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Antibiotics
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Antimicrobial Resistance and Infection Prevention and Control
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Antimicrobial Resistance and Infection Prevention and Control

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 13072

Special Issue Editor

Dr. Vincent Chi Chung Cheng

E-Mail Website
Guest Editor
Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
Interests: infection control and prevention; hand hygiene; environmental disinfection; carbapenem-resistant Acinetobacter baumannii; carbapenem-resistant Pseudomonas aeruginosa; carbapenem-resistant Enterobacterales; carbapenemase-producing Enterobacterales; methicillin-resistant Staphylococcus aureus; vancomycin-resistant enterococci; Clostridioides difficile

Special Issue Information

Dear Colleagues,

Antimicrobial-resistant organisms have been a major burden in the both acute care and long-term care facilities. For the past two decades, there has been worldwide concern about improving the containment of antimicrobial resistance. Although the World Health Organization prioritized a list of Gram-positive and Gram-negative organisms for the research and development of new antimicrobial agents in 2016, the launch of antimicrobial agents lags behind the emergence of antimicrobial-resistant organisms. Therefore, it is of the utmost importance to enforce infection prevention and control to minimize the risk of nosocomial transmission and outbreaks, while antimicrobial stewardship aims to reduce the emergence of antimicrobial-resistant organisms upstream.

The COVID-19 pandemic offers a chance to reshape our healthcare system; it has had a significant impact on infection prevention and control measures, and may result in the corresponding changes in the prevalence of antimicrobial-resistant organisms.

This Special Issue will include original research papers, review articles, and opinion papers covering any innovative infection control measures and the bundles of infection prevention to combat antimicrobial-resistant organisms, including but not limited to carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Pseudomonas aeruginosa, carbapenem-resistant Enterobacterales, carbapenemase-producing Enterobacterales, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and Clostridioides difficile, in acute care and long-term care facilities. We welcome submissions from both resource-rich and resource-limited areas.  

Dr. Vincent Chi Chung Cheng
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

  • Infection control and prevention
  • Hand hygiene
  • Environmental disinfection
  • Carbapenem-resistant Acinetobacter baumannii
  • Carbapenem-resistant Pseudomonas aeruginosa
  • Carbapenem-resistant Enterobacterales
  • Carbapenemase-producing Enterobacterales
  • Methicillin-resistant Staphylococcus aureus
  • Vancomycin-resistant enterococci
  • Clostridioides difficile

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Published Papers (5 papers)

