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Antibiotics
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State-of-the-Art in Antimicrobial Research in Greece
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State-of-the-Art in Antimicrobial Research in Greece

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

Deadline for manuscript submissions: 31 January 2025 | Viewed by 9850

Special Issue Editor

Dr. Paraskevi Papaioannidou

E-Mail Website
Guest Editor
Department of Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
Interests: antimicrobial resistance; antibiotic use; biofilms; COVID immunization; ELISA; microbial culture; microbiologic ELISA; pharmacoepidemiology; pharmacology; teaching of pharmacology

Special Issue Information

Dear Colleagues,

Greece has been among the European countries with the highest consumption of antibacterials in terms of DDDs (defined daily doses) per 1000 inhabitants per day for several years, according to data reported by the ECDC and OECD.

Another concern regarding antimicrobials in Greece is the use of antibacterials in the community: although in hospitals there is strict stewardship of antibacterial use, in the community there is uncontrolled overuse and misuse of antibacterials, exacerbated by over-the-counter use of antimicrobials. Indeed, until recently, antibacterials could be bought without a prescription in Greece.

Consequently, the overuse and misuse of antibiotics have increased antibiotic resistance, especially in hospital isolates.

To address the serious problem of antimicrobial resistance, it is obvious that strategic research and combined action should be performed in three main areas: basic research for the development of new and innovative antimicrobial agents, antimicrobial resistance surveillance and containment, and stewardship of antimicrobial use.

The aim of this Special Issue is to publish state-of-the-art antimicrobial research in Greece, including basic scientific research, epidemiological data and research from bench to clinical practice, as well as the pharmacoepidemiology and management of antimicrobial use. We invite contributions of research on all kinds of antimicrobials and all aspects of relevant research. The concept of the One Health approach is also welcome.

Dr. Paraskevi Papaioannidou
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

  • antibiotics
  • antimicrobials
  • antibiotic surveillance
  • antimicrobial resistance
  • biofilms
  • one health

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Published Papers (4 papers)

