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This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact

Science: general issues --- Medical microbiology & virology --- Microbiology (non-medical) --- antimicrobial resistance --- CRISPR-Cas --- oxazolidinone-resistant Enterococcus faecalis --- carbapenem-resistant A. baumannii --- colistin-resistant E. coli --- antibiotic-resistant non-typhoidal Salmonella --- MRSA --- VRE --- antimicrobial resistance --- CRISPR-Cas --- oxazolidinone-resistant Enterococcus faecalis --- carbapenem-resistant A. baumannii --- colistin-resistant E. coli --- antibiotic-resistant non-typhoidal Salmonella --- MRSA --- VRE

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Bacterial resistance to known and currently used antibiotics represents a growing issue worldwide. It poses a major problem in the treatment of infectious diseases in general and hospital-acquired infections in particular. This is in part due to the overuse and misuse of antibiotics in past decades, which led to the selection of highly resistant bacteria and even so-called superbugs – multidrug-resistant (MDR) bacteria. Nosocomial infections, particularly, are often caused by MDR bacterial pathogens and the treatment of such infections is very complicated and extensive, often leading to various side effects, including adverse effects on the natural human microbiome. At the same time, the development of novel antibiotics is lagging with very few new ones in the pipeline. Finding viable alternatives to treat such infections may help to overcome these therapeutic issues. This publication brings novel developments in the field of bacterial resistance, mainly in the hospital settings, adequate antibiotic therapy, and identification of compounds useful to battle this growing issue.

Medicine --- Epidemiology & medical statistics --- VRE --- GIT --- hemato-oncological patients --- clonality --- antibiotic stewardship --- resistance --- consumption of antibiotics --- clonal spread --- Enterococcus faecium --- Enterococcus faecalis --- linezolid resistance --- 23S rRNA --- optrA --- carbapenem-resistant Klebsiella pneumoniae --- carbapenem-resistant Acinetobacter baumannii --- N-acetylcysteine --- septic shock --- critically ill patients --- newborn --- infection --- bacteria --- antibiotic therapy --- hops --- C. difficile --- rat model --- Staphylococcus aureus --- MRSA --- spa typing --- MLST --- SCCmec typing --- clonal analysis --- epidemiology --- cancer patients --- duration of treatment --- colistin --- propensity score analysis --- multidrug-resistant Acinetobacter baumannii --- urinary tract infections --- UTIs --- MDR --- Escherichia coli --- Klebsiella --- uropathogens --- AMR --- antibiotic resistance --- ESBL-producing Klebsiella pneumoniae --- urinary tract infection --- clinical impact --- economic impact --- ventilator-associated pneumonia --- Klebsiella spp. --- Escherichia spp. --- pulsed-field gel electrophoresis (PFGE) --- endogenous infection --- methicillin-resistant --- porcine model --- methicillin-resistant Staphylococcus aureus (MRSA) --- long term care facilities (LTCF) --- multidrug resistance (MDR) --- enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) --- ESBL --- PCR --- primer --- antimicrobial resistance --- infection prevention and control --- antimicrobial stewardship --- hospital --- cluster analysis --- principal component analysis

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There has been much speculation about a possible antibiotic Armageddon; this would be the result of having untreatable post-operative infections, and similarly untreatable complications after chemotherapy. The now famous “O’Neill Report” (https://amr-review.org/) suggests that more people could die from resistant bacterial infections by 2050 than from cancer. We are still learning about all the subtle drivers of antibiotic resistance, and realizing that we need a single “whole of health” co-ordinated policy. We ingest what we sometimes feed to animals. There do not seem to be any new classes of antibiotics on our horizon. Perhaps something that has been around “forever” will come to our rescue—bacteriophages! Nevertheless, we have to do things differently, use antibiotics appropriately, for the correct indication, for the correct duration and with the correct dose, and with that, practice good antibiotic stewardship. Whilst by no means comprehensive, this book does cover some of the many topics of antibiotic stewardship. It also addresses some of the older antibiotics, some new combinations, and even some new agents. Last, and by no means least, there are two excellent articles on bacteriophages.

