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Antibiotics
Special Issues
Healthcare-Associated Infections (HAIs): Prevention, Control and Surveillance
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Healthcare-Associated Infections (HAIs): Prevention, Control and Surveillance

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 6265

Special Issue Editor

Dr. Maria Bagattini

E-Mail Website
Guest Editor
Department of Public Health, School of Medicine, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
Interests: healthcare associated infections (HAIs); molecular epidemiology of healthcare-associated infections; epidemiology of antimicrobial resistance; disinfectant tolerance; carbapenem resistant (CR) Acinetobacter baumannii; third generation cephalosporins and carbapenem resistant Enterobacterales
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Healthcare-associated infections (HAIs) are infections acquired while patients receive treatment for medical or surgical conditions. The widespread misuse of antibiotics has led to the emergence of multidrug-resistant bacteria, which are responsible for most HAIs. HAIs are associated with increased morbidity and mortality, prolonged hospital stays, and greater healthcare costs. Surveillance of HAIs is important to measure their burden, identify high-risk populations and procedures, and guide efforts to reduce HAI incidence. HAI surveillance is a core component of infection prevention and control (IPC) programmes worldwide. IPC is a practical, evidence-based approach preventing patients and health workers from being harmed by avoidable infections. IPC involves all aspects of healthcare, including antimicrobial resistance. The frequency of HAIs varies between countries and according to economic conditions. The risk of acquiring an HAI is up to 20 times higher in low-/middle-income countries (LMICs). Interestingly, in a global survey, the prevalence of resistance to antibiotics, including for carbapenems against Enterobacterales, Acinetobacter spp., and Pseudomonas spp., was significantly higher in LMICs. Effective IPC requires constant action at all levels of the health system, particularly in LMICs, from policymakers, facility managers, health workers and those who access health services.

For this Special Issue we invite you to submit a manuscript related to all aspects concerning HAI detection, control and management.

Dr. Maria Bagattini
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • healthcare-associated infections (HAIs)
  • infection prevention and control
  • antimicrobial resistance
  • HAIs management and control
  • carbapenem resistant (CR) Enterobacterales
  • carbapenem resistant (CR) Acinetobacter baumannii

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Published Papers (4 papers)

