Expert Review of Anti-infective Therapy最新文献

{"title":"Novel options for the management of <i>C. difficile</i>: a look into the future.","authors":"Guido Granata, Nicola Petrosillo, Fabrizio Taglietti","doi":"10.1080/14787210.2026.2739273","DOIUrl":"10.1080/14787210.2026.2739273","url":null,"abstract":"<p><strong>Introduction: </strong><i>Clostridioides difficile</i> infection (CDI) remains one of the leading causes of healthcare-associated diarrhea; additionally, evidence suggests a growing incidence of community-acquired CDI worldwide. CDI is characterized by substantial morbidity, mortality, and risk of recurrence. CDI underdiagnosis and recurrent CDI represent a major unmet clinical need, highlighting the need for innovative diagnostic, preventive and therapeutic strategies.</p><p><strong>Areas covered: </strong>This perspective article summarizes emerging approaches that may shape the future management of CDI, including novel microbiome-sparing antimicrobials, fecal microbiota transplantation (FMT), live biotherapeutic products, <i>C. difficile</i> vaccines, bacteriophage-derived therapies, CRISPR-Cas technology and artificial intelligence (AI) applications.</p><p><strong>Expert opinion: </strong>Future CDI management is expected to evolve toward precision medicine focused on microbiome preservation, prevention of recurrence, and individualized patient care. Novel antimicrobials such as ibezapolstat and CRS3123, phage-derived approaches, and CRISPR-guided antimicrobials may provide highly targeted alternatives to conventional treatments. Microbiota-based therapies will evolve to assume an increasingly central role in reducing microbiota disruption. Simultaneously, advances in diagnostics, vaccine development, and AI-driven predictive tools may improve risk stratification, therapeutic selection, and infection prevention and control. All these innovative strategies have the potential to redefine CDI prevention and treatment, although robust clinical validation and long-term safety data remain essential.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":4.6,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in combination therapies for serious infections due to multidrug-resistant gram-negative bacilli.","authors":"Luca Mezzadri, Abi Manesh, Ya-Ting Chang, Kim Anh Nguyen, David L Paterson","doi":"10.1080/14787210.2026.2730311","DOIUrl":"10.1080/14787210.2026.2730311","url":null,"abstract":"<p><strong>Introduction: </strong>Serious infections caused by multidrug-resistant Gram-negative bacteria (MDR-GNB) remain a major global challenge, with high morbidity, mortality, and limited therapeutic options. Combination antibiotic therapy has long been proposed as a strategy to improve clinical outcomes, enhance bacterial killing, and prevent antimicrobial resistance, yet its clinical value across key pathogen groups remains uncertain.</p><p><strong>Areas covered: </strong>This review summarizes current evidence on combination therapy for major MDR-GNB, including third-generation cephalosporin-resistant Enterobacterales, carbapenem-resistant Enterobacterales, carbapenem-resistant <i>Pseudomonas aeruginosa</i>, carbapenem-resistant <i>Acinetobacter baumannii</i>, <i>Stenotrophomonas maltophilia</i>, and other non-fermenters. We examine both clinical and preclinical data, reviewing <i>in vitro</i> synergy studies (checkerboard assays, time-kill experiments, and E-tests), randomized controlled trials, major observational studies, and treatment recommendations from international guidelines.</p><p><strong>Expert opinion: </strong>Robust clinical evidence supporting combination therapy is limited. Synergy observed <i>in vitro</i> does not reliably translate into improved patient outcomes, and toxicity risks remain important. For most MDR-GNB infections, current data support targeted monotherapy with newer β-lactam/β-lactam-inhibitors agents when active. Combination therapy may retain a role in selected scenarios, including salvage treatment, infections due to metallo-β-lactamase producers, A. baumannii and S. maltophilia, or in settings with limited access to newer agents.