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Antibiotics
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Frontier of Antibiotics in China
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Frontier of Antibiotics in China

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 12509

Special Issue Editors

Prof. Dr. Fupin Hu

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Guest Editor
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China
Interests: in vitro activities of new antimicrobial agents and antimicrobial surveillance; epidemiology, molecular mechanism of resistance genes including ESBL, AmpC, carbapenemases and 16S rRNA methyltransferase genes, etc.
Prof. Dr. Rong Zhang

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Guest Editor
Department of Laboratory Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
Interests: antibiotic resistance mechanism; gram-negative bacteria; molecular epidemiology; multidrug-resistant bacteria
Prof. Dr. Min Li

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Guest Editor
Department of Laboratory Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Interests: epidemiology, evolution and pathogenic mechanism of clinically important pathogens; interaction between clinically important pathogens and microbiome
Prof. Dr. Fangyou Yu

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Guest Editor
Department of Laboratory Medicine, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China
Interests: biofilms; antibiotic resistance mechanism; methicillin-resistant staphylococcus aureus; carbapenem-resistant gram-negative bacteria; beta-lactams; beta-lactamase inhibitors; antimicrobial stewardship

Special Issue Information

Dear Colleagues,

The dissemination of multidrug-resistant bacteria such as extended-spectrum, AmpC, or carbapenem-producing Gram-negative bacilli, as well as methicillin-resistant Staphylococcus aureus, pose a major threat to human health around the world. The high prevalence of antimicrobial resistance in clinical isolates has been attributed to various factors, such as the overuse or misuse of antimicrobials to fight infections. Antimicrobial resistance can be associated with acquired resistance by horizontal gene transfer and mutation. To address the challenges posed by infections caused by drug-resistant bacteria, new antimicrobial agents are continually being developed. However, with the widespread use of new antibacterial agents in the clinical setting, bacteria also develop new mechanisms of resistance to new antibacterial drugs through self-mutation or the acquisition of exogenous antimicrobial resistance plasmids under the strong pressure of new antibacterial agents.

The purpose of this topic is to understand the latest epidemiological characteristics of multidrug-resistant clinical strains in China, the mechanism of resistance to important antimicrobial agents and mutation mechanisms, and the progress of research on new antibiotics. This Research Topic will gather original research and review articles focusing on antimicrobial resistance. Potential topics include but are not limited to the following:

  • Antimicrobial resistance: molecular epidemiology, evolution of novel mobilomes facilitating resistance gene transmission, and new detection methods;
  • Discovery of novel antimicrobial resistance mechanisms;
  • Surveillance studies conducted in healthcare facilities;
  • Whole-genome sequencing (WGS) characterization of multidrug-resistant strains.

Prof. Dr. Fupin Hu
Prof. Dr. Rong Zhang
Prof. Dr. Min Li
Prof. Dr. Fangyou Yu
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 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

  • antimicrobial resistance
  • molecular epidemiology
  • whole-genome sequencing
  • genetic environment

Published Papers (6 papers)