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Research

11 pages, 244 KiB  
Article
Risk Factors for Clostridium difficile Infection in Inpatients: A Four-Year (2017–2020) Retrospective Study
by Chu-Hsuan Hsia, Hsiu-Yueh Su and Yi-Wen Chien
Antibiotics 2025, 14(2), 133; https://doi.org/10.3390/antibiotics14020133 - 29 Jan 2025
Viewed by 632
Abstract
Background: Clostridium difficile infection (CDI) impact on healthcare systems is concerning due to high treatment cost and increased hospitalization time. We found that the incidence rate of CDI increased annually at Taipei Medical University Hospital (TMUH). The study aimed to establish monitoring indicators [...] Read more.
Background: Clostridium difficile infection (CDI) impact on healthcare systems is concerning due to high treatment cost and increased hospitalization time. We found that the incidence rate of CDI increased annually at Taipei Medical University Hospital (TMUH). The study aimed to establish monitoring indicators for hospitalized patients receiving antibiotics to prevent CDI occurrences. Methods: A case–control study was conducted to identify the risk factors of CDI among patients who were admitted to TMUH and tested for C. difficile. Patient demographics, patient history, and laboratory data were collected and analyzed. Results: Nutrition Risk Screening 2002 score (NRS 2002) in CDI patients was significantly lower than in non-CDI patients (3.1 ± 1.7 vs. 3.5 ± 1.6). The percentage of tube feeding in CDI patients was significantly lower than in non-CDI patients (23.0% vs. 36.7%), whereas parenteral nutrition was higher (8.8% vs. 3.8%). Age (OR = 1.03, p = 0.00), NRS 2002 score (OR =0.86, p = 0.05), comorbidity with cardiovascular disease (OR = 1.73, p = 0.03) or pulmonary disease (OR = 3.72, p = 0.00), patients with tube feeding (OR = 2.02, p = 0.01), and the number of medications (OR = 1.15, p < 0.01) were significant predictors of CDI. Conclusion: This study revealed that nutritional factors, including NRS 2002 scores and feeding routes, were associated with CDI, emphasizing the importance of nutritional factors as key predictors in managing and preventing CDI. Full article
(This article belongs to the Special Issue Healthcare-Associated Infections (HAIs): Prevention, Control and Surveillance)
12 pages, 578 KiB  
Article
Vascular Access Device Infections: Current Management Practices and the Role of Multidisciplinary Teams at a Large Hospital in Northern Italy
by Marta Colaneri, Lucia Galli, Martina Offer, Fabio Borgonovo, Giovanni Scaglione, Camilla Genovese, Rebecca Fattore, Monica Schiavini, Giovanni De Capitani, Maria Calloni, Arianna Bartoli, Antonio Gidaro, Chiara Cogliati, Spinello Antinori, Andrea Gori and Antonella Foschi
Antibiotics 2025, 14(1), 27; https://doi.org/10.3390/antibiotics14010027 - 3 Jan 2025
Viewed by 678
Abstract
Introduction: Vascular access device (VAD)-associated infections, including catheter-related (CRBSI) and catheter-associated bloodstream infections (CABSI), present significant challenges in patient care. While multidisciplinary VAD teams (VATs) are equipped with protocols for managing these infections, adherence to these guidelines in real-life practice is inconsistent. [...] Read more.
Introduction: Vascular access device (VAD)-associated infections, including catheter-related (CRBSI) and catheter-associated bloodstream infections (CABSI), present significant challenges in patient care. While multidisciplinary VAD teams (VATs) are equipped with protocols for managing these infections, adherence to these guidelines in real-life practice is inconsistent. This study aims to evaluate the alignment between actual VAD infection management practices and VAT-recommended protocols. Methods: We conducted a retrospective, single-center study at Luigi Sacco Hospital (May 2021–October 2023) involving non-ICU adult patients with diagnosed CRBSI or CABSI. VAT experts independently reviewed infection management choices, which were divided into eight specific procedural options. These options included variations in VAD removal, timing of repositioning, and combinations of antimicrobial lock therapy and systemic therapy. Concordance between real-life practices and VAT recommendations was evaluated using Cohen’s kappa coefficient. Results: Of 2419 VAD placements, 146 (6%) developed infections (84 CABSI, 62 CRBSI). Clinicians removed VADs in 66.4% of cases compared to 62.3% per VAT recommendations, with moderate overall agreement (Cohen’s kappa = 0.58). Analysis of the eight management categories revealed moderate to low alignment (unweighted kappa = 0.44, weighted kappa = 0.30) between real-life practices and VAT guidance, with slightly improved concordance in CRBSI cases. Conclusions: Our findings underscore a discrepancy between real-life VAD infection management and VAT-recommended protocols, suggesting a need for clearer, more accessible guidelines and increased multidisciplinary collaboration. Enhanced VAT consultation and simplified protocol dissemination may improve consistency in infection management and ultimately lead to better patient outcomes. Full article
(This article belongs to the Special Issue Healthcare-Associated Infections (HAIs): Prevention, Control and Surveillance)
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15 pages, 1226 KiB  
Article