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Research

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13 pages, 1084 KiB  
Article
Central Venous Catheters versus Peripherally Inserted Central Catheters: A Comparison of Indwelling Time Resulting in Colonization by Multidrug-Resistant Pathogens
by Vassiliki C. Pitiriga, John Bakalis, Elsa Campos, Petros Kanellopoulos, Konstantinos Sagris, George Saroglou and Athanasios Tsakris
Antibiotics 2024, 13(1), 89; https://doi.org/10.3390/antibiotics13010089 - 17 Jan 2024
Cited by 2 | Viewed by 3232
Abstract
Background: The use of peripherally inserted central catheters (PICCs) as an alternative to central venous catheters (CVCs) has steadily risen over the last two decades. However, there is an ongoing debate regarding research evidence that supports any clear advantages or disadvantages of them [...] Read more.
Background: The use of peripherally inserted central catheters (PICCs) as an alternative to central venous catheters (CVCs) has steadily risen over the last two decades. However, there is an ongoing debate regarding research evidence that supports any clear advantages or disadvantages of them compared to traditional central venous lines. The present study was conducted to compare the indwelling time of CVC and PICC placements leading to microbial colonization by multidrug-resistant microorganisms (MDROs) in critically ill patients. Methods: A single-center retrospective descriptive study was performed that reviewed the medical records of critically ill patients with colonized CVCs and PICCs who were hospitalized during a 24-month period (May 2019–May 2021). To evaluate the association between indwelling time of catheter placement and colonization rates, events were categorized into three groups, each representing a one-week time interval of catheter indwelling time: group 1: ≤7 days, group 2: 8–14 days, and group 3: >14 days. Results: A total of 207 hospitalized patients with colonized PICCs or CVCs were included in the study. Of these, 144 (69.5%) had a CVC placement and 63 (30.5%) had a PICC placement. The overall colonization rate (per 1.000 catheter/days) was 14.73 in the CVC and 5.67 in the PICC cohort (p = 0.003). In the group of PICCs, 12/63 (19%) of the pathogens were MDROs and 51/63 (81%) were non-MDROs, while in the group of CVCs, 86/144 (59.7%) were MDROs and 58/144 (40.3%) were non-MDROs (p < 0.001). The colonization rate in the CVC cohort, was 6.98 for group 1, 21.57 for group 2, and 21.6 for group 3 (p = 0.019). The colonization rate of MDROs was 3.27 for group 1, 14.47 for group 2, and 12.96 for group 3 (p = 0.025). Regarding the PICC cohort, the colonization rate was 1.49 for group 1, 3.19 for group 2, and 8.99 for group 3 (p = 0.047). No significant difference existed between the three groups in terms of MDRO pathogens, with the colonization rate being 0 for group 1, 0.8 for group 2, and 1.69 for group 3 (p = 0.78). Within the CVC cohort, the most common isolated microorganism was MDR Acinetobacter baumannii (n = 44; 30.6%), followed by MDR Klebsiella pneumoniae (n = 27; 18.7%). In the PICC cohort, the predominant isolated microorganism was Candida non-albicans (n = 15; 23.8%), followed by Candida albicans, coagulase-negative staphylococci, and MDR Klebsiella pneumoniae in equal numbers (n = 6; 9.5%). Conclusions: Our findings show that while the indwelling time of PICC placement was longer compared to CVCs, its colonization rate was considerably lower. Furthermore, high colonization rates by microorganisms, especially MDROs, arose later during catheterization in PICCs compared to CVCs, suggesting that in terms of vascular infections, PICCs may be a safer alternative to conventional CVCs for long-term intravenous access. Full article
(This article belongs to the Special Issue State-of-the-Art in Antimicrobial Research in Greece)
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21 pages, 6718 KiB  
Article
Surveillance of Antimicrobial Resistance and Multidrug Resistance Prevalence of Clinical Isolates in a Regional Hospital in Northern Greece
by Maria Tsalidou, Theodouli Stergiopoulou, Ioannis Bostanitis, Christina Nikaki, Kalypso Skoumpa, Theofani Koutsoukou and Paraskevi Papaioannidou
Antibiotics 2023, 12(11), 1595; https://doi.org/10.3390/antibiotics12111595 - 5 Nov 2023
Cited by 2 | Viewed by 2249
Abstract
Antimicrobial resistance is a global health threat resulting in increased morbidity and mortality. This retrospective study aimed to estimate antimicrobial susceptibility and multidrug resistance prevalence of clinical isolates in a regional hospital in Northern Greece during the last 6 years by analyzing the [...] Read more.
Antimicrobial resistance is a global health threat resulting in increased morbidity and mortality. This retrospective study aimed to estimate antimicrobial susceptibility and multidrug resistance prevalence of clinical isolates in a regional hospital in Northern Greece during the last 6 years by analyzing the annual reports of the Laboratory of Microbiology. A total of 12,274 strains of certain bacteria were isolated from both hospitalized and ambulatory patients from biological products, mainly urine (range 63–78% during the study period). E. coli was the most frequent pathogen found (37.4%). A significant increase in the number of the main pathogens causing hospital-acquired infections (Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus faecium) was found in the time period of 2021–2023 compared to 2018–2020 (p < 0.0001). In total, 1767 multidrug-resistant bacterial strains were isolated, most of them belonging to Acinetobacter baumannii (36.4%) and Klebsiella pneumoniae (39.6%), and were located in the intensive care unit (ICU) (59.8%). Extensively drug resistance (XDR) and pan drug resistance (PDR) were significantly higher in 2021–2023 than in 2018–2020 (XDR: 641/1087 in 2021–2023 vs. 374/680 in 2018–2020 and PDR: 134/1087 in 2021–2023 vs. 25/680 in 2018–2020, p < 0.0001), resulting in an urgent need to establish certain strategies in order to eliminate this threatening condition. Full article
(This article belongs to the Special Issue State-of-the-Art in Antimicrobial Research in Greece)
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12 pages, 4030 KiB  
Article
Νanomaterial-Loaded Polymer Coating Prevents the In Vitro Growth of Candida albicans Biofilms on Silicone Biomaterials
by Alexios Tsikopoulos, Konstantinos Tsikopoulos, Gabriele Meroni, Christoforos Gravalidis, Prodromos Soukouroglou, Athanasios Chatzimoschou, Lorenzo Drago, Stefanos Triaridis and Paraskevi Papaioannidou
Antibiotics 2023, 12(7), 1103; https://doi.org/10.3390/antibiotics12071103 - 25 Jun 2023
Viewed by 1444
Abstract
Early failure of silicone voice prostheses resulting from fungal colonization and biofilm formation poses a major concern in modern ear nose throat surgery. Therefore, developing new infection prevention techniques to prolong those implants’ survivorship is crucial. We designed an in vitro laboratory study [...] Read more.
Early failure of silicone voice prostheses resulting from fungal colonization and biofilm formation poses a major concern in modern ear nose throat surgery. Therefore, developing new infection prevention techniques to prolong those implants’ survivorship is crucial. We designed an in vitro laboratory study to include nanomaterial-enhanced polymer coating with a plasma spraying technique against Candida albicans growth to address this issue. The anti-biofilm effects of high- and low-dose Al2O3 nanowire and TiO2 nanoparticle coatings were studied either alone or in conjunction with each other using checkerboard testing. It was demonstrated that both nanomaterials were capable of preventing fungal biofilm formation regardless of the anti-fungal agent concentration (median absorbance for high-dose Al2O3-enhanced polymer coating was 0.176 [IQR = 0.207] versus control absorbance of 0.805 [IQR = 0.381], p = 0.003 [98% biofilm reduction]; median absorbance for high-dose TiO2-enhanced polymer coating was 0.186 [IQR = 0.024] versus control absorbance of 0.766 [IQR = 0.458], p < 0.001 [93% biofilm reduction]). Furthermore, synergy was revealed when the Bliss model was applied. According to the findings of this work, it seems that simultaneous consideration of Al2O3 and TiO2 could further increase the existing antibiofilm potential of these nanomaterials and decrease the likelihood of localized toxicity. Full article
(This article belongs to the Special Issue State-of-the-Art in Antimicrobial Research in Greece)
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Review