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11 pages, 1404 KiB  
Article
Quinolone Resistance Genes and Their Contribution to Resistance in Vibrio cholerae Serogroup O139
by Yan-Yan Zhou, Li-Yan Ma, Li Yu, Xin Lu, Wei-Li Liang, Biao Kan and Jian-Rong Su
Antibiotics 2023, 12(2), 416; https://doi.org/10.3390/antibiotics12020416 - 20 Feb 2023
Cited by 2 | Viewed by 1660
Abstract
Background. Quinolones are commonly used for reducing the duration of diarrhea, infection severity, and limiting further transmission of disease related to Vibrio cholerae, but V. cholerae susceptibility to quinolone decreases over time. In addition to mutations in the quinolone-resistance determining regions (QRDRs), [...] Read more.
Background. Quinolones are commonly used for reducing the duration of diarrhea, infection severity, and limiting further transmission of disease related to Vibrio cholerae, but V. cholerae susceptibility to quinolone decreases over time. In addition to mutations in the quinolone-resistance determining regions (QRDRs), the presence of qnr and other acquired genes also contributes to quinolone resistance. Results. We determined the prevalence of quinolone resistance related genes among V. cholerae O139 strains isolated in China. We determined that eight strains carried qnrVC, which encodes a pentapeptide repeat protein of the Qnr subfamily, the members of which protect topoisomerases from quinolone action. Four qnrVC alleles were detected: qnrVC1, qnrVC5, qnrVC12, and qnrVC9. However, the strains carrying qnrVC1, qnrVC5, and qnrVC12 were ciprofloxacin (CIP)-sensitive. Contrastingly, the strain carrying qnrVC9 demonstrated high CIP resistance. qnrVC9 was carried by a small plasmid, which was conjugative and contributed to the high CIP resistance to the receptor V. cholerae strain. The same plasmid was also detected in V. vulnificus. The qnrVC1, qnrVC5, and qnrVC12 were cloned into expression plasmids and conferred CIP resistance on the host V. cholerae O139 strain. Conclusions. Our results revealed the contribution of quinolone resistance mediated by the qnrVC9 carried on the small plasmid and its active horizontal transfer among Vibrio species. The results also suggested the different effects of qnrVC alleles in different V. cholerae strains, which is possibly due to differences in sequences of qnrVC alleles and even the genetic characteristics of the host strains. Full article
(This article belongs to the Special Issue Frontier of Antibiotics in China)
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9 pages, 1582 KiB  
Article
Synergistic Inhibition of MRSA by Chenodeoxycholic Acid and Carbapenem Antibiotics
by Kaiyu Cui, Weifeng Yang, Shuang Liu, Dongying Li, Lu Li, Xing Ren, Yanan Sun, Gaiying He, Shuhua Ma, Jidan Zhang, Qing Wei and Yi Wang
Antibiotics 2023, 12(1), 71; https://doi.org/10.3390/antibiotics12010071 - 31 Dec 2022
Cited by 2 | Viewed by 1415
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) has posed a severe global health threat. In this study, we screened an antibiotic and non-antibiotic combination that provides a viable strategy to solve this issue by broadening the antimicrobial spectrum. We found that chenodeoxycholic acid (CDCA) could synergistically [...] Read more.
Methicillin-resistant Staphylococcus aureus (MRSA) has posed a severe global health threat. In this study, we screened an antibiotic and non-antibiotic combination that provides a viable strategy to solve this issue by broadening the antimicrobial spectrum. We found that chenodeoxycholic acid (CDCA) could synergistically act with carbapenem antibiotics to eradicate MRSA-related infections. This synergy specifically targets MRSA and was also validated using 25 clinical MRSA strains using time–kill analysis. We speculated that the underlying mechanism was associated with the interaction of penicillin-binding proteins (PBPs). As a result, the synergistic efficiency of CDCA with carbapenems targeting PBP1 was better than that of β-lactams targeting PBPs. Moreover, we showed that CDCA did not affect the expression level of PBPs, but sensitized MRSA to carbapenems by disrupting the cell membrane. In our study, we have revealed a novel synergistic combination of antibiotics and non-antibiotics to combat potential bacterial infections. Full article
(This article belongs to the Special Issue Frontier of Antibiotics in China)
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15 pages, 1490 KiB  
Article
Epidemiology, Clinical Characteristics, Risk Factors, and Outcomes of Candidemia in a Large Tertiary Teaching Hospital in Western China: A Retrospective 5-Year Study from 2016 to 2020
by Jie Hou, Jin Deng, Ya Liu, Weili Zhang, Siying Wu, Quanfeng Liao, Ying Ma and Mei Kang
Antibiotics 2022, 11(6), 788; https://doi.org/10.3390/antibiotics11060788 - 9 Jun 2022
Cited by 7 | Viewed by 2124
Abstract
The aim of this study was to investigate the current status of candidemia and evaluate the clinical characteristics, risk factors and outcomes among different species. We conducted a retrospective study by univariate and multivariate analysis between Candida albicans and non-albicans Candida (NAC) species [...] Read more.
The aim of this study was to investigate the current status of candidemia and evaluate the clinical characteristics, risk factors and outcomes among different species. We conducted a retrospective study by univariate and multivariate analysis between Candida albicans and non-albicans Candida (NAC) species in a Chinese national medical center from 2016 to 2020. Among the 259 episodes, C. albicans (38.6%) was the leading species, followed by C. tropicalis (24.3%), C. parapsilosis (20.5%), and C. glabrata (12.4%). Most C. albicans and C. parapsilosis were susceptible to nine tested antifungal agents, whereas C. tropicalis showed 30.2~65.9% resistance/non-wild-type to four azoles with great cross-resistance, indicating that fluconazole should not be used for empirical antifungal treatment. In multivariable models, the factor related to an increased risk of NAC was glucocorticoid exposure, whereas gastrointestinal hemorrhage and thoracoabdominal drainage catheters were associated with an increased risk in C. albicans. Subgroup analysis revealed leukemia and lymphoma, as well as glucocorticoid exposure, to be factors independently associated with C. tropicalis in comparison with C. albicans candidemia. No significant differences in 7-day mortality or 30-day mortality were observed between C. albicans and NAC. This study may provide useful information with respect to choosing empirical antifungal agents and exploring differences in molecular mechanisms. Full article
