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Microorganisms
Special Issues
Infections and Sepsis
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Infections and Sepsis

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: closed (15 April 2022) | Viewed by 17331

Special Issue Editor

Dr. Andrea Cortegiani

E-Mail Website
Guest Editor
1. Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, 90127 Palermo, Italy
2. Department of Anaesthesia Intensive Care and Emergency, Policlinico Paolo Giaccone, 90127 Palermo, Italy
Interests: sepsis; infections in the critically ill; fungal infection; respiratory infection
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Infection and sepsis are leading causes of death in both community and hospital settings. Indeed, nosocomial infection due to drug-resistant bacteria is an increasing worrisome clinical challenge. Critically ill patients, such as those admitted to intensive care units, and patients with altered immune functions are at higher risk of developing infections and sepsis.

The aim of this Special Issue is to collect original research and review articles focusing on clinical outcomes, pathogenesis, epidemiology, and other clinically relevant aspects of infections and sepsis, both community and hospital-acquired, especially in patients at risk.

Dr. Andrea Cortegiani
Guest Editor

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Published Papers (6 papers)

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12 pages, 1466 KiB  
Article
Hospital-Onset Bloodstream Infections Caused by Eight Sentinel Bacteria: A Nationwide Study in Israel, 2018–2019
by Amir Nutman, Liat Wullfhart, Elizabeth Temkin, Sarah F. Feldman, Vered Schechner, Mitchell J. Schwaber and Yehuda Carmeli
Microorganisms 2022, 10(5), 1009; https://doi.org/10.3390/microorganisms10051009 - 11 May 2022
Cited by 5 | Viewed by 3113
Abstract
Nationwide studies on hospital-onset bloodstream infections (HO-BSIs) are scarce. To describe incidence, mortality and antimicrobial resistance (AMR) of HO-BSI caused by eight sentinel bacteria in Israel, we used laboratory-based BSI surveillance data from 1 January 2018 to 31 December 2019. All hospitals reported [...] Read more.
Nationwide studies on hospital-onset bloodstream infections (HO-BSIs) are scarce. To describe incidence, mortality and antimicrobial resistance (AMR) of HO-BSI caused by eight sentinel bacteria in Israel, we used laboratory-based BSI surveillance data from 1 January 2018 to 31 December 2019. All hospitals reported positive blood cultures growing Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Streptococcus pneumoniae, Staphylococcus aureus, Enterococcus faecalis and Enterococcus faecium. We calculated HO-BSI incidence and 14-day, 30-day and 1-year mortality in adults. We performed multivariable logistic regression to identify predictors of 30-day mortality. The study included 6752 HO-BSI events: K. pneumoniae (1659, 22.1%), E. coli (1491, 19.8%), S. aureus (1315, 17.5%), P. aeruginosa (1175, 15.6%), E. faecalis (778, 10.4%), A. baumannii (654, 8.7%), E. faecium (405, 5.4%) and S. pneumoniae (43, 0.6%). Overall incidence was 2.84/1000 admissions (95% CI: 2.77–2.91) and 6.88/10,000 patient-days (95% CI: 6.72–7.05). AMR isolates accounted for 44.2% of events. Fourteen-day, thirty-day and one-year mortality were 30.6% (95% CI: 28.5%–32.8%), 40.2% (95% CI: 38.2%–42.1%) and 66.5% (95% CI: 64.7%–68.3%), respectively. Organisms with highest risk for 30-day mortality (compared with E. coli) were A. baumannii (OR 2.85; 95% CI: 2.3–3.55), E. faecium (OR 2.16; 95% CI: 1.66–2.79) and S. pneumoniae (OR 2.36; 95% CI: 1.21–4.59). Mortality was higher in AMR isolates (OR 1.57; 95% CI: 1.4–1.77). This study highlights the incidence, associated high mortality and important role of antibiotic resistance in HO-BSI. Full article
(This article belongs to the Special Issue Infections and Sepsis)
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12 pages, 1150 KiB  
Article
A Retrospective Study of the Proportion of Women at High and Low Risk of Intrauterine Infection Meeting Sepsis Criteria
by Hen Y. Sela, Vered Seri, Frederic S. Zimmerman, Andrea Cortegiani, Philip D. Levin, Arnon Smueloff and Sharon Einav
Microorganisms 2022, 10(1), 82; https://doi.org/10.3390/microorganisms10010082 - 31 Dec 2021
Viewed by 1676
Abstract
The Surviving Sepsis Campaign recently recommended that qSOFA not be used as a single parameter for identification of sepsis. Thus, we evaluated the efficacy of SIRS and qSOFA scores in identifying intrauterine infection. This case–control study evaluates SIRS and qSOFA criteria fulfillment in [...] Read more.
