Antibiotics-Basel最新文献

{"title":"Prediction Score for Identification of ESBL Producers in Urinary Infections Overestimates Risk in High-ESBL-Prevalence Setting.","authors":"Jorge Alberto Cortés, Julián Antonio Niño-Godoy, Heidi Johanna Muñoz-Latorre","doi":"10.3390/antibiotics14090938","DOIUrl":"10.3390/antibiotics14090938","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL) Enterobacterales have become more frequent. Therefore, strategies for assessing the risks posed by ESBL-producing infections have been developed, creating the need for local validation. The aim of this study was to validate the scoring system designed by Tumbarello et al. to identify ESBL producers in patients with a UTI that require hospital care in a region with a high prevalence of ESBL <i>Escherichia coli</i>. <b>Methods</b>: A retrospective cohort study was conducted in a third-level hospital in Bogotá (Colombia) between 2013 and 2020.The study included 817 patients, who were hospitalized due to pyelonephritis and treated with cefuroxime (the first-line antibiotic according to local guidelines), with an ESBL frequency of 9.68%. Diagnostic performances were estimated for a modified version of Tumbarello's score (omitting admission from another healthcare facility) evaluating the area under the curve (AUC) for ESBL presence with respect to resistance to second- and third-generation cephalosporins. <b>Results</b>: With an index cut-off of ≥6, the score showed a sensitivity of 18% and a specificity of 83%. The AUC for this cut-off was 0.47. This threshold index could not efficiently predict either third- (AUC = 0.49) or second-generation cephalosporin resistance (AUC = 0.51). <b>Conclusions</b>: In Colombia, a region with a high prevalence of ESBL <i>E. coli</i> producers, as the use of the Tumbarello index would result in excessive utilization of wide-spectrum antibiotics, it is not recommended in this specific scenario for UTIs. Further studies are required in order to develop accurate tools to assess the risk of ESBL producers in high-prevalence settings.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatology: First Exposure to Antibiotics from the Ethical Perspective of Parents, Physicians, and Regulators.","authors":"Iliya Mangarov, Simeon Iliev, Yulian Voynikov, Valentina Petkova, Iva Parvova, Antoaneta Tsvetkova, Irina Nikolova","doi":"10.3390/antibiotics14090936","DOIUrl":"10.3390/antibiotics14090936","url":null,"abstract":"<p><p>Premature infants are an especially vulnerable group that often needs extended intensive care. Prematurity naturally hampers the development of the immune system, significantly increasing the risk of infections. In the Neonatal Intensive Care Unit (NICU), antibiotic treatment is often a crucial, life-saving measure. For parents, the birth of a very preterm infant (before 32 weeks of gestation) turns what should be a happy event into a period filled with deep uncertainty and distress. Maintaining hope amid these difficulties relies heavily on maintaining regular communication with and trusting the medical team. Clinical realities in the NICU include a high risk of infection that requires multiple medications, including antibiotics. There is an inverse relationship between gestational age and pharmaceutical exposure. Parents worry about the amount of medication their child receives and the potential long-term effects on development. Over the past thirty years, initiatives such as antimicrobial stewardship programs have worked to reduce antibiotic use and treatment duration in the NICU, emphasizing proper care for premature infants worldwide. This article examines the ethical landscape from the perspectives of three primary stakeholders: parents, healthcare providers, and regulatory bodies. The key ethical question is whether these groups achieve meaningful cooperation or if institutional and professional priorities overshadow clinical practice. In the NICU, decision-making responsibility mainly lies with the medical team, as parents often have limited influence over treatment decisions, and regulatory oversight usually occurs indirectly. This concentration of authority underscores the complex and critical nature of neonatal intensive care.