(This article belongs to the Special Issue Frontier of Antibiotics in China)
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8 pages, 1577 KiB  
Article
Characterization of the First Carbapenem-Resistant Pseudocitrobacter faecalis Harboring blaOXA-181 in China
by Qingyu Shi, Yan Guo, Yang Yang, Shi Wu, Renru Han, Li Ding, Dandan Yin and Fupin Hu
Antibiotics 2022, 11(6), 737; https://doi.org/10.3390/antibiotics11060737 - 30 May 2022
Cited by 5 | Viewed by 2234
Abstract
With the wide use of carbapenems, carbapenem-resistant Enterobacterales have been increasingly reported worldwide. In this study, one blaOXA-181-positive Pseudocitrobacter faecalis strain was isolated from the blood culture of a patient with a bloodstream infection in China, which was its first clinical [...] Read more.
With the wide use of carbapenems, carbapenem-resistant Enterobacterales have been increasingly reported worldwide. In this study, one blaOXA-181-positive Pseudocitrobacter faecalis strain was isolated from the blood culture of a patient with a bloodstream infection in China, which was its first clinical report outside Pakistan. Species identification of P. faecalis was initially performed using MALDI-TOF/MS and further confirmed by 16S rRNA gene and housekeeping gene sequencing. The antimicrobial susceptibility testing was determined through the broth microdilution method, and their clonal relationship was analyzed by pulsed-field gel electrophoresis. To study the transmission and genetic structure of the blaOXA-181 gene, a transformation test and whole-genome sequencing (WGS) were performed. The results of the antimicrobial susceptibility testing indicated this P. faecalis was resistant to carbapenems, quinolones, and commonly used β-lactam/β-lactamase inhibitor combinations. Through WGS and transformation experiments, blaOXA-181 and qnrS1 genes causing antibiotic resistance were located on a 55,148-bp length IncX3 type plasmid with a truncated ColKp3 replicon gene. As a rare species of Enterobacterales, P. faecalis was clinically reported in China for the first time, and the blaOXA-181 gene it carried was located on a globally disseminated IncX3 plasmid. The spread of such bacteria and antibiotic resistance requires more clinical attention. Full article
(This article belongs to the Special Issue Frontier of Antibiotics in China)
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9 pages, 867 KiB  
Article
The Rapid Emergence of Ceftazidime-Avibactam Resistance Mediated by KPC Variants in Carbapenem-Resistant Klebsiella pneumoniae in Zhejiang Province, China
by Congcong Liu, Yuchen Wu, Ling Huang, Yanyan Zhang, Qiaoling Sun, Jiayue Lu, Yu Zeng, Ning Dong, Chang Cai, Zhangqi Shen, Gongxiang Chen and Rong Zhang
Antibiotics 2022, 11(6), 731; https://doi.org/10.3390/antibiotics11060731 - 30 May 2022
Cited by 8 | Viewed by 2457
Abstract
Ceftazidime-avibactam (CAV) is a new treatment option against carbapenem-resistant Klebsiella pneumoniae (CRKP) infections. However, the rapid emergence of CAV resistance mediated by KPC variants has posed a severe threat to healthcare after its clinical application. The characteristics of CAV resistance in CRKP strains [...] Read more.
Ceftazidime-avibactam (CAV) is a new treatment option against carbapenem-resistant Klebsiella pneumoniae (CRKP) infections. However, the rapid emergence of CAV resistance mediated by KPC variants has posed a severe threat to healthcare after its clinical application. The characteristics of CAV resistance in CRKP strains needs to be determined in China. A total of 477 CRKP isolates were collected from 46 hospitals in Zhejiang Province from 2018 to 2021. The results demonstrated that CAV had a potent activity against 94.5% of all CRKP (451/477, 95% CI: 93.0–96.1%) and 86.0% of CRKP strains carrying blaKPC genes (410/477, 95% CI: 83.5–88.4%). A total of 26 CAV-resistant strains were found. Among these strains, sixteen harbored metallo-β lactamases, and two carried KPC-2 carbapenemase and mutated ompK35 and ompK36. Eight CRKP strains encoded KPC-33 or KPC-93, belonging to ST11, among which seven strains were detected in patients hospitalized in 2021 after exposure to CAV and one strain was associated with intra-hospital spread. CAV is a potent agent in vitro against CRKP strains. The rapid development of CAV resistance mediated by various KPC variants after a short period of CAV treatment has increased and brought difficulties in treating infections caused by CRKP strains, especially those belonging to ST11. The surveillance of bacterial resistance against CAV is highly recommended due to the steep development of CAV resistance and rapid evolution of KPC enzymes. Full article
(This article belongs to the Special Issue Frontier of Antibiotics in China)
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6 pages, 485 KiB  
Case Report
Ceftazidime–Avibactam in Combination with Imipenem as Salvage Therapy for ST11 KPC-33-Producing Klebsiella pneumoniae
by Li Ding, Siquan Shen, Renru Han, Dandan Yin, Yan Guo and Fupin Hu
Antibiotics 2022, 11(5), 604; https://doi.org/10.3390/antibiotics11050604 - 29 Apr 2022
Cited by 6 | Viewed by 1842
Abstract
A 22-year-old man, after a hematopoietic stem cell transplant, suffered long-term pneumonia caused by blaKPC-2-positive K. pneumoniae and blaKPC-33-positive K. pneumoniae alternately and finally achieved pathogenic clearance and improvement of clinical infectious conditions after using ceftazidime–avibactam in combination with [...] Read more.
A 22-year-old man, after a hematopoietic stem cell transplant, suffered long-term pneumonia caused by blaKPC-2-positive K. pneumoniae and blaKPC-33-positive K. pneumoniae alternately and finally achieved pathogenic clearance and improvement of clinical infectious conditions after using ceftazidime–avibactam in combination with imipenem as salvage therapy. This case provides a reference for treating infection caused by K. pneumoniae with a KPC variant in countries lacking new antimicrobial agents. Full article
(This article belongs to the Special Issue Frontier of Antibiotics in China)
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