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Pathogens
Special Issues
Healthcare-Associated Infections and Drug-Resistant Pathogens: Surveillance, Transmission and Control Strategies
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Healthcare-Associated Infections and Drug-Resistant Pathogens: Surveillance, Transmission and Control Strategies

A special issue of Pathogens (ISSN 2076-0817).

Deadline for manuscript submissions: 25 October 2026 | Viewed by 1951

Editors

Dr. Spoto Silvia

E-Mail Website
Guest Editor
Diagnostic and Therapeutic Medicine, Rome Biomedical Campus University Foundation, Alvaro del Portillo Street n°200, 00128 Rome, Italy
Interests: infectious disease diagnosis; sepsis diagnosis and prognosis; multidrug-resistant (MDR) pathogens identification and analysis; epidemiology of infectious diseases, especially in a nosocomial setting; laboratory markers of inflammation and infection; diagnostic and prognostic markers associated with infectious and chronic diseases
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Silvia Angeletti

E-Mail Website
Guest Editor
1. Operative Research Unit of Laboratory, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy
2. Research Unit of Clinical Laboratory Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, Italy
Interests: MDRO; identification and analysis; phylogenetic analysis; infectious disease diagnosis and prognosis; epidemiology of infectious diseases, especially in a nosocomial setting; laboratory markers of inflammation and infection; diagnostic and prognostic markers associated with infectious and chronic diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Healthcare-associated infections (HAIs) remain a major challenge for modern healthcare systems worldwide, contributing to significant morbidity, mortality and healthcare costs. The rise in drug-resistant pathogens—such as multidrug-resistant Gram-negative bacteria, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE)—has further complicated prevention and treatment efforts. The ESKAPE pathogens—Enterococcus faecium, Staphylococcus aureus,  Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.—despite the introduction of several new antibiotics and antibiotic adjuvants, such as novel β-lactamase inhibitors, represent major clinical challenges.  Understanding how these pathogens emerge, spread and persist in healthcare settings is essential for developing effective control strategies.

This Special Issue aims to bring together high-quality research on the surveillance, transmission dynamics and control of HAIs and drug-resistant microorganisms. We welcome studies that explore molecular epidemiology, pathogen genomics, environmental contamination, patient-to-patient transmission and the effectiveness of infection prevention and control (IPC) measures. Research on antimicrobial stewardship, outbreak investigation, diagnostic advancements and innovative interventions to limit pathogen spread is also encouraged.

By integrating insights from clinical microbiology, molecular surveillance, epidemiology and public health practice, this Special Issue seeks to advance our understanding of healthcare-associated pathogens and support evidence-based strategies to reduce their impact on patients and healthcare systems.

Dr. Spoto Silvia
Prof. Dr. Silvia Angeletti
Guest Editors

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-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pathogens 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 2400 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

  • healthcare-associated infections (HAIs)
  • drug-resistant pathogens
  • antimicrobial resistance (AMR)
  • infection prevention and control
  • molecular surveillance
  • pathogen transmission
  • antimicrobial stewardship
  • outbreak investigation
  • ESKAPE pathogens

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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