Incidence and Predictors of Healthcare-Associated Infections in Patients Admitted to a Temporary Intensive Care Unit during the COVID-19 Pandemic Waves: A Two-Year (2021–2023) Retrospective Cohort Study in Rome, Italy
by Antonio Sciurti, Valentina Baccolini, Mariateresa Ceparano, Claudia Isonne, Giuseppe Migliara, Jessica Iera, Francesco Alessandri, Giancarlo Ceccarelli, Carolina Marzuillo, Guglielmo Tellan, Maria De Giusti, Francesco Pugliese, Paolo Villari and the Collaborating Group
Antibiotics 2024, 13(9), 842; https://doi.org/10.3390/antibiotics13090842 - 4 Sep 2024
Viewed by 1807
Abstract
To manage the number of critical COVID-19 patients, Umberto I Teaching Hospital in Rome established a temporary ICU on March 1, 2021. This study investigated the incidence and risk factors of healthcare-associated infections (HAIs) among these patients during various COVID-19 waves. Patients were [...] Read more.
To manage the number of critical COVID-19 patients, Umberto I Teaching Hospital in Rome established a temporary ICU on March 1, 2021. This study investigated the incidence and risk factors of healthcare-associated infections (HAIs) among these patients during various COVID-19 waves. Patients were grouped by admission date according to the dominant SARS-CoV-2 variant prevalent at the time (Alpha, Delta, Omicron BA.1, Omicron BA.2, Omicron BA.5, and Omicron XBB). First-HAI and mortality rates were calculated per 1000 patient-days. Predictors of first-HAI occurrence were investigated using a multivariable Fine–Gray regression model considering death as a competing event. Among 355 admitted patients, 27.3% experienced at least one HAI, and 49.6% died. Patient characteristics varied over time, with older and more complex cases in the later phases, while HAI and mortality rates were higher in the first year. Pathogens responsible for HAIs varied over time, with first Acinetobacter baumannii and then Klebsiella pneumoniae being progressively predominant. Multivariable analysis confirmed that, compared to Alpha, admission during the Omicron BA.1, BA.2, BA.5, and XBB periods was associated with lower hazards of HAI. Despite worsening COVID-19 patient conditions, late-phase HAI rates decreased, likely due to evolving pathogen characteristics, improved immunity, but also better clinical management, and adherence to infection prevention practices. Enhanced HAI prevention in emergency situations is crucial. Full article
(This article belongs to the Special Issue Healthcare-Associated Infections (HAIs): Prevention, Control and Surveillance)
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12 pages, 900 KiB  
Article
Sequential or Combination Treatments as Rescue Therapies in Immunocompromised Patients with Persistent SARS-CoV-2 Infection in the Omicron Era: A Case Series
by Bianca Maria Longo, Francesco Venuti, Alberto Gaviraghi, Tommaso Lupia, Fabio Antonino Ranzani, Andrea Pepe, Laura Ponzetta, Davide Vita, Tiziano Allice, Vanesa Gregorc, Pio Manlio Mirko Frascione, Francesco Giuseppe De Rosa, Andrea Calcagno and Stefano Bonora
Antibiotics 2023, 12(9), 1460; https://doi.org/10.3390/antibiotics12091460 - 19 Sep 2023
Cited by 7 | Viewed by 2220
Abstract
Prolonged SARS-CoV-2 infections are widely described in immunosuppressed patients, but safe and effective treatment strategies are lacking. We aimed to outline our approach to treating persistent COVID-19 in patients with immunosuppression from different causes. In this case series, we retrospectively enrolled all immunosuppressed [...] Read more.
Prolonged SARS-CoV-2 infections are widely described in immunosuppressed patients, but safe and effective treatment strategies are lacking. We aimed to outline our approach to treating persistent COVID-19 in patients with immunosuppression from different causes. In this case series, we retrospectively enrolled all immunosuppressed patients with persistent SARS-CoV-2 infections treated at our centers between March 2022 and February 2023. Patients received different sequential or combination regimens, including antivirals (remdesivir, nirmatrelvir/ritonavir, or molnupiravir) and/or monoclonal antibodies (mAbs) (tixagevimab/cilgavimab or sotrovimab). The main outcome was a complete virological response (negative SARS-CoV-2 RT-PCR on nasopharyngeal swabs) at the end of treatment. Fifteen patients were included as follows: eleven (11/15; 73%) with hematological disease and four (4/15; 27%) with recently diagnosed HIV/AIDS infection. Six patients (6/15; 40%) received a single antiviral course, four patients (4/15; 27%) received an antiviral and mAbs sequentially, and two patients (13%) received three lines of treatment (a sequence of three antivirals or two antivirals and mAbs). A combination of two antivirals or one antiviral plus mAbs was administered in three cases (3/15, 20%). One patient died while still positive for SARS-CoV-2, while fourteen (14/15; 93%) tested negative within 16 days after the end of treatment. The median time to negativization since the last treatment was 2.5 days. Both sequential and combination regimens used in this study demonstrated high efficacy and safety in the high-risk group of immunosuppressed patients. Full article
(This article belongs to the Special Issue Healthcare-Associated Infections (HAIs): Prevention, Control and Surveillance)
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