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Research

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9 pages, 234 KiB  
Article
Efficacy of Environmental Cleaning Protocol Featuring Real-Time Feedback with and without PX-UV in Reducing the Contamination of Gram-Negative Microorganisms on High-Touch Surfaces in Four Intensive Care Units in Thailand
by Ornnicha Sathitakorn, Kittiya Jantarathaneewat, David J Weber, Piyaporn Apisarnthanarak, Sasinuch Rutjanawech and Anucha Apisarnthanarak
Antibiotics 2023, 12(3), 438; https://doi.org/10.3390/antibiotics12030438 - 22 Feb 2023
Cited by 3 | Viewed by 1465
Abstract
Environmental cleaning and disinfection practices have been shown to reduce microorganism bioburden in the healthcare environment. This study was performed in four intensive care units in Thailand. Five high-touch surfaces were sampled before and after terminal manual cleaning and disinfection, and after pulsed [...] Read more.
Environmental cleaning and disinfection practices have been shown to reduce microorganism bioburden in the healthcare environment. This study was performed in four intensive care units in Thailand. Five high-touch surfaces were sampled before and after terminal manual cleaning and disinfection, and after pulsed xenon UV (PX-UV). Five nursing station sites were collected on a weekly basis before and after terminal manual cleaning. There were 100 patient rooms—50 rooms in the intervention arm and 50 rooms in the control arm—plus 32 nursing station sites. In the intervention arm, rooms with positive Gram-negative microorganisms were reduced by 50% after terminal manual cleaning and disinfection (p = 0.04) and 100% after PX-UV disinfection (p < 0.001). On five nursing station sites, colony counts of Gram-negative contamination decreased by 100% (p < 0.001) in the intervention arm while decreasing by 65.2% (p = 0.03) in the control arm after terminal manual cleaning and disinfection. The in-room time use was 15.6 min per room. A PX-UV device significantly reduced the level of Gram-negative microorganisms on high-touch surfaces in intensive care units. The application of a PX-UV device was practical a in resource-limited setting without compromising cleaning and disinfection times. Full article
(This article belongs to the Special Issue Antimicrobial Resistance and Infection Prevention and Control)
11 pages, 543 KiB  
Article
Impact of Pharmacist-Led Multidisciplinary Team to Attain Targeted Vancomycin Area under the Curved Monitoring in a Tertiary Care Center in Thailand
by Kittiya Jantarathaneewat, Tuangrat Phodha, Kankanit Singhasenee, Panipak Katawethiwong, Nuntra Suwantarat, Bernard Camins, Thanawat Wongphan, Sasinuch Rutjanawech and Anucha Apisarnthanarak
Antibiotics 2023, 12(2), 374; https://doi.org/10.3390/antibiotics12020374 - 11 Feb 2023
Cited by 2 | Viewed by 1903
Abstract
Vancomycin Area Under the Curve (AUC) monitoring has been recommended to ensure successful clinical outcomes and minimize the risk of nephrotoxicity, rather than traditional trough concentration. However, vancomycin AUC monitoring by a pharmacist-led multidisciplinary team (PMT) has not been well established in Southeast [...] Read more.
Vancomycin Area Under the Curve (AUC) monitoring has been recommended to ensure successful clinical outcomes and minimize the risk of nephrotoxicity, rather than traditional trough concentration. However, vancomycin AUC monitoring by a pharmacist-led multidisciplinary team (PMT) has not been well established in Southeast Asia. This study was conducted at Thammasat University Hospital. Adult patients aged ≥ 18 years who were admitted and received intravenous vancomycin ≥48 h were included. The pre-PMT period (April 2020–September 2020) was defined as a period using traditional trough concentration, while the post-PMT period (October 2020–March 2021) was defined as a period using PMT to monitor vancomycin AUC. The primary outcome was the rate of achievement of the therapeutic target of an AUC/MIC ratio of 400–600. There was a significantly higher rate of achievement of therapeutic target vancomycin AUC during post-PMT period (66.7% vs. 34.3%, p < 0.001). Furthermore, there was a significant improvement in the clinical cure rate (92.4% vs. 69.5%, p < 0.001) and reduction in 30-day ID mortality (2.9% vs. 12.4%, p = 0.017) during the post-PMT period. Our study demonstrates that PMT was effective to help attain a targeted vancomycin AUC, improve the clinical cure rate, and reduce 30-day ID mortality. This intervention should be encouraged to be implemented in Southeast Asia. Full article
(This article belongs to the Special Issue Antimicrobial Resistance and Infection Prevention and Control)
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13 pages, 1402 KiB  
Article
Gastrointestinal Colonization of Carbapenem-Resistant Acinetobacter baumannii: What Is the Implication for Infection Control?
by Shuk-Ching Wong, Jonathan Hon-Kwan Chen, Pui-Hing Chau, Simon Yung-Chun So, Christine Ho-Yan AuYeung, Lithia Lai-Ha Yuen, Veronica Wing-Man Chan, Germaine Kit-Ming Lam, Kelvin Hei-Yeung Chiu, Pak-Leung Ho, Janice Yee-Chi Lo, Kwok-Yung Yuen and Vincent Chi-Chung Cheng
Antibiotics 2022, 11(10), 1297; https://doi.org/10.3390/antibiotics11101297 - 22 Sep 2022
Cited by 6 | Viewed by 2629
Abstract
The epidemiology of patients with gastrointestinal colonization of carbapenem-resistant Acinetobacter baumannii (CRAB) has not been systematically analyzed. We aimed to analyze the incidence, risk factors, and clinical outcomes of patients with newly identified gastrointestinal colonization of CRAB in a healthcare region in Hong [...] Read more.
The epidemiology of patients with gastrointestinal colonization of carbapenem-resistant Acinetobacter baumannii (CRAB) has not been systematically analyzed. We aimed to analyze the incidence, risk factors, and clinical outcomes of patients with newly identified gastrointestinal colonization of CRAB in a healthcare region in Hong Kong, where a multi-pronged screening strategy for gastrointestinal colonization of CRAB, together with other multidrug-resistant organisms (MDROs), was conducted by collecting fecal specimens (rectal swab or stool) upon admission and during hospitalization. From 1 October 2015 to 31 December 2019, a total of 161,339 fecal specimens from 63,588 patients, 61,856 (97.3%) of whom were hospitalized patients, and 54,525 (88.1%) were screened upon admission, with 1309 positive for CRAB (2.4% prevalence). Among patients positive for CRAB in fecal specimens, 698 (53.3%) had newly detected gastrointestinal colonization of CRAB, giving an incidence of 10.03 per 10,000 patient admissions and constituting 2646 CRAB colonization days in the general wards. Excluding the 164 patients with co-colonization of other MDROs, 534 patients had gastrointestinal colonization with only CRAB, and 12.5% (67/534) developed symptomatic CRAB infections at a median of 61 days (range: 2 to 671 days), during prospective follow-up for 2 years. Compared with age- and sex-matched controls, patients being referred from residential care homes for the elderly, the presence of indwelling devices, use of beta-lactam/beta-lactamase inhibitors, carbapenems, and proton pump inhibitors in the preceding 6 months, and history of hospitalization in the past 6 months were significantly associated with gastrointestinal colonization with CRAB, as shown by multivariable analysis. Log-rank test showed that cases had significantly shorter survival duration than controls (p < 0.001). The adjusted hazard ratio of gastrointestinal colonization of CRAB was 1.8 (95% CI: 1.5–2.2; p < 0.001), as shown by Cox regression analysis. Whole-genome sequencing of eight patients with CRAB isolates in their blood cultures and rectal swabs during the same episode of hospitalization revealed ST-195 as the predominant type, as shown by multilocus sequencing type. Gastrointestinal colonization of CRAB poses a considerable challenge for infection prevention and control. Full article
(This article belongs to the Special Issue Antimicrobial Resistance and Infection Prevention and Control)
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13 pages, 1312 KiB  
Article
Impact of Skin Disinfection on Cutaneous Microbiota, before and after Peripheral Venous Catheter Insertion
by Manon Prat, Jeremy Guenezan, Bertrand Drugeon, Christophe Burucoa, Olivier Mimoz and Maxime Pichon
Antibiotics 2022, 11(9), 1209; https://doi.org/10.3390/antibiotics11091209 - 7 Sep 2022
Cited by 1 | Viewed by 2343
Abstract
Introduction. Patients with invasive medical devices are at high risk for infection. Skin colonization is the initial stage of these infections, leading to the recommendation of practices requiring disinfection using antiseptics. Microbial communities playing a major role in skin health could be impacted [...] Read more.
Introduction. Patients with invasive medical devices are at high risk for infection. Skin colonization is the initial stage of these infections, leading to the recommendation of practices requiring disinfection using antiseptics. Microbial communities playing a major role in skin health could be impacted by antiseptic procedures. Aim. To characterize and compare the bacterial communities of skin samples from patients before an antisepsis procedure, and after removal of the medical device itself, according to the nature of the antiseptic molecule (povidone iodine or chlorhexidine). Methods. The study focused on alterations in bacterial communities depending on the nature of the antiseptic procedure and type of intravascular device. After amplification of 16S rDNA, libraries (n = 498 samples) were sequenced using MiSeq platform. Results. Using an in-house pipeline (QIIME2 modules), while no alteration in skin microbiota diversity was associated with antiseptic procedure or PVC type, according to culture results (p < 0.05), alterations were at times associated with restricted diversity and higher dissimilarity (p < 0.05). Antiseptic procedures and PVC types were associated with the modification of specific bacterial representations with modulation of the Bacillota/Bacteroidota (Firmicutes/Bacteroidetes) ratio (modulation of C. acnes, Prevotella, Lagierella, and Actinomyces spp.) (p < 0.05). At baseline, the microbiota shows certain bacteria that are significantly associated with future PVC colonization and/or bacteremia (p < 0.05). All of these modulations were associated with altered expression of metabolic pathways (p < 0.05). Discussion. Finally, this work highlights the need to optimize the management of patients requiring intravascular devices, possibly by modulating the skin microbiota. Full article
(This article belongs to the Special Issue Antimicrobial Resistance and Infection Prevention and Control)
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Review

