Dynamics and Molecular Features of Multidrug-Resistant Enterobacterales Lineages in Global Dissemination in a One Health Context (Humans, Animals, and Environment)

Dear Colleagues,

The aim of this Special Issue is to elucidate the molecular features of genes, plasmids, and clones of Enteroacterales in low- and middle-income nations with their limited resources for molecular analysis of the clonality of the Enterobacterales species and molecular characterization of the bacterial antimicrobial resistances.

Among multidrug-resistant (MDR) bacteria, Gram-negative bacilli (GNB) are a most pressing concern. The Enterobacterales is a huge family of pathogens involved in community-associated and nosocomial infections. Due to the emergence and spread of multidrug-resistant (MDR) Enterobacterales in healthcare settings, carbapenems have become one of the last-resort antimicrobials for severe infections caused by these MDR-GNB isolates. Moreover, there are different issues with the different species that we see causing antibiotic resistance, e.g., E. coli, Klebsiella spp.

Extended-spectrum beta-lactamase producing GNB (ESBL) are intrinsically resistant to oxyimino-beta-lactams, including the first three generations of cephalosporins and some beta-lactam/beta-lactamase inhibitor combinations and aztreonam. ESBL-producing GNB should be considered when patients have been pretreated with oxyimino-betalactams, especially third-generation cephalosporins. Urine catheter users have an additional risk. The ESBL rate up to >80% is not only high in Southern and Western Europe, in most Asian countries, in the Middle East Region, and in South America, but also in numerous African regions. The travel history is therefore important since such pathogens will last for weeks after returning from these regions. The high risk to all MDR-GNB must be taken into account in the continuous migration situation. Carbapenems work well against these infections. However, they are essentially the broadest spectrum class of antimicrobials that we have. Moreover, overusing these leads to resistance in Enterobacterales, causing the problem that we have very few options remaining for carbapenem-resistant bacteria, which are rising in numbers worldwide. A question that often comes up is, how do we treat infections associated with such MDR Enterobacterales? Furthermore, MDR-GNB are considered a cross-sectoral issue because the extensive use of antimicrobial agents in livestock has led to emergence of MDR-GNB that can spread directly to exposed workers or indirectly through the food chain. Therefore, surveillance of livestock-associated MDR-GNB, their resistance, and virulence determinants are important for conducting epidemiological analysis of such factors, designing risk management, and strategically controlling farming due to the fact that these data are highly relevant to public health.

As Guest Editor of this Special Issue, I am delighted to invite colleagues investigating any of the pathogenic Enterobacterales within the areas of their ecology, genetics, genomics, immunology, diagnostic detection, public health, and antimicrobial development to submit their manuscripts to this Special Issue in the form of original research, short communication, and reviews. This includes original clinical and laboratory-based research, together with reports of clinical trials and reviews dealing with the epidemiology, clinical diagnosis, treatment, and control of MDR-GNB, including ESBL and CRE.

Dr. Raspail Carrel Founou Zangue
Dr. Malik Aydin
Guest Editors

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