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the ABxSG Mobile Application on Antibiotic Prescribing: An Interrupted Time Series Study.","authors":"Lai Wei Lee, Shena Yun Chun Lim, Yvonne Peijun Zhou, Shimin Jasmine Chung, De Zhi Chin, Andrea Lay Hoon Kwa, Winnie Hui Ling Lee","doi":"10.3390/antibiotics14090933","DOIUrl":"10.3390/antibiotics14090933","url":null,"abstract":"<p><strong>Background: </strong>A point prevalence survey conducted at Singapore General Hospital in 2021 showed 48% of inpatients on antibiotics. We hypothesize that a mobile application, transforming complex antibiotic prescribing information into a succinct and individualized resource, will empower healthcare professionals and improve antibiotic prescriptions. Hence, we developed ABxSG using the behavioral design thinking approach (BDTA) to ensure positive user experience and sustained engagement. We aim to evaluate the impact of ABxSG on the proportion of inpatients on antibiotics, antibiotic appropriateness, and the number of antibiotic-related interventions by pharmacists.</p><p><strong>Methods: </strong>ABxSG was launched in March 2023. An interrupted time series analysis was conducted to evaluate its impact on the above outcomes measured using data collected from October 2021 to September 2024. There were 18 data points pre- and post-ABxSG.</p><p><strong>Results: </strong>Following the ABxSG launch, there was an immediate reduction in the proportion of inpatients on antibiotics by 1.66% (<i>p</i> < 0.01), followed by a sustained reduction of 3.12% at 18 months (<i>p</i> < 0.01). Piperacillin-tazobactam appropriateness increased by 2.76% at 1 month (<i>p</i> = 0.11) and further increased by 7.09% at 18 months (<i>p</i> < 0.05). Similarly, ceftriaxone appropriateness increased by 5.74% (<i>p</i> < 0.05) at 1 month and remained above pre-ABxSG levels. There was a significant increase in the number of pharmacist-led interventions for dosing optimization, with 96 more interventions/month at 18 months (<i>p</i> = 0.14).</p><p><strong>Conclusion: </strong>Antimicrobial stewardship teams must remain agile, embrace innovations, and adopt digital technologies to engage and empower clinicians. ABxSG reduced the proportion of inpatients on antibiotics and improved antibiotic prescriptions. The incorporation of BDTA in ABxSG, strong hospital leader support, and strategic planning to promote adoption led to its success.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genotypic and Phenotypic Characterization of Antimicrobial Resistance and Virulence in <i>Campylobacter</i> spp. Isolated from Turkeys: Uncovering a Neglected Reservoir in the One Health Context.","authors":"Sebastian Alexandru Popa, Viorel Herman, Khalid Ibrahim Sallam, Emil Tîrziu, Claudiu Andor, Adriana Morar, Mirela Imre, Alexandra Ban-Cucerzan, Răzvan-Tudor Pătrînjan, Alexandra Pocinoc, Kálmán Imre","doi":"10.3390/antibiotics14090935","DOIUrl":"10.3390/antibiotics14090935","url":null,"abstract":"<p><p><b>Background:</b><i>Campylobacter</i> spp. are leading foodborne pathogens, with increasing antimicrobial resistance (AMR) posing a critical public health threat. While broiler chickens have been widely studied, turkeys represent an underexplored reservoir. The present study investigates <i>Campylobacter</i> spp. in turkeys, focusing on isolation frequency, resistance, and virulence within the context of One Health. <b>Methods:</b> A total of 182 cecal samples were collected from slaughtered turkeys in Romania. Isolation and identification of <i>Campylobacter jejuni</i> and <i>C. coli</i> followed ISO 10272-1:2017 guidelines. Antimicrobial susceptibility testing was conducted via broth microdilution, and molecular analyses using PCR targeted species identification, resistance determinants, and virulence-associated genes. <b>Results:</b><i>Campylobacter</i> spp. were detected in 75.8% of samples, with <i>C. jejuni</i> and <i>C. coli</i> accounting for 54.3% and 45.7%, respectively. High resistance rates were observed to ciprofloxacin (89.9%) and tetracycline (85.5%), with moderate resistance to erythromycin and ertapenem. No resistance was found to gentamicin or chloramphenicol. Genotypic analyses confirmed the presence of resistance genes (e.g., <i>tetO</i>, <i>gyrA</i>-Thr-86-Ile mutation, <i>ermB</i>, <i>cmeB</i>) and widespread virulence genes (<i>flaA</i>, <i>cadF</i>, <i>cdtAB</i>, <i>ciaB</i>), supporting phenotypic results. <b>Conclusions</b>: The survey highlights turkeys as a significant but neglected source of resistant and virulent <i>Campylobacter</i> spp., with implications for food safety and public health. The convergence of AMR and virulence aspects calls for integrated surveillance and control strategies across veterinary and human health sectors, supporting the One Health strategy.