Journal of global antimicrobial resistance最新文献

{"title":"Hybrid Sequencing of Chromosome and Plasmids from Multidrug Resistant Escherichia coli Isolated in Cambodia: Are Megaplasmids Vectors of Antibiotic Resistance Genes?","authors":"Ella Marcy, Sivhour Chiek, Mallorie Hidé, Savatey Hak, Chiva Ma, Meymey Lem, Gauthier Delvallez, Anne-Laure Bañuls, Sokleaph Cheng, Juliette Hayer","doi":"10.1016/j.jgar.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.jgar.2025.09.003","url":null,"abstract":"<p><strong>Objectives: </strong>The prevalence of Antimicrobial Resistance (AMR) in Escherichia coli infections in Cambodia is high and increasing, yet data distinguishing plasmid- and chromosome-mediated AMR-spread remain limited. The aim of this study was to characterise chromosomal and plasmid structures in clinically relevant E. coli resistant strains to investigate mechanisms driving the spread of Antibiotic Resistance Genes (ARGs) in Battambang Province, Cambodia.</p><p><strong>Methods: </strong>Hybrid genome assembly was performed using short- and long-read sequencing of six Extended Spectrum Betalactamase (ESBL)- and Carbapenemase Producing (CP) E. coli isolates collected from patients at Battambang Provincial Hospital, Cambodia. Detailed bacteriological analyses were conducted, as well as comprehensive genomic investigations to characterise Sequence Types (STs), plasmids, resistance mechanisms, and phylogenetic relationships among the strains, and to perform pairwise comparisons of plasmid sequences.</p><p><strong>Results: </strong>Chromosome and plasmid sequences were successfully recovered for each strain. Five STs were identified: ST1193 (two strains), ST131, ST205, ST405 and ST4204. All strains displayed a megaplasmid carrying ARGs, and one to five regular-sized plasmids without ARGs. Four distinct megasplasmids sequences were identified, including one shared by two ST1193 strains and one shared by ST131 and ST205 strains.</p><p><strong>Conclusions: </strong>The identification of megaplasmids carrying ARGs and shared by different strains highlights their potential role in the spread of antimicrobial resistance through horizontal gene transfer (HGT) in Cambodia. This study also confirms the circulation of the high-risk multidrug-resistant (MDR) clones ST131 and ST1193 in Battambang province, Cambodia, and underscores the importance of hybrid genome assembly to study plasmid structure and identify their role in AMR spread.</p>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring of antimicrobial resistance in hospital, municipal, and treated wastewater in Mbarara, Uganda.","authors":"Claudia Stange, Rogers Kalyetsi, Judith Owokuhaisa, Moses Ntaro, Arthur Leon, Paul R Hunter, Andreas Tiehm, Edgar M Mulogo","doi":"10.1016/j.jgar.2025.09.002","DOIUrl":"10.1016/j.jgar.2025.09.002","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to estimate the prevalence of antimicrobial resistance in the population of Mbarara through analysis of wastewater and determine the effectiveness of wastewater treatment in reducing discharge of antibiotic-resistant bacteria and antibiotic resistance genes into the environment.</p><p><strong>Methods: </strong>Hospital, municipal, and treated wastewater (collected on 10 different dates) from Mbarara, Uganda, were analysed for extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli using a culture-based method and selected clinically relevant antibiotic resistance genes using quantitative PCR.</p><p><strong>Results: </strong>The finding of this study demonstrated that 30.6% of the total E. coli were ESBL producers, constituting a high proportion compared to studies in other countries. Furthermore, the investigation revealed the widespread distribution of the carbapenemase gene bla_CMY-2 within the population. The comparative study of the inflow and outflow of the waste stabilisation pond system, which is used for wastewater treatment, demonstrated a log reduction of 1.9-2.4 for coliform bacteria and total as well as ESBL-producing E. coli. Conversely, the wastewater treatment was associated with an increase of the antibiotic resistance genes sul1 and tetC.