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Molecular Strategies to Overcome Antibiotic Resistance in Carbapenem-Producing Bacteria

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Biology".

Deadline for manuscript submissions: 31 October 2024 | Viewed by 500

Special Issue Editors


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Guest Editor
Department of Bacteriology-Virology-Parasitology, University of Medicine and Pharmacy of Craiova, Romania
Interests: epidemiology of multidrug-resistant pathogens; infection prevention and control; healthcare-associated infections surveillance; public heath; vaccines
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Special Issue Information

Dear Colleagues,

Antibiotic resistance, particularly in carbapenem-producing bacteria, presents a critical challenge to global healthcare. The escalation of resistance mechanisms, including the emergence of carbapenemases, has severely limited treatment options, leading to increased morbidity and mortality rates worldwide. Understanding the intricate molecular pathways driving resistance is essential for devising effective therapeutic interventions.

This Special Issue endeavors to comprehensively explore innovative molecular strategies aimed at overcoming antibiotic resistance in carbapenem-producing bacteria. It seeks to advance our understanding of the underlying genetic and biochemical mechanisms driving resistance, with a focus on identifying novel targets for therapeutic intervention. The scope of this collection encompasses a wide array of research topics, including mechanistic studies, drug discovery efforts, and clinical investigations, with the ultimate goal of informing the development of urgently needed antimicrobial therapies.

This Special Issue will showcase pioneering research at the forefront of efforts to combat antibiotic resistance in carbapenem-producing bacteria. Contributions will encompass a diverse range of methodologies, including, but not limited to, genomic and proteomic analyses, the structural elucidation of resistance determinants, innovative drug screening approaches, and clinical trials of novel therapeutics. Emphasis will be placed on studies that offer novel insights into resistance mechanisms and propose transformative solutions with the potential to reshape clinical practice.

Supervised by Prof. Dr. Daniela Calina and Dr Ovidiu Zlatian and assisted by Associate Prof. Dr. Alice Ghenea, we invite submissions of original research articles, comprehensive reviews, and insightful perspectives that significantly advance our understanding of molecular strategies to overcome antibiotic resistance in carbapenem-producing bacteria. Submissions may span basic mechanistic studies, translational research efforts, and clinical investigations, provided they offer substantial scientific merit and contribute to the overarching goals of this Special Issue.

Prof. Dr. Daniela Calina
Dr. Ovidiu Zlatian
Guest Editors

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Keywords

  • antibiotic resistance
  • antimicrobial agents
  • bacterial pathogens
  • carbapenemases
  • genomics
  • molecular mechanisms
  • therapeutic targets

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Published Papers (1 paper)

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Review

14 pages, 14618 KiB  
Review
Systematic Review and Meta-Analysis of Clinical Efficacy and Safety of Meropenem-Vaborbactam versus Best-Available Therapy in Patients with Carbapenem-Resistant Enterobacteriaceae Infections
by Alexandra Bucataru, Adina Turcu-Stiolica, Daniela Calina, Andrei Theodor Balasoiu, Ovidiu Mircea Zlatian, Andrei Osman, Maria Balasoiu and Alice Elena Ghenea
Int. J. Mol. Sci. 2024, 25(17), 9574; https://doi.org/10.3390/ijms25179574 - 4 Sep 2024
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Abstract
Antimicrobial resistance is increasingly concerning, causing millions of deaths and a high cost burden. Given that carbapenemase-producing Enterobacterales are particularly concerning due to their ability to develop structural modifications and produce antibiotic-degrading enzymes, leading to high resistance levels, we sought to summarize the [...] Read more.
Antimicrobial resistance is increasingly concerning, causing millions of deaths and a high cost burden. Given that carbapenemase-producing Enterobacterales are particularly concerning due to their ability to develop structural modifications and produce antibiotic-degrading enzymes, leading to high resistance levels, we sought to summarize the available data on the efficacy and safety regarding the combination of meropenem-vaborbactam (MV) versus the best available therapy (BAT). Articles related to our objective were searched in the PubMed and Scopus databases inception to July 2024. To assess the quality of the studies, we used the Cochrane risk-of-bias tool, RoB2. The outcomes were pooled as a risk ratio (RR) and a 95% confidence interval (95%CI). A total of four published studies were involved: one retrospective cohort study and three phase 3 trials, including 432 patients treated with MV and 426 patients treated with BAT (mono/combination therapy with polymyxins, carbapenems, aminoglycosides, colistin, and tigecycline; or ceftazidime-avibactam; or piperacillin-tazobactam). No significant difference in the clinical response rate was observed between MV and the comparators at the TOC (RR = 1.29, 95%CI [0.92, 1.80], p = 0.14) and EOT (RR = 1.66, 95%CI [0.58, 4.76], p = 0.34) visits. MV was associated with a similar microbiological response as the comparators at TOC (RR = 1.63, 95%CI [0.85, 3.11], p = 0.14) and EOT assessment (RR = 1.16, 95%CI [0.88, 1.54], p = 0.14). In the pooled analysis of the four studies, 28-day all-cause mortality was lower for MV than the control groups (RR = 0.47, 95%CI [0.24, 0.92], p = 0.03). MV was associated with a similar risk of adverse events (AEs) as comparators (RR = 0.79, 95%CI [0.53, 1.17], p = 0.23). Additionally, MV was associated with fewer renal-related AEs than the comparators (RR = 0.32, 95%CI [0.15, 0.66], p = 0.002). MV was associated with a similar risk of treatment discontinuation due to AEs (RR = 0.76, 95%CI [0.38, 1.49], p = 0.42) or drug-related AEs (RR = 0.56, 95%CI [0.28, 1.10], p = 0.09) as the comparators. In conclusion, MV presents a promising therapeutic option for treating CRE infections, demonstrating similar clinical and microbiological responses as other comparators, with potential advantages in mortality outcomes and renal-related AEs. Full article
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