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-17"},"PeriodicalIF":4.6,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel potential treatment options for infections caused by multi-drug and extensively drug-resistant <i>Neisseria gonorrhoeae</i> strains.","authors":"Susanne Jacobsson, Magnus Unemo","doi":"10.1080/14787210.2026.2733617","DOIUrl":"10.1080/14787210.2026.2733617","url":null,"abstract":"<p><strong>Introduction: </strong><i>Neisseria gonorrhoeae</i> has evolved antimicrobial resistance (AMR) since antimicrobial treatment of gonorrhea was introduced. The AMR development is driven by the bacterium's high capacity for genetic adaptation, antimicrobial overuse and misuse, and insufficient surveillance. Novel therapeutic options are urgently needed.</p><p><strong>Areas covered: </strong>This review summarizes novel gonorrhea treatment options, with special emphasis on the novel oral antimicrobials zoliflodacin and gepotidacin that obtained US FDA-approval for treatment of uncomplicated urogenital gonorrhea in December 2025. It also highlights compounds in early clinical or preclinical development that have demonstrated promising <i>in vitro</i> activity against <i>N. gonorrhoeae</i>.</p><p><strong>Expert opinion: </strong>Zoliflodacin and gepotidacin have the potential to optimize gonorrhea management as oral alternatives to current injectable ceftriaxone. Their successful long-term use will depend on optimized use strategies, including indications, evidence-based approved dosing, adherence, surveillance, and population-specific considerations. Public-health agencies and clinicians will need to balance broad clinical access with antimicrobial stewardship measures to delay the AMR emergence. Looking ahead, gonorrhea management will hopefully shift from empirical, syndromic treatment toward etiology-guided and AMR-informed therapy, driven by advances in rapid point-of-care testing and whole-genome sequencing technologies. Continuous phenotypic and genomic surveillance remains essential to detect early AMR signals, transmission of AMR strains, and inform treatment guidelines.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-19"},"PeriodicalIF":4.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten-year trends in sepsis-causing multidrug-resistant pathogens: a nationwide multicenter laboratory-based surveillance in Pakistan (2013-2022) and predictive forecasting of antimicrobial resistance (2030).","authors":"Muhammad Usman Qamar, Gohar Zaman, Muhammad Rizwan, Rizwan Uppal, Aatika, Rehan Uppal, Umar Saeed, Aftab Ahmad Khan, Zuhaib Ali, Azhar Rasheed, Imran Ali Khan, Zikria Saleem, Hamid Iqbal","doi":"10.1080/14787210.2026.2734514","DOIUrl":"10.1080/14787210.2026.2734514","url":null,"abstract":"<p><strong>Objectives: </strong>To characterise the epidemiology of bloodstream pathogens causing sepsis in Pakistan over a 10-year period.</p><p><strong>Methods: </strong>We conducted a retrospective, multicenter laboratory-based surveillance study of blood cultures processed in Pakistan. A total of 45,216 blood culture specimens were analyzed. Clinically significant bloodstream isolates were identified using standard microbiological methods, and antimicrobial susceptibility testing was performed according to Clinical and Laboratory Standards Institute guidelines. Major resistance phenotypes, including extended-spectrum β-lactamase (ESBL) production and methicillin-resistant <i>Staphylococcus aureus</i> (MRSA), were evaluated.</p><p><strong>Results: </strong>Among 45,216 blood cultures, 4356 (9.6%) yielded clinically significant bloodstream isolates. Gram-negative bacilli (GNB) predominated (2776; 63.7%), followed by Gram-positive cocci (GPC) (1468; 33.7%) and fungi (112; 2.6%). <i>Salmonella</i> Typhi (46.0%) was the most frequently isolated pathogens among GNB, followed by <i>Escherichia coli</i> (14.4%). Among GNB, ESBL production was detected in 23.2% of isolates, with the highest prevalence in <i>Klebsiella pneumoniae</i> (85.9%). Carbapenem-resistant organisms accounted for 9.7%, predominantly <i>K. pneumoniae</i> (42.9%). Furthermore, 12.1% of <i>S</i>. Typhi isolates were multidrug-resistant, and 13.4% were extensively drug-resistant. Among GPC, 43.9% were methicillin-resistant coagulase-negative <i>Staphylococci</i>, and 8.1% were MRSA. By 2030, MDR-ST and XDR-ST exhibiting the most pronounced upward trajectories.