Antimicrobial resistance --- antibiotics --- antimicrobial stewardship --- inappropriate prescribing --- days of therapy --- Start Smart then Focus --- piperine --- piperlongumine --- antibacterial --- antifungal --- synergy --- non-target feed --- florfenicol --- thiamfenicol --- chloramfenicol --- HPLC–MS/MS --- validation --- swine --- out-of-hours care --- primary care --- quality of care --- quality indicators --- practitioners cooperative --- antibiotic stewardship --- fluoroquinolones --- guidelines --- urinary tract infections --- quality improvement --- general practitioners --- guideline --- health inequalities --- health equity assessment tool --- public health --- Enterobacteriaceae --- carbapenem-resistant --- CRE --- antibiotic resistance --- antimicrobials --- bacteriophages --- biofilms --- novel antimicrobials --- Antibiotics --- resistance --- broad-spectrum agents --- hospital epidemiology --- antibiotic utilization --- infection control --- infection prevention --- Pseudomonas aeruginosa --- Acinetobacter baumannii --- extended-spectrum beta-lactamases --- carbapenem-resistant Enterobacteriaceae --- methicillin-resistant Staphylococcus aureus --- clinical trials --- infectious disease --- phage therapy --- silver complexes --- camphorimine --- anti-Candida activity --- antifungals --- antibacterials --- efflux inhibitors --- efflux pumps --- erm(41) --- mutations --- mycobacteria --- verapamil --- actinomycetes --- bioactivity --- polyketides --- polyketide synthases --- biosynthesis --- antimicrobial resistance --- economic evaluation --- cost-utility analysis --- cost-effectiveness analysis --- policy analysis --- One Health --- Singapore --- antibiotic prescribing --- implementation --- behavior change --- stakeholder consultation --- n/a --- HPLC-MS/MS

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There has been much speculation about a possible antibiotic Armageddon; this would be the result of having untreatable post-operative infections, and similarly untreatable complications after chemotherapy. The now famous “O’Neill Report” (https://amr-review.org/) suggests that more people could die from resistant bacterial infections by 2050 than from cancer. We are still learning about all the subtle drivers of antibiotic resistance, and realizing that we need a single “whole of health” co-ordinated policy. We ingest what we sometimes feed to animals. There do not seem to be any new classes of antibiotics on our horizon. Perhaps something that has been around “forever” will come to our rescue—bacteriophages! Nevertheless, we have to do things differently, use antibiotics appropriately, for the correct indication, for the correct duration and with the correct dose, and with that, practice good antibiotic stewardship. Whilst by no means comprehensive, this book does cover some of the many topics of antibiotic stewardship. It also addresses some of the older antibiotics, some new combinations, and even some new agents. Last, and by no means least, there are two excellent articles on bacteriophages.

Medicine --- Antimicrobial resistance --- antibiotics --- antimicrobial stewardship --- inappropriate prescribing --- days of therapy --- Start Smart then Focus --- piperine --- piperlongumine --- antibacterial --- antifungal --- synergy --- non-target feed --- florfenicol --- thiamfenicol --- chloramfenicol --- HPLC-MS/MS --- validation --- swine --- out-of-hours care --- primary care --- quality of care --- quality indicators --- practitioners cooperative --- antibiotic stewardship --- fluoroquinolones --- guidelines --- urinary tract infections --- quality improvement --- general practitioners --- guideline --- health inequalities --- health equity assessment tool --- public health --- Enterobacteriaceae --- carbapenem-resistant --- CRE --- antibiotic resistance --- antimicrobials --- bacteriophages --- biofilms --- novel antimicrobials --- Antibiotics --- resistance --- broad-spectrum agents --- hospital epidemiology --- antibiotic utilization --- infection control --- infection prevention --- Pseudomonas aeruginosa --- Acinetobacter baumannii --- extended-spectrum beta-lactamases --- carbapenem-resistant Enterobacteriaceae --- methicillin-resistant Staphylococcus aureus --- clinical trials --- infectious disease --- phage therapy --- silver complexes --- camphorimine --- anti-Candida activity --- antifungals --- antibacterials --- efflux inhibitors --- efflux pumps --- erm(41) --- mutations --- mycobacteria --- verapamil --- actinomycetes --- bioactivity --- polyketides --- polyketide synthases --- biosynthesis --- antimicrobial resistance --- economic evaluation --- cost-utility analysis --- cost-effectiveness analysis --- policy analysis --- One Health --- Singapore --- antibiotic prescribing --- implementation --- behavior change --- stakeholder consultation --- Antimicrobial resistance --- antibiotics --- antimicrobial stewardship --- inappropriate prescribing --- days of therapy --- Start Smart then Focus --- piperine --- piperlongumine --- antibacterial --- antifungal --- synergy --- non-target feed --- florfenicol --- thiamfenicol --- chloramfenicol --- HPLC-MS/MS --- validation --- swine --- out-of-hours care --- primary care --- quality of care --- quality indicators --- practitioners cooperative --- antibiotic stewardship --- fluoroquinolones --- guidelines --- urinary tract infections --- quality improvement --- general practitioners --- guideline --- health inequalities --- health equity assessment tool --- public health --- Enterobacteriaceae --- carbapenem-resistant --- CRE --- antibiotic resistance --- antimicrobials --- bacteriophages --- biofilms --- novel antimicrobials --- Antibiotics --- resistance --- broad-spectrum agents --- hospital epidemiology --- antibiotic utilization --- infection control --- infection prevention --- Pseudomonas aeruginosa --- Acinetobacter baumannii --- extended-spectrum beta-lactamases --- carbapenem-resistant Enterobacteriaceae --- methicillin-resistant Staphylococcus aureus --- clinical trials --- infectious disease --- phage therapy --- silver complexes --- camphorimine --- anti-Candida activity --- antifungals --- antibacterials --- efflux inhibitors --- efflux pumps --- erm(41) --- mutations --- mycobacteria --- verapamil --- actinomycetes --- bioactivity --- polyketides --- polyketide synthases --- biosynthesis --- antimicrobial resistance --- economic evaluation --- cost-utility analysis --- cost-effectiveness analysis --- policy analysis --- One Health --- Singapore --- antibiotic prescribing --- implementation --- behavior change --- stakeholder consultation