The Surviving Sepsis Campaign recently recommended that qSOFA not be used as a single parameter for identification of sepsis. Thus, we evaluated the efficacy of SIRS and qSOFA scores in identifying intrauterine infection. This case–control study evaluates SIRS and qSOFA criteria fulfillment in preterm premature rupture of membranes (n = 453)—at high infection risk—versus elective cesarean—at low infection risk (n = 2004); secondary outcomes included intrauterine infection and positive culture rates. At admission, 14.8% of the study group and 4.6% of control met SIRS criteria (p = 0.001), as did 12.5% and 5.5% on post-operation day (POD) 1 (p = 0.001), with no significant differences on POD 0 or 2. Medical records did not suffice for qSOFA calculation. In the study group, more cultures (29.8% versus 1.9%—cervix; 27.4% versus 1.1%—placenta; 7.5% versus 1.7%—blood; p = 0.001—all differences) and positive cultures (5.5% versus 3.0%—urine—p = 0.008; 4.2% versus 0.2%—cervix—p = 0.001; 7.3% versus 0.0%—placenta—p = 0.001; 0.9% versus 0.1%—blood—p = 0.008) were obtained. Overall, 10.6% of the study group and 0.4% of control met the intrauterine infection criteria (p = 0.001). Though a significant difference was noted in SIRS criteria fulfillment in the study group versus control, there was considerable between-group overlap, questioning the utility of SIRS in intrauterine infection diagnosis. Furthermore, the qSOFA scores could not be assessed. Full article
(This article belongs to the Special Issue Infections and Sepsis)
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11 pages, 780 KiB  
Article
Clinical Application of Metagenomic Next-Generation Sequencing in Patients with Hematologic Malignancies Suffering from Sepsis
by Wang-Da Liu, Ting-Yu Yen, Po-Yo Liu, Un-In Wu, Prerana Bhan, Yu-Chi Li, Chih-Hung Chi and Wang-Huei Sheng
Microorganisms 2021, 9(11), 2309; https://doi.org/10.3390/microorganisms9112309 - 6 Nov 2021
Cited by 15 | Viewed by 3016
Abstract
Background: Sepsis remains a common but fatal complication among patients with immune suppression. We aimed to investigate the performance of metagenomic next-generation sequencing (mNGS) compared with standard microbiological diagnostics in patients with hematologic malignancies. Methods: We performed a prospective study from June 2019 [...] Read more.
Background: Sepsis remains a common but fatal complication among patients with immune suppression. We aimed to investigate the performance of metagenomic next-generation sequencing (mNGS) compared with standard microbiological diagnostics in patients with hematologic malignancies. Methods: We performed a prospective study from June 2019 to December 2019. Adult patients with hematologic malignancies and a clinical diagnosis of sepsis were enrolled. Conventional diagnostic methods included blood cultures, serum galactomannan for Aspergillus, cryptococcal antigen and cytomegalovirus (CMV) viral loads. Blood samples for mNGS were collected within 24 h after hypotension developed. Results: Of 24 patients enrolled, mNGS and conventional diagnostic methods (blood cultures, serology testing and virus RT-PCR) reached comparable positive results in 9 cases. Of ten patients, mNGS was able to identify additional pathogens compared with conventional methods; most of the pathogens were virus. Conclusion: Our results show that mNGS may serve as adjunctive diagnostic tool for the identification of pathogens of hematologic patients with clinically sepsis. Full article
(This article belongs to the Special Issue Infections and Sepsis)
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15 pages, 2174 KiB  
Article
Bloodstream Infections in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis
by Mariachiara Ippolito, Barbara Simone, Carlotta Filisina, Francesca Romana Catalanotto, Giulia Catalisano, Claudia Marino, Giovanni Misseri, Antonino Giarratano and Andrea Cortegiani
Microorganisms 2021, 9(10), 2016; https://doi.org/10.3390/microorganisms9102016 - 23 Sep 2021
Cited by 32 | Viewed by 3481
Abstract
Background: Little is known about the occurrence of bloodstream infections in hospitalized patients with COVID-19 and the related clinical consequences. The aim of this systematic review and meta-analysis was to estimate the pooled occurrence of BSIs among hospitalized patients with COVID-19 and mortality [...] Read more.
