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Antibiotics
Special Issues
Infection Diagnostics and Antimicrobial Therapy for Critical Patient
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Infection Diagnostics and Antimicrobial Therapy for Critical Patient

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 8624

Special Issue Editor

Dr. Giovanna Travi

E-Mail Website
Guest Editor
Asst Grande Ospedale Metropolitano Niguarda, Milan, Italy
Interests: infections in immunocomprmised hosts

Special Issue Information

Dear Colleagues,

A prompt and correct antibacterial therapy affects the mortality of critical patients. New diagnostic methods are available for a faster diagnosis than conventional techniques to start targeted antimicrobial therapy. Targeted therapy also reduces the risk of developing multidrug-resistant (MDR) bacteria. MDR bacteria are a major issue in many hospitals, especially in ICUs with in-hospital outbreaks and increased mortality. The development of MDR bacteria in ICUs is also due to the specific characteristics of critical patients (i.e., large volumes of distribution, multi organ failure, drug–drug interactions). The correct infusion of antibacterial (i.e., extended or continuous infusion) and therapeutic drug monitoring is fundamental. This Special Issue seeks manuscript submissions that further our understanding of diagnostic and antimicrobial therapy in critical patients. Submissions on new microbiological techniques (PCR: film array) in critical patients, adequate dosage of antibacterials in this setting with the support of therapeutic drug monitoring, and antibacterial therapy in difficult-to-treat bacteria in this setting (i.e., Stenotrophomonas, MDR Enterobacteria, Acinetobacter) are especially encouraged.

Kind regards

Dr. Giovanna Travi
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. Antibiotics 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 2900 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

  • TDM (therapeutical drug monitoring)
  • bacterials array
  • septic shock
  • MDR (multi drug resistance)

Published Papers (3 papers)

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Research

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27 pages, 1047 KiB  
Article
Rebound Inverts the Staphylococcus aureus Bacteremia Prevention Effect of Antibiotic Based Decontamination Interventions in ICU Cohorts with Prolonged Length of Stay
by James Hurley
Antibiotics 2024, 13(4), 316; https://doi.org/10.3390/antibiotics13040316 - 29 Mar 2024
Viewed by 856
Abstract
Could rebound explain the paradoxical lack of prevention effect against Staphylococcus aureus blood stream infections (BSIs) with antibiotic-based decontamination intervention (BDI) methods among studies of ICU patients within the literature? Two meta-regression models were applied, each versus the group mean length of stay [...] Read more.
Could rebound explain the paradoxical lack of prevention effect against Staphylococcus aureus blood stream infections (BSIs) with antibiotic-based decontamination intervention (BDI) methods among studies of ICU patients within the literature? Two meta-regression models were applied, each versus the group mean length of stay (LOS). Firstly, the prevention effects against S. aureus BSI [and S. aureus VAP] among 136 studies of antibiotic-BDI versus other interventions were analyzed. Secondly, the S. aureus BSI [and S. aureus VAP] incidence in 268 control and intervention cohorts from studies of antibiotic-BDI versus that among 165 observational cohorts as a benchmark was modelled. In model one, the meta-regression line versus group mean LOS crossed the null, with the antibiotic-BDI prevention effect against S. aureus BSI at mean LOS day 7 (OR 0.45; 0.30 to 0.68) inverted at mean LOS day 20 (OR 1.7; 1.1 to 2.6). In model two, the meta-regression line versus group mean LOS crossed the benchmark line, and the predicted S. aureus BSI incidence for antibiotic-BDI groups was 0.47; 0.09–0.84 percentage points below versus 3.0; 0.12–5.9 above the benchmark in studies with 7 versus 20 days mean LOS, respectively. Rebound within the intervention groups attenuated and inverted the prevention effect of antibiotic-BDI against S. aureus VAP and BSI, respectively. This explains the paradoxical findings. Full article
(This article belongs to the Special Issue Infection Diagnostics and Antimicrobial Therapy for Critical Patient)
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11 pages, 228 KiB  
Communication
Experience with PCR Testing for Enteric Bacteria and Viruses of Emergency Department Patients with Acute Gastroenteritis: Are There Implications for the Early Treatment of Clostridioides difficile Infection?
by Andreas Iffland, Maria Zechel, Jan-Christoph Lewejohann, Birgit Edel, Stefan Hagel, Michael Hartmann, Bettina Löffler and Jürgen Rödel
Antibiotics 2024, 13(3), 243; https://doi.org/10.3390/antibiotics13030243 - 6 Mar 2024
Viewed by 1085
Abstract
Early identification of acute gastroenteritis (AGE) pathogens via PCR may improve the management of patients presenting to the emergency department (ED). In this study, we evaluated the implementation of a testing algorithm for ED patients with AGE using the BD MAX automated PCR [...] Read more.
Early identification of acute gastroenteritis (AGE) pathogens via PCR may improve the management of patients presenting to the emergency department (ED). In this study, we evaluated the implementation of a testing algorithm for ED patients with AGE using the BD MAX automated PCR system. Data from 133 patients were analyzed. A total of 56 patients (42%) tested positive via PCR for at least one bacterial or viral pathogen. The median time to report PCR results was 6.17 h compared to 57.28 h for culture results for bacterial pathogens. The most common pathogen was Clostridioides difficile (n = 20, 15%). In total, 14 of the 20 C. difficile-positive patients were aged >65 years and 17 of the 20 patients (85%) were diagnosed with a clinically relevant infection based on typical symptoms and laboratory values. They received antibiotics, mostly oral vancomycin, starting a median of 11.37 h after ED admission. The introduction of PCR for the diagnosis of AGE infection in patients presenting to the ED may have the greatest impact on the rapid identification of C. difficile and the timely administration of antibiotics if necessary. Full article
(This article belongs to the Special Issue Infection Diagnostics and Antimicrobial Therapy for Critical Patient)