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Length and Type of Antibiotic Prophylaxis for Infection Prevention in Adults Patient in the Cardiac Surgery Intensive Care Unit: A Narrative Review.","authors":"Raffaele Barbato, Benedetto Ferraresi, Massimo Chello, Alessandro Strumia, Ilaria Gagliardi, Francesco Loreni, Alessia Mattei, Giuseppe Santarpino, Massimiliano Carassiti, Francesco Grigioni, Mario Lusini","doi":"10.3390/antibiotics14090934","DOIUrl":"10.3390/antibiotics14090934","url":null,"abstract":"<p><strong>Background: </strong>Infections following cardiac surgery are a significant cause of morbidity and mortality, particularly in intensive care units (ICUs). The role of antibiotic prophylaxis (AP) in preventing surgical site infections (SSIs) and other nosocomial infections is crucial; however, the optimal approach to agent selection, dosing, and duration remains controversial.</p><p><strong>Objective: </strong>This narrative review aims to summarise the current evidence and expert recommendations regarding the use of perioperative antibiotic prophylaxis (AP) in adults undergoing cardiac surgery, with a particular focus on intensive care settings, transplant recipients, and adult patients on extracorporeal membrane oxygenation (ECMO).</p><p><strong>Methods: </strong>A comprehensive review of recent literature was conducted, focusing on pharmacokinetic/pharmacodynamic (PK/PD) principles, microbial epidemiology, antimicrobial resistance (AMR), and practical strategies for tailored prophylaxis in high-risk populations.</p><p><strong>Results: </strong>Cefazolin remains the first-line agent for most procedures, with vancomycin or clindamycin reserved for patients who are allergic to β-lactams or who are colonised with MRSA. Redosing is recommended in cases of prolonged surgery or cardiopulmonary bypass. Evidence supports limiting prophylaxis to ≤24 h, with a potential extension to 48 h in select high-risk cases; however, continuation beyond this is discouraged due to the risk of resistance. In heart transplantation, multimodal prophylaxis against bacteria, fungi, and viruses is essential but must be tailored to the individual patient. In the ECMO setting, the current evidence does not support the routine administration of prophylaxis (AP), and therapy should be tailored based on pharmacokinetics (PK)/pharmacodynamics (PD) changes and the clinical context. A multidisciplinary, evidence-based approach to AP in cardiac surgery is essential. Prophylaxis should be patient-specific, microbiologically guided, and limited in duration to reduce the emergence of multidrug-resistant organisms. Integrating antimicrobial stewardship, non-pharmacological measures, and rigorous surveillance is crucial for optimising the prevention of infections in this vulnerable population.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time Trends in Prevalence and Antimicrobial Resistance of Respiratory Pathogens in a Tertiary Hospital in Rome, Italy: A Retrospective Analysis (2018-2023).","authors":"Fabio Ingravalle, Massimo Maurici, Antonio Vinci, Stefano Di Carlo, Cartesio D'Agostini, Francesca Pica, Marco Ciotti","doi":"10.3390/antibiotics14090932","DOIUrl":"10.3390/antibiotics14090932","url":null,"abstract":"<p><strong>Background: </strong>The increase in antimicrobial resistance (AMR) is a growing concern for global health. Understanding longitudinal trends in pathogen prevalence and resistance patterns is essential for guiding clinical management and antibiotic stewardship. This retrospective observational study analyzed respiratory microbial isolates collected from 2018 to 2023 in Tor Vergata University Hospital, Rome, Italy.</p><p><strong>Methods: </strong>The data were analyzed through WHOnet 2025 software, and the breakpoint references used are those of EUCAST 2025. The data analyzed included pathogen identification, antibiotic resistance rates, and specimen types. Time-trend analyses were conducted to assess changes in pathogen prevalence and antibiotic resistance rates over time, using the Pearson correlation coefficient and linear regression model.</p><p><strong>Results: </strong>More than 54,000 unique microorganism/drug associations were analyzed, with the majority of them relative to inpatients (over 90%). <i>A. baumannii</i> showed persistently high prevalence and drug resistance to multiple antibiotics. Significant upward resistance trends of <i>K. pneumoniae</i> to multiple antibiotics were observed. Approximately 20% of clinical isolates were fungi, also including some non-albicans Candida (NAC) species, which exhibit intrinsic resistance to azoles. Other microorganisms displayed variable trends in prevalence and resistance profiles.