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19 pages, 394 KiB  
Review
Periprosthetic Joint Infection Diagnosis: A Narrative Review
by Konstantinos Tsikopoulos and Gabriele Meroni
Antibiotics 2023, 12(10), 1485; https://doi.org/10.3390/antibiotics12101485 - 27 Sep 2023
Cited by 4 | Viewed by 2281
Abstract
Replacement of native joints aims to restore patients’ quality of life by relieving pain and improving joint function. While periprosthetic joint infection (PJI) affects a small percentage of patients, with an estimated incidence of 1–9% following primary total joint replacement, this postoperative complication [...] Read more.
Replacement of native joints aims to restore patients’ quality of life by relieving pain and improving joint function. While periprosthetic joint infection (PJI) affects a small percentage of patients, with an estimated incidence of 1–9% following primary total joint replacement, this postoperative complication necessitates a lengthy hospitalisation, extended antibiotic treatment and further surgery. It is highlighted that establishing the correct diagnosis of periprosthetic infections is critical in order for clinicians to avoid unnecessary treatments in patients with aseptic failure. Of note, the PJI diagnosis could not purely rely upon clinical manifestations given the fact that heterogeneity in host factors (e.g., age and comorbidities), variability in infection period, difference in anatomical location of the involved joint and discrepancies in pathogenicity/virulence of the causative organisms may confound the clinical picture. Furthermore, intra-operative contamination is considered to be the main culprit that can result in early or delayed infection, with the hematogenous spread being the most prevalent mode. To elaborate, early and hematogenous infections often start suddenly, whereas chronic late infections are induced by less virulent bacteria and tend to manifest in a more quiescent manner. Last but not least, viruses and fungal microorganisms exert a role in PJI pathogenesis. Full article
(This article belongs to the Special Issue State-of-the-Art in Antimicrobial Research in Greece)
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