Background: Little is known about the occurrence of bloodstream infections in hospitalized patients with COVID-19 and the related clinical consequences. The aim of this systematic review and meta-analysis was to estimate the pooled occurrence of BSIs among hospitalized patients with COVID-19 and mortality of this patient population. Methods: A systematic search was performed on PubMed, EMBASE, and Web of Science from inception to 19 April 2021. The primary outcome was the occurrence of BSIs among hospitalized patients with COVID-19. The secondary outcome was mortality at the longest available follow-up. Results: Forty-six studies met the inclusion criteria, with a total of 42,694 patients evaluated. The estimated occurrence of BSIs was 7.3% (95% CI 4.7–1.1%) among hospitalized patients with COVID-19, with a mortality rate of 41% (95% CI 30%–52.8%). The subgroup analysis conducted on patients admitted to ICU provided an estimated occurrence of 29.6% (95% CI 21.7%–38.8%). A higher occurrence of BSI was observed in patients with COVID-19, in comparison with patients without COVID-19 (OR 2.77; 95% CI 1.53–5.02; p < 0.001). Conclusions: Our analysis estimated the occurrence of BSIs among hospitalized patients with COVID-19 at around 7%. A four-times higher occurrence was estimated among patients admitted to ICU. Full article
(This article belongs to the Special Issue Infections and Sepsis)
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9 pages, 610 KiB  
Brief Report
Reactivation of Herpes Simplex Virus Type 1 (HSV-1) Detected on Bronchoalveolar Lavage Fluid (BALF) Samples in Critically Ill COVID-19 Patients Undergoing Invasive Mechanical Ventilation: Preliminary Results from Two Italian Centers
by Daniele Roberto Giacobbe, Stefano Di Bella, Silvia Dettori, Giorgia Brucci, Verena Zerbato, Riccardo Pol, Ludovica Segat, Pierlanfranco D’Agaro, Erik Roman-Pognuz, Federica Friso, Luigi Principe, Umberto Lucangelo, Lorenzo Ball, Chiara Robba, Denise Battaglini, Andrea De Maria, Iole Brunetti, Nicolò Patroniti, Federica Briano, Bianca Bruzzone, Giulia Guarona, Laura Magnasco, Chiara Dentone, Giancarlo Icardi, Paolo Pelosi, Roberto Luzzati and Matteo Bassettiadd Show full author list remove Hide full author list
Microorganisms 2022, 10(2), 362; https://doi.org/10.3390/microorganisms10020362 - 4 Feb 2022
Cited by 19 | Viewed by 2487
Abstract
Reactivation of herpes simplex virus type 1 (HSV-1) has been described in critically ill patients with coronavirus disease 2019 (COVID-19) pneumonia. In the present two-center retrospective experience, we primarily aimed to assess the cumulative risk of HSV-1 reactivation detected on bronchoalveolar fluid (BALF) [...] Read more.
Reactivation of herpes simplex virus type 1 (HSV-1) has been described in critically ill patients with coronavirus disease 2019 (COVID-19) pneumonia. In the present two-center retrospective experience, we primarily aimed to assess the cumulative risk of HSV-1 reactivation detected on bronchoalveolar fluid (BALF) samples in invasively ventilated COVID-19 patients with worsening respiratory function. The secondary objectives were the identification of predictors for HSV-1 reactivation and the assessment of its possible prognostic impact. Overall, 41 patients met the study inclusion criteria, and 12/41 patients developed HSV-1 reactivation (29%). No independent predictors of HSV-1 reactivation were identified in the present study. No association was found between HSV-1 reactivation and mortality. Eleven out of 12 patients with HSV-1 reactivation received antiviral therapy with intravenous acyclovir. In conclusion, HSV-1 reactivation is frequently detected in intubated patients with COVID-19. An antiviral treatment in COVID-19 patients with HSV-1 reactivation and worsening respiratory function might be considered. Full article
(This article belongs to the Special Issue Infections and Sepsis)
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5 pages, 498 KiB  
Case Report
Real-Time Optimization of Pharmacodynamic Target Attainment at Infection Site during Treatment of Post-Neurosurgical Ventriculitis Caused by Carbapenem-Resistant Gram Negatives with Ceftazidime–Avibactam-Based Regimens: A Report of Two Cases
by Milo Gatti, Giulio Virgili, Pier Giorgio Cojutti, Paolo Gaibani, Matteo Conti, Carmelo Sturiale, Federico Pea and Pierluigi Viale
Microorganisms 2022, 10(1), 154; https://doi.org/10.3390/microorganisms10010154 - 12 Jan 2022
Cited by 21 | Viewed by 2539
Abstract
We present two cases of post-neurosurgical ventriculitis caused by carbapenem-resistant Gram-negative pathogens successfully treated with high-dose ceftazidime/avibactam. The existence of a real-time clinical pharmacological advice program, by enabling the optimization of the PK/PD targets over time at the infection site, turned out to [...] Read more.
We present two cases of post-neurosurgical ventriculitis caused by carbapenem-resistant Gram-negative pathogens successfully treated with high-dose ceftazidime/avibactam. The existence of a real-time clinical pharmacological advice program, by enabling the optimization of the PK/PD targets over time at the infection site, turned out to be very helpful. Full article
(This article belongs to the Special Issue Infections and Sepsis)
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