Multidrug Resistance in Bacteria and New Therapeutic Options

Dear Colleagues,

Antimicrobial resistance presents a critical threat to public health and a great challenge to clinicians treating patients in intensive care units. Carbapenem resistance is increasing in Enterobacterales (CRE), Pseudomonas aeruginosa (CRPA) and Acinetobacter baumannii (CRAB). The rate of carbapenem resistance has increased to over 10% in Enterobacterales and over 90% in A. baumannii in geographic regions such as East Europe and the Mediterranean area. Colistin, which is neurotoxic and nephrotoxic, is often the last-resort antibiotic. However, colistin-resistant isolates have recently emerged among Enterobacterales, A. baumannii and occasionally, although rarely, P. aeruginosa. Clinicians often do not have any other therapeutic option, and have to rely on antibiotic combinations in order to treat the patient. In the last few years, new antibiotics have been licenced for the treatment of infections due to CRE, CRAB and CRPA, including ceftolozan/tazobactam (CTA) ceftazidime/avibactam (CZA), imipenem/cilastatin/relebactam (IMR) and cefiderocol, as well as eravacycline, which is efficient against MRSA and VRE. The majority of these antibiotics exert good activity against KPC- and OXA-48-producing Enterobacterales and CRPA, but with the exception of cefiderocol, do not exhibit any activity against metalo-beta-lactamase-producing organisms or CRAB. Thus, the scope of this Special Issue is mostly focused on the in vitro and in vivo activity of the novel compounds for the treatment of infections associated with CRE, CRPA and CRAB.

Topics of interest include, but are not limited to:

1. In vitro activity of the novel compounds (CZA, CTA, IMR, cefiderocol, eravacycline, including compounds currently in development) against multidrug or extensively drug Gram-negative and Gram-positive pathogens in human and veterinary medicine;
2. Mechanisms of bacterial resistance to novel drugs and molecular epidemiology of resistant isolates in humans, animals and the environment;
3. Clinical trials with new antibiotics.

Dr. Gordana Maravić Vlahoviček
Dr. Branka Bedenić
Guest Editors

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