The Emergence of Multidrug Resistance: Genetic Mechanisms, Fitness Cost, and Dissemination in the Human-Environment Continuum

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Mechanism and Evolution of Antibiotic Resistance".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 2324

Special Issue Editors


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Guest Editor
1. Cornell Atkinson Center for Sustainability, Cornell University, Ithaca, NY 14853, USA
2. Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
Interests: medical microbiologist and molecular epidemiologist focused on infectious diseases and antimicrobial resistance, evidence-based medicine, and one Health interventions
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Guest Editor
Center for Food Safety, Department of Food Science and Technology, University of Georgia, Griffin, GA 30223, USA
Interests: antimicrobial resistance; antibiotic resistance genes; bacterial fitness; bacterial adaptations; virulence; foodborne bacterial pathogens; infectious disease; One Health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The misuse and over-reliance on antimicrobial drugs have driven the emergence and dissemination of multidrug-resistant (MDR) microorganisms. Although surveillance is an essential tool to assess the spread of MDR pathogens and the robustness of stewardship programs, there is a notable lack of data on antimicrobial use and AMR in many countries across the globe due to many factors, including high cost and specialized infrastructure. However, novel, rapid, and cost-effective methods have revolutionized AMR surveillance and epidemiology, allowing the use of whole genome and metagenomic sequencing at a broad scale across the globe. These technologies have the potential to greatly enhance AMR analysis and tracking at both the local and international levels. Gene/ genome sequencing is a useful epidemiological tool that allows the study of AMR gene transmission and links phenotypic susceptibility patterns to genetic determinants. To address the global challenge of AMR, genomic studies are critical to defining the factors and mechanisms that can mitigate the spread or resistance. These studies are valuable resources for guiding stakeholders, from policymakers to infection prevention specialists.

This Special Issue focuses on expanding genomic data on the global AMR threat and on filling knowledge gaps in our understanding of the transmission dynamics of AMR genes and mobile genetic elements. We cordially invite researchers working in these areas to contribute Original Research, Case Reports, and General and Systematic Reviews. Reports focused on low- and middle-income countries (LMICs) and disenfranchised populations/ settings are particularly welcomed.

Dr. Marwan Osman
Dr. Issmat Kassem
Guest Editors

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Keywords

  • antimicrobial resistance
  • molecular epidemiology
  • genome analysis
  • gene sequencing
  • next generation sequencing
  • nucleotide polymorphism sequence
  • mobile genetic elements
  • plasmids
  • resistance mechanisms

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Published Papers (1 paper)

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Research

14 pages, 595 KiB  
Article
Antifungal Use and Resistance in a Lower–Middle-Income Country: The Case of Lebanon
by Nesrine Hassoun, Issmat I. Kassem, Monzer Hamze, Jad El Tom, Nicolas Papon and Marwan Osman
Antibiotics 2023, 12(9), 1413; https://doi.org/10.3390/antibiotics12091413 - 6 Sep 2023
Cited by 2 | Viewed by 1839
Abstract
Antimicrobial resistance is a serious threat, particularly in low- and middle-income countries (LMICs). Antifungal resistance is often underestimated in both healthcare and non-clinical settings. In LMICs, it is believed that the inappropriate use of antifungals, limited surveillance systems, and low diagnostic capacities are [...] Read more.
Antimicrobial resistance is a serious threat, particularly in low- and middle-income countries (LMICs). Antifungal resistance is often underestimated in both healthcare and non-clinical settings. In LMICs, it is believed that the inappropriate use of antifungals, limited surveillance systems, and low diagnostic capacities are significant drivers of resistance. Like other LMICs, Lebanon lacks antifungal use and resistance surveillance programs, and the impact of antifungal resistance in the country remains unclear, especially during the unfolding economic crisis that has severely affected medical care and access to safe food and water. Interestingly, the widespread use of antifungals in medicine and agriculture has raised concerns about the development of antifungal resistance in Lebanon. In this light, we aimed to survey available antifungal drugs in the country and evaluate susceptibility patterns of prevalent fungal species to guide empiric treatments and develop antifungal stewardship programs in Lebanon. We noted that the economic crisis resulted in significant increases in antifungal drug prices. Additionally, a comprehensive literature search across PubMed, ScienceDirect, and Google Scholar databases identified 15 studies on fungal infections and antifungal resistance conducted from 1998 to 2023 in Lebanon. While data on antifungal resistance are limited, 87% of available studies in Lebanon focused on candidiasis, while the remaining 13% were on aspergillosis. Overall, we observed a marked antimicrobial resistance among Candida and Aspergillus species. Additionally, incidences of Candida auris infections have increased in Lebanese hospitals during the COVID-19 pandemic, with a uniform resistance to fluconazole and amphotericin-B. Taken together, a One Health approach, reliable diagnostics, and prudent antifungal use are required to control the spread of resistant fungal pathogens in healthcare and agricultural settings. Full article
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