</p><p><strong>Conclusion: </strong>Antimicrobial-resistant bloodstream pathogens associated with sepsis are increasing in Pakistan and are projected to continue rising through 2030. Strengthened surveillance, antimicrobial stewardship, and infection prevention strategies are urgently needed to curb this growing public health threat.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-11"},"PeriodicalIF":4.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistance of uropathogens to fosfomycin: an evaluation of the published evidence.","authors":"Konstantinos Μ Katsikas, Panagiota Poziou, Panagiotis Stavroulakis, Paraskevi Maria Paliogianni, Charalampos Filippou, Matthew E Falagas","doi":"10.1080/14787210.2026.2733621","DOIUrl":"10.1080/14787210.2026.2733621","url":null,"abstract":"<p><strong>Introduction: </strong>Fosfomycin has reemerged as a therapeutic option for both uncomplicated and complicated urinary tract infections (UTIs), demonstrating <i>in</i> <i>vitro</i> activity even against isolates with advanced antimicrobial resistance profiles. This review aimed to evaluate its <i>in</i> <i>vitro</i> activity against common urinary pathogens.</p><p><strong>Areas covered: </strong>Overall, 41 studies comprising 25,689 urinary isolates of <i>Escherichia coli</i>, <i>Klebsiella pneumoniae</i>, and <i>Enterococcus faecalis</i> were included. Among <i>E. coli</i> isolates, resistance was 1.2%-54.1% and 0%-63.2% according to EUCAST and CLSI breakpoints, respectively (with 0.5%-1.5% intermediate according to CLSI). Among <i>K. pneumoniae</i> isolates, resistance was 13.1%-88.2% and 0%-73.6% according to EUCAST and CLSI breakpoints, respectively (with 1.6%-3.2% intermediate according to CLSI). Lastly, among <i>E. faecalis</i> isolates, resistance was 2.6%-66.5% and 2.1%-11.6% according to EUCAST and CLSI breakpoints, respectively.</p><p><strong>Expert opinion: </strong>Although routine susceptibility testing is methodologically challenging, the available data suggest that fosfomycin demonstrates <i>in</i> <i>vitro</i> activity against a considerable proportion of uropathogens. However, the use of fosfomycin in clinical practice should be guided by <i>in</i> <i>vitro</i> susceptibility testing results, given that the proportion of uropathogens resistant to the antibiotic may vary, especially in hospitalized patients. Emerging data suggest a role of fosfomycin against multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative uropathogens, especially in combination therapy.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-14"},"PeriodicalIF":4.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early versus delayed IV-to-oral antibiotic transition: clinical deterioration after oral switch and variation across regimen pathways.","authors":"Khalid Orayj, Azfar Athar Ishaqui, Salman Ashfaq Ahmad, Sultan M Alshahrani, Rayah Asiri, Adnan Iqbal, Asaad Ahmed Asaad Khalil, Mohammed Ali Kaddoura, Muhammad Bilal Maqsood, Javeria Farooq, Narendar Kumar","doi":"10.1080/14787210.2026.2729395","DOIUrl":"10.1080/14787210.2026.2729395","url":null,"abstract":"<p><strong>Objective: </strong>To assess associations of delayed (>72 hours) versus early (≤72 hours) IV-to-oral antibiotic switching with 7-day switch failure and adjusted post-switch clinical outcomes in hospitalized adults.</p><p><strong>Methods: </strong>Adult admissions receiving IV antibiotics followed by oral therapy during the same hospitalization were included. Early switch occurred within 72 hours of admission and delayed switch after 72 hours. Switch failure was defined as IV restart or antibiotic escalation within 7 days. Adjusted models assessed post-switch length of stay (LOS), in-hospital mortality, ICU transfer, and vasopressor initiation within 7 days.