</p><p><strong>Conclusions: </strong>These findings underscore the dynamism of changing patterns of prevalence of microorganisms and their resistance to antimicrobials. They underscore the importance of continuous microbiological surveillance to optimize empirical therapies and guide infection control policies.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypic and Molecular Study of Multidrug-Resistant <i>Escherichia coli</i> Isolates Expressing Diverse Resistance and Virulence Genes from Broilers in Tunisia.","authors":"Ghassan Tayh, Fatma Nsibi, Khaled Abdallah, Omar Abbes, Ismail Fliss, Lilia Messadi","doi":"10.3390/antibiotics14090931","DOIUrl":"10.3390/antibiotics14090931","url":null,"abstract":"<p><p>This study investigated the molecular and phenotypic characteristics of antimicrobial resistance in <i>Escherichia coli</i> isolates recovered from the ceca of healthy broilers in Tunisia. A total of 111 <i>E. coli</i> isolates were obtained from chicken samples collected at slaughterhouses and cultured on cefotaxime-supplemented MacConkey agar. All isolates exhibited a multidrug-resistant (MDR) phenotype, and 72.1% were confirmed as extended-spectrum β-lactamase (ESBL) producers. The most frequent β-lactamase gene was <i>bl</i>a_CTX-M-G1, followed by <i>bla</i>_TEM and <i>bla</i>_SHV. Carbapenem resistance genes (<i>bla</i>_OXA-48 and <i>bla</i>_IMP) were detected in 12.6% and 6.3% of isolates, respectively, while six isolates harbored the colistin resistance gene <i>mcr-1</i>. Among the tested virulence genes, <i>fimH</i>, <i>traT</i>, and <i>iutA</i> were the most prevalent, detected in over 70% of isolates. Class 1 integrons were present in 83% of isolates, and class 2 integrons in 39.6%, with gene cassettes encoding resistance to trimethoprim (<i>dfrA</i>) and streptomycin (<i>aadA</i>). These findings highlight the widespread presence of MDR and ESBL-producing <i>E. coli</i> strains with virulence traits and integrons in poultry, underscoring the risk of transmission to humans. This study provides essential data supporting the implementation of integrated surveillance strategies in line with the One Health approach.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidrug-Resistant <i>Escherichia coli</i> Associated with Respiratory and Systemic Infection in a Domestic Rabbit in Romania: First Confirmed Case.","authors":"Vlad Iorgoni, Livia Stanga, Ionica Iancu, Janos Degi, Ionela Popa, Alexandru Gligor, Gabriel Orghici, Bogdan Sicoe, Ioan Cristian Dreghiciu, David Purec, Paula Nistor, Bogdan Florea, Corina Kracunović, Viorel Herman","doi":"10.3390/antibiotics14090929","DOIUrl":"10.3390/antibiotics14090929","url":null,"abstract":"<p><strong>Background/objectives: </strong>This report documents the first confirmed case in Romania of fatal pneumonia and septicemia in a domestic rabbit caused by multidrug-resistant <i>Escherichia coli</i>, highlighting both its pathogenic potential and One Health implications.</p><p><strong>Case study: </strong>An 8-month-old male German Giant Spotted rabbit raised on a rural farm under poor husbandry conditions developed acute respiratory distress and died within 48 h. Post-mortem examination revealed severe pulmonary congestion, tracheal inflammation, serofibrinous pericarditis, and systemic vascular lesions. Bacteriological analysis confirmed <i>E. coli</i> from lung, trachea, and bone marrow samples. The isolate demonstrated strong Congo red binding, was confirmed by MALDI-TOF mass spectrometry, and showed resistance to beta-lactams, fluoroquinolones, tetracyclines, sulfonamides, macrolides, and phenicols, remaining susceptible only to aminoglycosides. PCR screening identified virulence genes (<i>fimH</i>, <i>papC</i>, <i>iutA</i>, <i>ompA</i>) linked to adhesion, immune evasion, and iron acquisition, with potential for horizontal gene transfer.</p><p><strong>Conclusions: </strong>This first documented case in Romania emphasizes the clinical threat posed by multidrug-resistant <i>E. coli</i> in rabbits and the importance of early diagnosis, improved biosecurity, and responsible antimicrobial use. The zoonotic and environmental risks in backyard farming underscore the urgent need for integrated surveillance. Alternative control strategies, including phage therapy and probiotics, should be explored to reduce reliance on conventional antibiotics.