The Epidemiology, Clinical Aspects, Treatment and Preventive Strategies for Infectious Diseases in the Era of Antimicrobial Resistance (AMR)

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

Deadline for manuscript submissions: 30 June 2026 | Viewed by 6496

Special Issue Editor


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Guest Editor
1. Faculty of Medicine, Lucian Blaga University of Sibiu, Sibiu, Romania
2. County Clinical Emergency Hospital, Sibiu, Romania
Interests: COVID-19; sepsis; clostridioides difficile; respiratory tract infections; bacterial infections; viral infections; arboviral disease; hospital aquired infections; bone and joint infection; surgical site infections
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Special Issue Information

Dear Colleagues,

Antimicrobial resistance (AMR) is one of the most pressing global health issues of our time, particularly in the context of bacterial and fungal infections. The increasing incidence of multidrug-resistant bacteria and emerging antifungal resistance challenge current diagnostic algorithms, therapeutic strategies, and infection control protocols in both community and healthcare settings.

By 2050, it is projected that antimicrobial resistance (AMR) will have caused an estimated 1.91 million deaths directly attributable to resistant infections, with there being a total of 8.22 million deaths in which AMR played a role. This projected toll highlights the immediate need for intensified efforts to understand, monitor, and combat resistant pathogens.

The clinical burden of drug-resistant infections continues to rise, with pathogens such as Klebsiella pneumoniaeAcinetobacter baumanniiPseudomonas aeruginosaStaphylococcus aureus, and Candida species showing alarming levels of resistance to frontline treatments. The convergence of microbial adaptation, antibiotic misuse, and gaps in surveillance has created a complex epidemiological landscape that requires urgent interdisciplinary attention.

This Special Issue, entitled “The Epidemiology, Clinical Aspects, Treatment and Preventive Strategies for Infectious Diseases in the Era of Antimicrobial Resistance (AMR)”, seeks to gather high-quality contributions that explore the biological, clinical, and public health dimensions of AMR in bacterial and fungal pathogens.

We welcome original research articles, reviews, and short communications addressing, but not limited to, the following topics:

  • Local, regional, and global epidemiology of multidrug-resistant bacterial and fungal infections;
  • Mechanisms of resistance in Gram-positive, Gram-negative, and fungal pathogens;
  • Clinical outcomes and management of infections caused by resistant organisms;
  • Rapid microbiological diagnostics and antimicrobial susceptibility testing;
  • Development of new antimicrobial agents and combination therapies;
  • Stewardship programs targeting high-risk settings and vulnerable populations;
  • Nosocomial outbreaks and infection prevention strategies;
  • Resistance surveillance in humans;
  • Biofilm-associated resistance in chronic infections;
  • Translational research on host–pathogen interactions in resistant infections.

This Special Issue aims to contribute to a more informed and coordinated global response to AMR by bridging clinical microbiology, infectious diseases, and public health. By fostering collaboration across disciplines, we hope to drive innovation in treatment and prevention, ultimately improving patient outcomes and the sustainability of antimicrobials.

We look forward to your valuable contributions.

Prof. Dr. Victoria Birlutiu
Guest Editor

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Keywords

  • antimicrobial resistance (AMR)
  • multidrug-resistant bacteria
  • antifungal resistance
  • infectious disease epidemiology
  • clinical microbiology
  • rapid diagnostics
  • biofilm-related infections
  • antimicrobial stewardship
  • infection prevention
  • resistance surveillance

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Published Papers (3 papers)