</p><p><strong>Conclusions: </strong>The study shows that the waste stabilisation pond system is releasing significant amounts of coliform bacteria, E. coli, ESBL-producing E. coli, somatic bacteriophages, and antibiotic resistance genes into the Rwizi River. We also demonstrated that wastewater-based surveillance is a cost-effective method of obtaining information on the prevalence of AMR in the population, especially in countries where clinical surveillance is limited due to a lack of resources and infrastructure.</p>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":" ","pages":"100-106"},"PeriodicalIF":3.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro evaluation of Ibrexafungerp against clinical and environmental isolates of cryptococcus neoformans and cryptococcus gattii","authors":"Andrés Ceballos-Garzon,&nbsp;Carolina Firacative","doi":"10.1016/j.jgar.2025.09.001","DOIUrl":"10.1016/j.jgar.2025.09.001","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 84-85"},"PeriodicalIF":3.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dispensing of antibiotics without prescription in community drug retail outlets of Bahir Dar city in Northwest Ethiopia: A simulated client visit before and after educational intervention.","authors":"Masho Tigabe Tekle, Faisel Dula Sema, Minichil Chanie Worku, Abdisa Gemedi Jara, Worku Endalamaw Ayenew","doi":"10.1016/j.jgar.2025.08.017","DOIUrl":"https://doi.org/10.1016/j.jgar.2025.08.017","url":null,"abstract":"<p><strong>Objectives: </strong>Non-prescription supply of antibiotics in community drug retail outlets (CDROs) significantly contributes to antibiotic resistance (ABR). This study aimed to assess the effectiveness of educational intervention for pharmacy practitioners (PPs) in reducing over-the-counter (OTC) antibiotic sales.</p><p><strong>Methods: </strong>From August 1, 2022 to January 30, 2023 a total of 80 simulated client (SC) visits (40 pre-intervention; 40:post-intervention) were made in 40 CDROs of Bahir Dar city, to determine the baseline and post-intervention extent of OTC sale of antibiotics. Verbally a 30 minute one time onsite education regarding antimicrobials, antibiotics, ABR, rational use of antibiotics, role of community PPs in ensuring rational use of antibiotics, and good antibiotic dispensing practice (GADP) as an intervention was provided to 70 PPs who were working in the 40 CDROs. The education was guided with a written informational material which was delivered to each PPs. Two months after the intervention, its effectiveness was tested using McNemar's chi-square test and P-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The intervention resulted significant improvements in; reducing non-prescription sale of antibiotics in CDROs (55% (pre-intervention) Vs 20% (post-intervention), increasing requesting of a prescription paper (35% Vs 75%), insisting antibiotic must be dispensed with prescription paper (33.3% Vs 68.7%) and reducing dispensing of antibiotic at level 1 demand (50% Vs 25%).</p><p><strong>Conclusions: </strong>Educational intervention provided to PPs was effective in reducing the non-prescription sale of antibiotics and it improves the antibiotic dispensing practice.</p>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-existence of mcr-1 and bla_CTX-M from porcine-derived Escherichia coli isolated in China and selection of mcr-1 under cephalosporins pressure.","authors":"Zixian Wang, Jingyi Guo, Gejin Lu, Jie Jing, Shiwen Sun, Yang Sun, Xue Ji, Bowen Jiang, Bing Liang, Chuanfang Zhao, Lin Zheng, Lingwei Zhu, Xuejun Guo","doi":"10.1016/j.jgar.2025.08.018","DOIUrl":"https://doi.org/10.1016/j.jgar.2025.08.018","url":null,"abstract":"<p><strong>Objectives: </strong>The usage of cephalosporins (CEFs) and co-existence of extended-spectrum β-lactamase (ESBL) gene bla_CTX-M in the same host may promote the prevalence of colistin (CST) resistance gene mcr-1. This study aims to investigate the underlying mechanisms how the mcr-1 and bla_CTX-M demonstrate significant co-occurrence in Escherichia coli (E. coli).