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cold Plasma as a Revolutionary Antimicrobial Modality: A Multifaceted Weapon Against Antibiotic Resistance.","authors":"Yehia A-G Mahmoud, Nehal E Elkaliny, Farah M Elshikh, Yara Ashraf, Kamel Metwally, Galal Yahya, Sameha Sherif","doi":"10.3390/antibiotics14090930","DOIUrl":"10.3390/antibiotics14090930","url":null,"abstract":"<p><p>The rise of antibiotic resistance has transformed once-curable infections into urgent global health threats, leaving hospitals with outbreaks, patients with prolonged illnesses, and doctors with limited therapeutic options. The era of antibiotic resistance is no longer a distant concern; it is a pressing reality demanding innovative solutions. Among emerging alternatives, cold plasma a partially ionized state of matter enriched with reactive species offers a multi-targeted antimicrobial strategy. Unlike conventional antibiotics, cold plasma disrupts bacterial survival through diverse mechanisms, including membrane rupture, protein and nucleic acid damage, and oxidative stress that overwhelms microbial defenses. This review synthesizes current evidence on the mechanisms of cold plasma, the factors influencing its antimicrobial efficacy, and its applications across healthcare, food safety, and environmental protection. In addition, it highlights the synergistic potential of cold plasma when combined with antibiotics, nanomaterials, or bacteriophages to enhance effectiveness against resistant pathogens. While challenges remain regarding safety validation, standardization, and large-scale application, cold plasma represents a promising non-traditional approach to complement existing therapies. This review not only summarizes recent progress but also outlines future directions, emphasizing its potential role in combating antibiotic resistance.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Healthcare-Associated Infections and Antimicrobial Resistance in a Romanian Cardiovascular and Transplant Center: Factors Associated with Mortality.","authors":"Mihaela-Alexandra Budianu, Cristina Nicoleta Ciurea, Liviu Moraru, Septimiu Voidăzan","doi":"10.3390/antibiotics14090926","DOIUrl":"10.3390/antibiotics14090926","url":null,"abstract":"<p><strong>Background/objectives: </strong>Healthcare-associated infections (HAIs) are a major burden in tertiary hospitals, particularly in high-risk populations such as cardiovascular and transplant patients. The emergence of antimicrobial resistance (AMR) further complicates management, contributes to poor outcomes and increases costs. This study aimed to describe the burden of HAIs, the antimicrobial resistance patterns of the main pathogens, and to identify predictors of mortality among patients hospitalized in a Romanian cardiovascular and transplant center.</p><p><strong>Methods: </strong>We conducted a retrospective study including all patients with HAIs reported to the Infection Prevention and Control Service of the Emergency Institute for Cardiovascular Diseases and Transplantation, Târgu Mureș, Romania, between 2023 and the first quarter of 2025. Descriptive statistics summarized demographic and clinical data. Univariable and multivariable logistic regression were used to assess risk factors for mortality. Antimicrobial resistance was evaluated through cumulative antibiograms.</p><p><strong>Results: </strong>A total of 139 HAIs were reported during the study period, with a prevalence of 1.05% in 2023 and 1.0% in 2024. The most common pathogens were SARS-CoV-2 (15%), <i>Klebsiella pneumoniae</i> (14%), and <i>Acinetobacter baumannii</i> (13%). Overall, all-cause in-hospital mortality was 32%, with 30% of deaths associated with <i>A. baumannii</i> and 27% with <i>K. pneumoniae</i>. More than half of bacterial isolates were resistant to multiple antibiotic classes; 22% were extensively drug-resistant. ICU admission and treatment with more than three antibiotics were independently associated with mortality.</p><p><strong>Conclusions: </strong>Although the prevalence of HAIs in our study was low, the cases that occurred in cardiovascular and transplant patients were often severe, frequently involved multidrug-resistant organisms, and were associated with high mortality. Strengthening infection prevention and antimicrobial stewardship is essential to reduce the impact of HAIs in this vulnerable population.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}