Review

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13 pages, 640 KiB  
Review
Toxic Shock Syndrome: A Literature Review
by Enora Atchade, Christian De Tymowski, Nathalie Grall, Sébastien Tanaka and Philippe Montravers
Antibiotics 2024, 13(1), 96; https://doi.org/10.3390/antibiotics13010096 - 18 Jan 2024
Viewed by 6375
Abstract
Toxic shock syndrome (TSS) is a rare, life-threatening, toxin-mediated infectious process linked, in the vast majority of cases, to toxin-producing strains of Staphylococcus aureus or Streptococcus pyogenes. The pathophysiology, epidemiology, clinical presentation, microbiological features, management and outcome of TSS are described in [...] Read more.
Toxic shock syndrome (TSS) is a rare, life-threatening, toxin-mediated infectious process linked, in the vast majority of cases, to toxin-producing strains of Staphylococcus aureus or Streptococcus pyogenes. The pathophysiology, epidemiology, clinical presentation, microbiological features, management and outcome of TSS are described in this review. Bacterial superantigenic exotoxins induces unconventional polyclonal lymphocyte activation, which leads to rapid shock, multiple organ failure syndrome, and death. The main described superantigenic exotoxins are toxic shock syndrome toxin—1 (TSST-1) and enterotoxins for Staphylococcus aureus and Streptococcal pyrogenic exotoxins (SpE) A, B, and C and streptococcal superantigen A (SsA) for Streptococcus pyogenes. Staphylococcal TSS can be menstrual or nonmenstrual. Streptococcal TSS is linked to a severe group A streptococcal infection and, most frequently, to a necrotizing soft tissue infection. Management of TSS is a medical emergency and relies on early detection, immediate resuscitation, source control and eradication of toxin production, bactericidal antibiotic treatment, and protein synthesis inhibiting antibiotic administration. The interest of polyclonal intravenous immunoglobulin G administration as an adjunctive treatment for TSS requires further evaluation. Scientific literature on TSS mainly consists of observational studies, clinical cases, and in vitro data; although more data on TSS are required, additional studies will be difficult to conduct due to the low incidence of the disease. Full article
(This article belongs to the Special Issue Infection Diagnostics and Antimicrobial Therapy for Critical Patient)
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