Drug-Resistant Bacterial and Fungal Infections in Immunocompromised Patients

Immunocompromised patients, including those with cancer, organ transplants, autoimmune diseases, and critical illnesses, are highly vulnerable to infections caused by bacteria and fungi. Due to impaired immune defenses, these patients often require frequent, prolonged, or prophylactic use of antibiotics and antifungal agents in hospital settings. While these treatments are essential for survival, their extensive use has significantly contributed to the emergence and spread of antimicrobial resistance (AMR), particularly multidrug-resistant (MDR) pathogens.

Hospitals worldwide are increasingly reporting resistant bacterial infections caused by organisms such as carbapenem-resistant Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus. In parallel, antifungal resistance has emerged as a major clinical challenge, with resistant species such as Candida auris, azole-resistant Candida, and drug-resistant molds posing serious threats to immunocompromised populations. These infections are associated with high morbidity, mortality, prolonged hospital stays, and limited therapeutic options.

Antimicrobial consumption patterns, including empirical therapy, prophylaxis, and inappropriate or prolonged treatment, play a critical role in shaping resistance trends in hospitals. Antimicrobial stewardship programs (ASPs) are therefore essential to balance effective infection management with resistance prevention. Recent advances in molecular diagnostics, rapid pathogen identification, resistance gene detection, and precision or personalized medicine offer new opportunities to optimize antimicrobial therapy in high-risk patients. These approaches can support early targeted treatment, reduce unnecessary broad-spectrum antimicrobial exposure, and improve clinical outcomes in immunocompromised hosts.

This Research Topic aims to explore the burden, drivers, and clinical impact of drug-resistant bacterial and fungal infections in immunocompromised patients, with a particular focus on hospital antimicrobial consumption and stewardship practices. The objective is to provide evidence-based insights that support rational antimicrobial use while ensuring optimal patient outcomes in high-risk clinical settings.
We welcome multidisciplinary contributions that address microbiological, clinical, epidemiological, and stewardship-related aspects of AMR in immunocompromised hosts.

The sub-themes include, but are not limited to:

• Epidemiology and trends of drug-resistant bacterial and fungal infections in immunocompromised patients
• Antimicrobial and antifungal resistance mechanisms in hospital settings
• Patterns of antimicrobial consumption (e.g., defined daily dose (DDD) and days of therapy (DOT)) and their relationship with resistance
• Antimicrobial and antifungal stewardship strategies in oncology, transplant, ICU, and hematology units
• Molecular diagnostics, rapid resistance detection, and precision or personalized antimicrobial therapy in immunocompromised patients
• Diagnostic-guided therapy and infection prevention measures
• Clinical outcomes, mortality, and healthcare burden associated with MDR infections

By integrating clinical practice, antimicrobial use data, and stewardship interventions, this Research Topic aims to advance strategies that reduce resistance, optimize therapy, and improve the quality of care for immunocompromised patients in hospital environments.
In this Research Topic we welcome the following article types: FAIR² DATA Direct Submission, FAIR² Data, Hypothesis and Theory, Methods, Mini Review, Opinion, Original Research, Perspective, Review, Systematic Review, Technology and Code.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Conceptual Analysis
• Curriculum, Instruction, and Pedagogy
• Data Report
• Editorial
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Conceptual Analysis
• Curriculum, Instruction, and Pedagogy
• Data Report
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Policy and Practice Reviews
• Policy Brief
• Review
• Specialty Grand Challenge
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: Antimicrobial resistance, multidrug-resistant pathogens, immunocompromised patients, antifungal resistance, antimicrobial consumption, hospital stewardship, molecular diagnostics, precision medicine

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.