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Research

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14 pages, 1051 KB  
Article
Genus Klebsiella: Infections Encountered in a General Surgery Department and Antimicrobial Drugs Susceptibility Patterns
by Sergiu-Ciprian Matei, Justin Horia Lăpușan, Ana-Maria Ungureanu, Edida Maghet, Vlad Meche, Marcel Berceanu Vaduva, Claudia Livia Stanga, Mihaela Valcovici, Abhinav Sharma and Nilima Rajpal Kundnani
Microorganisms 2026, 14(4), 773; https://doi.org/10.3390/microorganisms14040773 - 28 Mar 2026
Viewed by 390
Abstract
Klebsiella species, particularly Klebsiella pneumoniae, are among the most frequently isolated Gram-negative pathogens in surgical departments, associated with a growing trend in multidrug resistance. To identify the types of infections caused by Klebsiella spp. in a general surgery department and to analyze [...] Read more.
Klebsiella species, particularly Klebsiella pneumoniae, are among the most frequently isolated Gram-negative pathogens in surgical departments, associated with a growing trend in multidrug resistance. To identify the types of infections caused by Klebsiella spp. in a general surgery department and to analyze their antimicrobial susceptibility patterns. This retrospective observational study includes bacteriological cultures collected from surgical inpatients between October 2016 and December 2024. Only cases with confirmed Klebsiella spp. isolation were included. Specimen types, infection categories, and antibiotic susceptibility profiles were extracted and analyzed. A total of 138 Klebsiella-positive cultures were identified. Clinical characteristics were analyzed in 38 patients with complete records. The most common infection types included surgical site infections (SSIs), intra-abdominal infections, and biliary tract infections. Sensitivity was highest to carbapenems, while marked resistance was observed to ampicillin-sulbactam and third-generation cephalosporins. Some isolates exhibited ESBL or carbapenemase-producing phenotypes. Reported colistin non-susceptibility was elevated in our cohort; however, these results should be interpreted cautiously because the reference broth microdilution method was not systematically documented. The findings underscore the importance of local surveillance of Klebsiella spp. in surgical settings to info rm empirical treatment and control the spread of multidrug-resistant organisms. Full article
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14 pages, 1208 KB  
Article
Prevalence, Antimicrobial Resistance, and Molecular Characteristics of MRSA in Saudi Arabia: A Retrospective Study
by Soha Abdallah Moursi, Mohd Saleem, Azharuddin Sajid Syed Khaja, Ehab Rakha, Kareemah Salem Alshurtan, Nahed Fathallah Fahmy, Amal Daher Alshammari, Emad Abboh Abdallah Abboh, Metab Nasser Alshammari and Homoud Almalaq
Microorganisms 2026, 14(1), 227; https://doi.org/10.3390/microorganisms14010227 - 19 Jan 2026
Cited by 1 | Viewed by 756
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in both healthcare-associated (HA-MRSA) and community-associated (CA-MRSA) infections, posing major challenges due to its evolving antimicrobial resistance (AMR) and genetic diversity. This study investigates the prevalence, antimicrobial resistance patterns, and molecular characteristics of HA-MRSA and [...] Read more.
Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in both healthcare-associated (HA-MRSA) and community-associated (CA-MRSA) infections, posing major challenges due to its evolving antimicrobial resistance (AMR) and genetic diversity. This study investigates the prevalence, antimicrobial resistance patterns, and molecular characteristics of HA-MRSA and CA-MRSA isolates in Saudi Arabia. A retrospective analysis was conducted on 178 MRSA isolates obtained from clinical samples. MRSA identification was performed using cefoxitin disk diffusion, and antimicrobial susceptibility testing for vancomycin, linezolid, and ciprofloxacin was conducted using the BD Phoenix M50 system. Molecular characterization included SCCmec typing, spa typing, and PCR-based detection of virulence genes (pvl, tst, eta, etb, lukS, lukF). Statistical analysis was carried out using SPSS, with a significance threshold of p < 0.05. Among 1496 S. aureus isolates, 178 (11.9%) were confirmed as MRSA, with HA-MRSA (61.8%) being more prevalent than CA-MRSA (38.2%). Notably, 7.8% of HA-MRSA isolates exhibited heteroresistant vancomycin-intermediate S. aureus (hVISA). Ciprofloxacin resistance was significantly higher in HA-MRSA (85.0%) compared to CA-MRSA (38.9%). SCCmec type V was the predominant genotype (87.1%), suggesting increased infiltration of CA-MRSA strains into hospital settings. Spa typing revealed high genetic diversity, with t037 being the most common (27%). Virulence genes were detected in 6% of isolates, indicating limited dissemination of these factors. The findings highlight the increasing prevalence of MRSA, the emergence of hVISA, and shifts in clonal distribution, underscoring the need for ongoing molecular surveillance and stringent antimicrobial stewardship programs to control MRSA spread in both healthcare and community environments. Full article
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Review

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16 pages, 599 KB  
Review
An Overview of the Epidemiology of Multidrug Resistance and Bacterial Resistance Mechanisms: What Solutions Are Available? A Comprehensive Review
by Victoria Birlutiu and Rares-Mircea Birlutiu
Microorganisms 2025, 13(9), 2194; https://doi.org/10.3390/microorganisms13092194 - 19 Sep 2025
Cited by 15 | Viewed by 4887
Abstract
Antimicrobial resistance has emerged as one of the most critical public health challenges of the 21st century, threatening to undermine the foundations of modern medicine. In 2019, bacterial infections accounted for 13.6% of all global deaths, with more than 7.7 million fatalities directly [...] Read more.
Antimicrobial resistance has emerged as one of the most critical public health challenges of the 21st century, threatening to undermine the foundations of modern medicine. In 2019, bacterial infections accounted for 13.6% of all global deaths, with more than 7.7 million fatalities directly attributable to 33 bacterial pathogens, most prominently Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Resistance mechanisms are multifactorial, encompassing enzymatic degradation, target modification, efflux pump overexpression, reduced membrane permeability, and biofilm formation, often in combination, leading to multidrug-resistant, extensively drug-resistant, and pandrug-resistant phenotypes. Alarmingly, projections estimate that by 2050 AMR could result in over 10 million deaths annually. This comprehensive review synthesizes global epidemiological data, insights into bacterial resistance mechanisms, and emerging therapeutic solutions, including novel antibiotics such as lasso peptides and macrocyclic peptides (e.g., zosurabalpin), naturally derived compounds (e.g., corallopyronin, clovibactin, chlorotonil A), and targeted inhibitors (e.g., Debio 1453 for Neisseria gonorrhoeae). Addressing the AMR crisis requires coordinated international efforts, accelerated drug discovery, and the integration of innovative non-antibiotic approaches to preserve the efficacy of existing therapies and ensure preparedness against future bacterial threats. Full article
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