In the agro-industrial complex (AIC), a group of relatively rare antimicrobial drugs is used in addition to medically critical antibiotics; they are not considered to have a significant impact on the problem of antibiotic resistance among pathogenic microorganisms. As is the case with growth stimulants and fungicides, certain types of antiparasitic antibiotics and insecticides, as well as food additives and preservatives, are recommended for use in the agricultural sector. These drugs differ from those used in medicine in terms of their mechanisms of action. They can act as inhibitors of the functions of cell membranes, growth factors, synthesis of the cell wall of bacteria and fungi, synthesis of nucleic acids, as well as disrupt cellular balance. The review notes that although the compounds under consideration do not pose an immediate threat to the development of antibiotic resistance of pathogenic microorganisms, the drugs based on these compounds can still affect the increase in the level of resistance of other microorganisms circulating in the environment.
Antibiotic resistance represents one of the pressing challenges of contemporary clinical practice, as it contributes to increased mortality, prolonged hospitalization, and a growing economic burden on healthcare systems. This problem is of particular significance in infections caused by ESKAPE pathogens, carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii , and Pseudomonas aeruginosa , for which the timely selection of rational antibacterial therapy directly affects prognosis. The aim of the present review is to synthesize current evidence on the value of rapid methods for pathogen identification and antibiotic resistance mechanism detection in optimizing antibiotic therapy. The literature search was conducted in PubMed/MEDLINE, eLibrary, CyberLeninka, Google Scholar, Springer Link, and ScienceDirect; a total of 70 publications were included in the analysis. The capabilities of multiplex PCR panels, MALDI-TOF MS, rapid phenotypic antimicrobial susceptibility testing methods, metagenomic sequencing, and ancillary biomarkers are examined. It has been demonstrated that rapid diagnostics can shorten the time to appropriate therapy, accelerate escalation upon detection of resistant strains, facilitate de-escalation, and reduce unnecessary antibiotic use. The most pronounced clinical effect is achieved when rapid diagnostic tests are integrated into antimicrobial stewardship programs involving microbiologists, clinical pharmacologists, and infectious disease specialists. At the same time, data on the impact of rapid diagnostics on mortality rates, length of hospital stay, and economic costs remain heterogeneous, which is attributable to local epidemiological indicators, the availability of technologies, the organization of laboratory workflows, and the quality of clinical interpretation of results.
Background . Antimicrobial resistance (AMR) has high medical and social significance, as it is shaped by clinical, veterinary, agricultural, and environmental processes, as well as horizontal transfer of mobile genetic elements. Its analysis requires the assessment of individual resistance genes, experimental models, diagnostic approaches, as well as surveillance systems that track antibiotic resistance genes (ARGs) across human, animal, and environmental reservoirs. The aim of the study was to summarize data on experimental and computational models of ARG dissemination, characterize selected AMR markers, and evaluate current methods for their detection. Material and methods . A narrative review with a transparent search strategy and thematic synthesis was conducted. The search included PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar; the last search was performed on May 2, 2026. After full-text assessment, 46 sources were included in the review. Results. The review discusses blaCTX-M-15, blaNDM, blaKPC, blaOXA-23, floR and intI1 markers, as well as mobile genetic elements involved in their dissemination. It summarizes the strengths and limitations of in vitro models, gut models, mouse models, biofilm systems, mathematical modelling, AST, PCR/qPCR, WGS, mNGS, machine learning, and CRISPR-Cas12a diagnostics. Conclusion . CRISPR-Cas12a platforms may support rapid targeted screening of predefined ARGs but do not replace phenotypic susceptibility testing or genome-scale analysis. The most robust strategy is the integration of AST, WGS/mNGS, targeted molecular diagnostics, machine learning, and One Health surveillance.
Sepsis remains one of the leading causes of mortality in intensive care units, and its course is frequently complicated by sepsis-induced coagulopathy and disseminated intravascular coagulation, which substantially worsen the prognosis. The aim of this review was to systematize current concepts regarding the role of antibacterial therapy in the comprehensive management of patients with sepsis complicated by coagulopathy. Antibacterial therapy is regarded as an essential component of treatment directed at eliminating the infectious trigger of thromboinflammation. The most strongly supported requirement that remains is early infection control when there is a high probability of bacterial sepsis or septic shock, including adequate empiric therapy and source control. At the same time, the extent to which antibiotics specifically influence the dynamics of coagulopathy remains less well studied, as most studies do not stratify patients by coagulation status or source of infection. The review discusses the diagnostic role of biomarkers — namely, procalcitonin, presepsin, C-reactive protein, extracellular free DNA, complement markers, antithrombin activity, and fibrinogen. Evidence indicates that these may assist in assessing infectious burden, the risk of disseminated intravascular coagulation, and prognosis; however, none should be used as an autonomous criterion for initiating or discontinuing antibiotics and anticoagulants. The organ-specific nature of sepsis-associated disseminated intravascular coagulation further demonstrates that the source of infection influences prognosis, the feasibility of source control, baseline antithrombin activity, and the potential applicability of anticoagulant interventions. A clinical framework is proposed, founded on early adequate antibacterial therapy, concurrent assessment of coagulation status, active source control, individualized antibiotic dosing in the presence of organ dysfunction and extracorporeal support, and the consideration of anticoagulant therapy only after evaluation of the coagulation phenotype, source of infection, and bleeding risk. The need for prospective studies stratified by coagulation status and source of infection is emphasized in order to refine optimal therapeutic strategies.
The problem of comorbid infections remains the focus of modern rheumatology. The second part of this review presents currently effective data on the frequency and localization of major infections in rheumatological patients treated with antiB-cell drugs. The analyzed publications highlight numerous potential infection risks associated with anti-B-cell therapy, primarily with rituximab. Long-term randomized controlled clinical trials are needed to identify strategies for monitoring and personalized infection risk management for patients receiving treatment with these drugs.