</p><p><strong>Results: </strong>Among 3898 admissions, 2002 had delayed and 1896 early switches. Switch failure within 7 days occurred in 14.7% versus 6.4%, respectively. Delayed switching was associated with longer post-switch LOS (adjusted ratio 1.94, 95% CI 1.70-2.22), higher in-hospital mortality (aOR 2.29, 1.21-4.34), vasopressor initiation (aOR 9.68, 2.28-41.04), and IV restart within 7 days (aOR 2.24, 1.79-2.81). ICU transfer showed no clear adjusted difference.</p><p><strong>Conclusion: </strong>Delayed switching after 72 hours was associated with more 7-day events and worse adjusted outcomes. However, switch timing is a surrogate for underlying clinical status and should not be interpreted as a direct measure of disease severity or cause of deterioration. Interpretation should consider physiologic stability, infection severity, source control, microbiology, and the feasibility of oral treatment. .</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-11"},"PeriodicalIF":4.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methicillin-resistant <i>Staphylococcus aureus</i> treatment and control in neonates: lessons learned - a Vietnam perspective.","authors":"Jennifer Le, Tavin Sayles, Duy Kieu Nguyen, Anh Viet Nguyen, Ha Thu Vu, Nga Thi Bich Nguyen, Dua Thi Nguyen","doi":"10.1080/14787210.2026.2726969","DOIUrl":"10.1080/14787210.2026.2726969","url":null,"abstract":"<p><strong>Introduction: </strong>Vietnam bears a substantial burden of methicillin-resistant Staphylococcus aureus (MRSA), yet neonatal data on epidemiology, antimicrobial resistance, treatment, and prevention remain limited and fragmented across regions and healthcare settings.</p><p><strong>Areas covered: </strong>This review summarizes MRSA epidemiology, risk factors, treatment, and prevention in neonatal intensive care units (NICUs), identifies key knowledge gaps, and highlights priorities for clinical practice, antimicrobial stewardship, and future research to support more effective management and control strategies. MRSA comprises 73% of <i>S. aureus</i> isolates nationally, with notable regional variation. Antibiotic overuse is common, affecting roughly 67.4% of hospitalized patients, and up to 90% of pediatric prescriptions are inappropriate, driving resistance. Vancomycin remains the first-line therapy for severe MRSA infections. Alternative agents-including linezolid, daptomycin, ceftaroline, clindamycin, and adjunctive rifampin-have limited roles, underscoring the importance of local antibiogram-guided therapy.</p><p><strong>Expert opinion: </strong>Optimizing vancomycin use through AUC-guided dosing, therapeutic drug monitoring, and de-escalation is critical to balance efficacy and toxicity. Although MRSA remains largely susceptible to vancomycin, the emergence of vancomycin-resistant enterococci (up to 34%) threatens last-line treatment sustainability. Effective strategies to reduce MRSA burden include infection prevention bundles, surveillance cultures, targeted decolonization, and antimicrobial stewardship programs. These interventions must be tailored to Vietnam's healthcare.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":4.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pan-TB regimens: too good to be true?","authors":"Stephen J Aston, Geraint R Davies","doi":"10.1080/14787210.2026.2719692","DOIUrl":"10.1080/14787210.2026.2719692","url":null,"abstract":"","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-3"},"PeriodicalIF":4.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 12-year trend of antimicrobial resistance among ESKAPEEc organisms isolated from blood cultures in a large private medical diagnostic laboratory network in Malaysia (2013-2024).","authors":"Omotayo Fatokun, Ali Haider Mohammed, Chuan Sheng Yap, Ariza Adnan, Si Wei Fong, Bassam Abdul Rasool Hassan","doi":"10.1080/14787210.2026.2729403","DOIUrl":"https://doi.org/10.1080/14787210.2026.2729403","url":null,"abstract":"<p><strong>Background: </strong>ESKAPEEc blood culture isolates are important indicators of invasive bacterial disease and antimicrobial resistance (AMR). This study examined 12-year AMR trends in Malaysia.