Complex Infectious Issues in Critically Ill Patients 2.0

Dear Colleagues,

Infection and sepsis, whether community or hospital-acquired, are important causes of morbidity and mortality in ICU and postoperative patients. These conditions require an early, prophylactic and appropriate antibiotic treatment, associated with rapid infection source control, hemodynamic optimization, and support of organ failure. Furthermore, concomitant infection with COVID-19 requires particular attention that requires specific treatment.

The β-lactam antibiotics, because of their large antimicrobial spectrum and low toxicity, are among the first-line therapies for critically ill patients, particularly when a Gram-negative infection is suspected.

Ideally, individualized dosing strategies should account for the altered pharmacokinetic and pathogen susceptibility in each patient. However, administering the appropriate therapy may be challenging in critically ill patients with infectious diseases due to the dynamic and variable fluctuations. Fluid administration, alterations in protein-binding, and capillary permeability can affect the volume of distribution, while hemodynamic resuscitation may result in increased cardiac output and augmented renal clearance, with increased drug clearance and subsequent insufficient drug levels to treat less-susceptible strains. Altered pharmacokinetics can result in insufficient β-lactam serum concentrations, and can lead to treatment failure and increased selection pressure and resistance in critically ill patients.

This Special Issue will increase our knowledge of the epidemiology and treatment of complex infections in ICU and postoperative patients, and improve our understanding of the effects of antibiotic use in critical conditions. In addition, we would like to focus attention on the role of co-infection with COVID-19. We welcome all submissions dealing with the emergence of resistance, the epidemiology of multi-drug-resistant pathogens, drug dosing, and/or toxicity related to the use of β-lactam antibiotics.

Dr. Savino Spadaro
Dr. Gaetano Scaramuzzo
Guest Editors

Manuscript Submission Information

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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.

• β-lactam antibiotics
• infection
• pharmacokinetics
• infection gram negative
• multi drug resistance
• sepsis
• critically ill patients

• Complex Infectious Issues in Critically Ill Patients in Microorganisms (8 articles)