 pages, 392 KiB  
Article
The First Report of mcr-1-Carrying Escherichia coli, Isolated from a Clinical Sample in the North-East of Romania
by Mădălina-Alexandra Vlad, Brîndușa-Elena Lixandru, Andrei-Alexandru Muntean, Irina Trandafir, Cătălina Luncă and Cristina Tuchiluş
Microorganisms 2024, 12(12), 2461; https://doi.org/10.3390/microorganisms12122461 - 29 Nov 2024
Cited by 1 | Viewed by 1035
Abstract
Colistin resistance poses a significant clinical challenge, particularly in Gram-negative bacteria. This study investigates the occurrence of plasmid-mediated colistin resistance among Enterobacterales isolates (Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp.) and non-fermentative rods (Acinetobacter baumannii and Pseudomonas aeruginosa). [...] Read more.
Colistin resistance poses a significant clinical challenge, particularly in Gram-negative bacteria. This study investigates the occurrence of plasmid-mediated colistin resistance among Enterobacterales isolates (Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp.) and non-fermentative rods (Acinetobacter baumannii and Pseudomonas aeruginosa). We analyzed 114 colistin-resistant isolates that were selected, based on resistance phenotypes, and isolated between 2019 and 2023. To achieve this, we used the rapid immunochromatographic test, NG-Test® MCR-1; multiplex PCR for mcr-1 to mcr-8, and real-time PCR for mcr-1 and mcr-2. One E. coli isolate was identified as carrying the mcr-1 gene, confirmed by NG-Test® MCR-1, multiplex PCR and whole-genome sequencing. This strain, belonging to ST69, harbored four plasmids, harboring different antimicrobial resistance genes, with mcr-1 being located on a 33,304 bp circular IncX4 plasmid. No mcr-2 to mcr-8-positive isolates were detected, prompting further investigation into alternative colistin resistance mechanisms. This is the first report of a mcr-1-positive, colistin-resistant E. coli isolated from a human clinical sample in the North-East of Romania. Full article
(This article belongs to the Special Issue Emerging Infectious Diseases and Multidrug Resistance)
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