13 pages, 3266 KB  
Article
Antimicrobial Consumption and Prescribing Patterns in Hospitalized Children During and After the COVID-19 Pandemic
by Sandra Prgomet, Danica Boban, Zvonimir Boban and Nataša Boban
Pathogens 2026, 15(8), 841; https://doi.org/10.3390/pathogens15080841 - 12 Aug 2026
Viewed by 176
Abstract
The COVID-19 pandemic shifted pediatric infection epidemiology from bacterial toward viral predominance as public health measures relaxed. To determine how hospital antibiotic prescribing adapted, antimicrobial consumption was characterized and linked to underlying pathogen type. Antibiotic use was retrospectively analyzed among 567 children admitted [...] Read more.
The COVID-19 pandemic shifted pediatric infection epidemiology from bacterial toward viral predominance as public health measures relaxed. To determine how hospital antibiotic prescribing adapted, antimicrobial consumption was characterized and linked to underlying pathogen type. Antibiotic use was retrospectively analyzed among 567 children admitted with a positive microbiological finding to the pediatric ward of a tertiary hospital in Split, Croatia, during the first quarters of 2021–2024. Consumption was quantified using Days of Therapy (DOT), Length of Therapy (LOT), and Days of Antibiotic Spectrum Coverage (DASC) per 1000 patient-days (PD). Antibiotics were grouped by the WHO Access/Watch/Reserve (AWaRe) classification and linked to discharge diagnosis and pathogen type. The proportion of children receiving antibiotics rose from 60.5% (26/43) in 2021 to 71.4% (130/182) in 2024, with the cohort shifting toward younger infants and virally driven diagnoses. DOT, DASC, and DOT/LOT peaked in 2022 (DOT 2164/1000 PD, DOT/LOT 2.2) before settling near 1400/1000 PD, with mean per-day spectrum (DASC/DOT) declining modestly (7.7 to 6.8). Watch-group antibiotics dominated throughout (~80%), with Access contribution of ~20% and Reserve antibiotic use negligible. Ceftriaxone usage rose fivefold (150 to 755 DOT/1000 PD) to become the leading agent. Ceftriaxone and azithromycin were administered more often to children with viral than bacterial infections (respiratory syncytial virus being most common), whereas vancomycin and meropenem were tied to bacterial isolates. These findings identify a high-yield stewardship target and underscore the value of multi-metric, pathogen-aware surveillance. Full article
(This article belongs to the Special Issue Healthcare-Associated Infections and Drug-Resistant Pathogens: Surveillance, Transmission and Control Strategies)
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37 pages, 458 KB  
Article
Ventilator-Associated Pneumonia (VAP) Prevention Bundle: A Multicenter Cross-Sectional Saudi Study to Assess Knowledge, Adherence, and Perceived Barriers Among ICU Practitioners in Hail Region
by Ashwaq Abdullah Alanezi, Waleed E. Elawamy, Huda Khalaf Alshammri, Eman Ali Elkordy and Ahmed E. Taha
Pathogens 2026, 15(6), 656; https://doi.org/10.3390/pathogens15060656 - 22 Jun 2026
Viewed by 889
Abstract
Ventilator-associated pneumonia (VAP) is linked to high mortality rates, especially in developing countries. This cross-sectional survey study was conducted across three central hospitals in the Hail region of Saudi Arabia, King Salman Specialist Hospital, Hail General Hospital, and King Khalid Hospital, to assess [...] Read more.
Ventilator-associated pneumonia (VAP) is linked to high mortality rates, especially in developing countries. This cross-sectional survey study was conducted across three central hospitals in the Hail region of Saudi Arabia, King Salman Specialist Hospital, Hail General Hospital, and King Khalid Hospital, to assess the knowledge and adherence of intensive care unit (ICU) healthcare practitioners to the ventilator bundle (VB) for VAP prevention. It also looked at the practitioners’ perceived barriers to effective VB deployment. The study (n = 86) revealed significant disparities in VAP prevention knowledge across educational levels regarding the recommended degree of head-of-bed (HOB) elevation (p < 0.001), the use of endotracheal tubes with extra lumens for subglottic drainage (p < 0.001), and the protective effects of 0.12% chlorhexidine gluconate antiseptic oral rinse (p = 0.019). Professional experience significantly influenced knowledge of non-standard VB components (p < 0.001), the recommended frequency of awakening and spontaneous breathing trials (SBTs) (p < 0.001), and knowledge of extra-lumen tubes (p = 0.038) and kinetic beds vs. standard beds (p = 0.005). Significant differences were found between professional categories regarding knowledge of hand hygiene performance (p = 0.032), the correct degree of HOB elevation (p = 0.007), and patient positioning (semi-recumbent vs. supine) (p = 0.023). Years of experience significantly impacted reported compliance with institutional VB (p = 0.013), adherence to oral care protocols (p = 0.035), and the assessment of sedation depth (p = 0.002). While basic measures like HOB elevation practice and DVT prophylaxis showed universal reported compliance (100%), significant performance gaps were identified in more complex tasks, such as interrupting continuous sedative infusions and performing SBTs as recommended (p < 0.001), particularly among novice practitioners. The primary implementation barrier preventing full compliance with the VB was identified as educational deficit, which was prioritized as the most important area for quality improvement, highlighting the need for targeted training for newly hired ICU staff. Full article
(This article belongs to the Special Issue Healthcare-Associated Infections and Drug-Resistant Pathogens: Surveillance, Transmission and Control Strategies)
18 pages, 2035 KB  
Article
Direct-from-Specimen Detection of Major Carbapenemases by Carbapenem-Resistant K.N.I.V.O. Detection K-Set: Comparative Analysis of Accuracy and Turnaround Time
by Basant Mostafa Gabr, Mona Abd El-Aziz Gadallah, Wafaa Abd Elaziz, Sama Metwally, Raghda Gabr Mashaal, Rasha A. Abd Ellatif, Ahmed G. Elkhouly, Hanan Salem, Amira E. Oraiby, Bsant S. Kasem, Sherif Abdelbaky, Reham M. Elkolaly and Marwa S. Taha
Pathogens 2026, 15(6), 634; https://doi.org/10.3390/pathogens15060634 - 15 Jun 2026
Viewed by 452
Abstract
To improve clinical decision-making about Carbapenem-resistant Gram-negative bacteria (CR-GNB) infections and halt the spread of resistant microbes, quicker and less expensive diagnostic techniques are required. Thus, the purpose of this study was to thoroughly evaluate the diagnostic efficiency (sensitivity, specificity, and concordance) of [...] Read more.
To improve clinical decision-making about Carbapenem-resistant Gram-negative bacteria (CR-GNB) infections and halt the spread of resistant microbes, quicker and less expensive diagnostic techniques are required. Thus, the purpose of this study was to thoroughly evaluate the diagnostic efficiency (sensitivity, specificity, and concordance) of direct-from-specimen multiplex lateral flow immunoassay (LFIA) across diverse raw clinical specimens and pathogen types from critically sick patients. A total of 300 non-duplicate samples were tested to detect CR-GNB. Five major Carbapenemase genes were detected directly from the specimen using carbapenem-resistant K.N.I.V.O. detection K-Set and from culture using culture-enhanced multiplex PCR. Turnaround time (TAT) of each method was calculated. The direct LFIA revealed 100% specificity for NDM, KPC, and IMP enzymes in all tested clinical matrices (blood, urine, and respiratory samples). The study demonstrated 100% sensitivity and specificity with perfect categorical agreement (κ = 1.000) for the blaKPC in the Klebsiella pneumoniae and for blaOXA-48 and blaIMP in the Acinetobacter baumannii; however, sensitivity of blaVIM was significantly diminished across all isolates and samples. TAT decreased significantly (p < 0.001) from 30 to 70 h to about 50 min. The tested direct LFIA facilitates the prompt enhancement of lifesaving tailored antibiotic treatment for severe illnesses. Full article
(This article belongs to the Special Issue Healthcare-Associated Infections and Drug-Resistant Pathogens: Surveillance, Transmission and Control Strategies)
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