</p><p><strong>Research design and methods: </strong>This retrospective laboratory-based study analyzed de-identified blood culture records from a large private diagnostic laboratory network between January 2013 and December 2024. An Antimicrobial Resistance Index (ARI) was calculated for each deduplicated patient-year isolate, and multivariable logistic regression identified factors associated with high ARI (≥0.5).</p><p><strong>Results: </strong>Among 10,274 eligible isolates, <i>Escherichia coli</i> was most common (44.5%), followed by <i>Klebsiella pneumoniae</i> (20.7%) and <i>Staphylococcus aureus</i> (19.6%). Mean ARI increased from 0.22 in 2013 to 0.28 in 2024 (<i>p</i> < 0.001), while high-ARI isolates rose from 12.1% in 2020 to 22.8% in 2024. Significant increases occurred in <i>E. coli</i>, <i>K. pneumoniae</i>, and <i>Enterobacter</i> spp./complex. Male sex, Indian or other ethnicity, <i>Acinetobacter baumannii</i>, <i>Enterococcus</i> spp. and year 2024 were associated with high ARI.</p><p><strong>Conclusions: </strong>AMR burden increased, particularly in 2024, supporting stronger stewardship, surveillance, and updated empiric treatment guidance. Findings should be interpreted cautiously because changes in AST methods, breakpoints, test panels, referral patterns, and case mix could not be fully adjusted.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-11"},"PeriodicalIF":4.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four-year surveillance of major Gram-negative pathogens in a Saudi tertiary hospital: clinical distribution, comorbidity profiles, and antimicrobial resistance.","authors":"Kamaleldin B Said, Khalid F Alshammari, Ruba M Elsaid Ahmed, Hamad Alshetaiwi, Naif K Binsaleh, Ahmed N Alshammari, Ibrahim Alshaghdali, Ahmed A Alsolami, Somaia Ibrahim, Nahlah F Alreshidi, Amel B Elhag, Sara A Yousef, Layan Z Alhamashi, Muath B Alghubayni, Rahaf S Alazmi","doi":"10.1080/14787210.2026.2729396","DOIUrl":"10.1080/14787210.2026.2729396","url":null,"abstract":"<p><strong>Purpose: </strong>To describe four-year diagnostic-distribution, burden, and antimicrobial-resistances of major Enterobacterales and <i>Pseudomonas aeruginosa</i> in a tertiary-care surveillance framework.</p><p><strong>Patients and methods: </strong>We retrospectively studied first non-duplicate-isolate per/patient/organism between 2022-2025 at a Saudi tertiary-care. Diagnostics used automated-platforms with GeneXpert-Carba-R employed parallel to cultures. Susceptibility interpretations used CLSI-breakpoints relevant to test-year. Annual-trends were assessed with grouped-binomial logistic-regression, and Benjamini-Hochberg false-discovery-rate correction was applied within prespecified analysis.</p><p><strong>Results: </strong>Among 1,857 isolates, <i>Klebsiella pneumoniae</i> was most frequent (36.2%), followed by <i>P. aeruginosa</i> (33.4%), <i>Escherichia coli</i> (17.9%), and <i>Enterobacter cloacae</i> (12.3%). Mean patient age was 64.8 years, 51.3% isolates were from intensive-care, 37.4% from urine, and 80.8% records had comorbidity. <i>K. pneumoniae</i> showed overall ESBL (76.6%), CRE (59.9%), MDR (69.3%), panel-defined XDR (64.7%), and panel-defined PDR (15.2%) frequencies. Enterobacterales ESBL-positivity increased (58.1% to 76.8%;q <0.001), whereas meropenem non-susceptibility decreased (52.6% to 33.2%;q <0.001). In <i>P. aeruginosa</i>, ceftazidime non-susceptibility increased (55.2% to 78.6%;q <0.001), meropenem decreased (46.8% to 32.9%;q = 0.031), and tobramycin increased (22.2% to 45.7%;q = 0.030). Crude-comorbidity differences remained insignificant after false-discovery-rate correction.</p><p><strong>Conclusion: </strong>We show a persistent species-specific Gram-negative resistance burden, led by <i>K. pneumoniae</i> and accompanied by substantial <i>P. aeruginosa</i> non-susceptibility. This supports organism-specific detections, antibiograms and continued multicenter-surveillance linked to antimicrobial exposure, genomic-data, and patient outcomes.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-10"},"PeriodicalIF":4.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}