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17 pages, 877 KiB  
Review
Chlorhexidine Resistance or Cross-Resistance, That Is the Question
by Hadeel Mohammed Abbood, Karolin Hijazi and Ian M. Gould
Antibiotics 2023, 12(5), 798; https://doi.org/10.3390/antibiotics12050798 - 22 Apr 2023
Cited by 14 | Viewed by 3441
Abstract
Chlorohexidine (CHX) is a widely used biocide in clinical and household settings. Studies over the last few decades have reported CHX resistance in different bacterial species, but at concentrations well below those used in the clinical setting. Synthesis of these findings is hampered [...] Read more.
Chlorohexidine (CHX) is a widely used biocide in clinical and household settings. Studies over the last few decades have reported CHX resistance in different bacterial species, but at concentrations well below those used in the clinical setting. Synthesis of these findings is hampered by the inconsistent compliance with standard laboratory procedures for biocide susceptibility testing. Meanwhile, studies of in vitro CHX-adapted bacteria have reported cross-resistance between CHX and other antimicrobials. This could be related to common resistance mechanisms of CHX and other antimicrobials and/or the selective pressure driven by the intensive use of CHX. Importantly, CHX resistance and cross-resistance to antimicrobials should be investigated in clinical as well as environmental isolates to further our understanding of the role of CHX in selection of multidrug resistance. Whilst clinical studies to support the hypothesis of CHX cross-resistance with antibiotics are currently lacking, we recommend raising the awareness of healthcare providers in a range of clinical disciplines regarding the potential adverse impact of the unfettered use of CHX on tackling antimicrobial resistance. Full article
(This article belongs to the Special Issue Antimicrobial Resistance and Infection Prevention and Control)
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