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Carbapenem-resistant Enterobacterales (CRE) are a common cause of infections in both community and healthcare settings and have become an increasing threat to public health worldwide. The focus of this Special Issue includes aspects concerning plasmid-mediated antimicrobial resistance along with other carbapenem resistance mechanisms. Understanding the prevalence and routes of transmission of CRE is important in developing specific interventions for healthcare facilities, as well as the general impact of CRE circulation on the environment. Attention has also been focused on carbapenemase testing in order to provide advanced phenotypic and molecular assays for the identification of CRE, as a valid tool for active global surveillance, and from this perspective, the study of resistance mechanisms can provide significant support for the development of new and appropriate antimicrobial molecules. For all of these reasons, the phenomenon of carbapenem resistance deserves more attention, for the sake of public health.

Research & information: general --- Biology, life sciences --- Microbiology (non-medical) --- carbapenem resistance --- carbapenemase --- whole genome sequencing --- long reads, plasmid --- Klebsiella pneumoniae --- extensively drug-resistant --- molecular typing --- carbapenemases --- Enterobacteriales --- human --- animal --- food --- environment --- carbapenemase-producing Enterobacterales --- KPC --- carbapenem --- multidrug resistance --- nosocomial --- Enterobacteriaceae --- ESBL --- resistance genes --- cattle --- blaOXA-48 --- ERIC-PCR --- plasmid profile analysis --- biofilm formation --- PCR-based replicon typing --- antibiotic-resistance --- sequence types --- multilocus sequence typing --- plasmids --- antimicrobial resistance --- carbapenem inactivation method --- carbapenem-resistant Enterobacterales --- real-time multiplex PCR --- whole-genome sequencing --- carbapenem-resistance --- Qatar --- CRE --- OXA-48 --- carbapenems resistance --- Gram-negative bacteria --- infection --- colonization --- COVID-19 --- K. pneumoniae --- porins --- ceftazidime/avibactam --- ESKAPE --- healthcare-associated infections --- antimicrobial peptides --- Temporin L --- Klebsiella michiganensis --- Citrobacter farmeri --- KPC-2 --- plasmid --- transposon --- carbapenem-resistant Enterobacteriaceae (CRE) --- outbreak --- infection control --- pulsed-field gel electrophoresis (PFGE) --- multilocus sequence typing (MLST) --- IMP-6 --- porin --- efflux pump --- nosocomial infections --- NDM-1 --- Fourier transform infrared spectroscopy --- Eazyplex® SuperBug CRE assay --- extended-spectrum beta-lactamases --- gram-negative rods --- LAMP method --- NDM --- VIM --- molecular epidemiology --- PFGE --- Carbapenemase producing Enterobacterales --- IncX-3 --- one health --- water --- colistin susceptibility testing --- broth microdilution --- colistin broth disc elution --- Vitek 2 compact --- rapid polymyxin NP test --- Etest --- ChromID colistin R agar --- micronaut MIC-strip colistin --- population analysis profiling --- Enterobacterales --- neonates --- plasmid-typing --- sequence type --- wastewater --- virulence