</p><p><strong>Methods: </strong>Conjugation assays were performed on 22 porcine-derived mcr-1-positive and bla_CTX-M-positive E. coli (MCRPEC::bla_CTX-M⁺) isolates from China to assess co-transfer potential. Whole genome sequencing characterized the genetic localization and context of mcr-1 and bla_CTX-M. Fitness cost and genetic stability were evaluated through growth curve and anti-microbial resistance (AMR) gene stability rates measurement. Additionally, we examined mcr-1 selection during bla_CTX-M co-existence under CEFs pressure by monitoring fitness and stability variations in mcr-1.</p><p><strong>Results: </strong>Successful co-transfer of mcr-1 and bla_CTX-M occurred in 36% (8/22) of isolates, demonstrating co-transfer efficiency ranging from 1.3×10^-5 to 1.5×10^-3. Predominant plasmid combinations facilitating co-transfer were IncI2(mcr-1) + IncI1(bla_CTX-M) combination. Notably, we report the first identification of bla_CTX-M-positive E. coli (CTX-M-EC) carrying dual mcr-1 copies on plasmids. mcr-1 and bla_CTX-M did not exhibit fitness costs in 63% (5/8) of transconjugants, with 88% (7/8) maintaining over 70% stable rate in 10 days. CEFs pressure enhanced both fitness and stability of mcr-1 in bla_CTX-M co-harboring transconjugants.</p><p><strong>Conclusions: </strong>The observed high co-transfer efficiency, high stability rates, and low fitness costs of mcr-1 and bla_CTX-M across distinct plasmid types and the mcr-1 selection driven by CEFs support the co-existence of mcr-1 and bla_CTX-M in E. coli hosts. Our findings support a suggestion that an urgent need for coordinated antibiotic stewardship targeting both drug classes to curb multidrug-resistant bacteria spread.</p>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of the risk of mortality associated with methicillin-resistant Staphylococcus aureus clones","authors":"Anastasia A. Asantewaa,&nbsp;Samuel N.-A. Yartey,&nbsp;Eric S. Donkor","doi":"10.1016/j.jgar.2025.08.015","DOIUrl":"10.1016/j.jgar.2025.08.015","url":null,"abstract":"<div><h3>Objectives</h3><div>This systematic review and meta-analysis aimed to quantify mortality associated with MRSA clones and evaluate the contribution of specific molecular features to outcome variation.</div></div><div><h3>Methods</h3><div>Databases including PubMed, Scopus, Web of Science, and Google Scholar were searched for studies reporting mortality among patients with MRSA infection and associated molecular typing data, including clonal complex, sequence type and SCCmec type. Results were presented in thematic narratives, tables and figures. A random-effects meta-analysis was performed to estimate pooled mortality and prevalence proportions.</div></div><div><h3>Results</h3><div>Twenty-seven included studies reported on MRSA isolates from 12 different countries. The overall pooled mortality was 22.47% (95% CI: 17.31–28.07), with the highest mortality observed in Europe. Among MRSA clonal complexes, the highest mortality was observed among CC5 (50.75%), followed by CC8 (37.56%). Although ST72 (66.16%) was the most prevalent sequence type, the highest mortality rates were observed in ST764 (38.74%) and ST1 (38.72%). SCCmec type IV (36.95%) was dominant but had a lower mortality rate (18.71%) compared to types II (39.09%) and III (27.52%).</div></div><div><h3>Conclusions</h3><div>The clear dominance and lethality of specific lineages affirm the clinical utility of molecular diagnostics in guiding treatment and predicting outcomes. These insights call for an expansion of MRSA typing programs in hospital laboratories and national surveillance systems.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 86-99"},"PeriodicalIF":3.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to Antimicrobial resistance in Campylobacter spp. focussing on C. jejuni and C. coli – A Narrative Review’ Journal of Global Antimicrobial Resistance Volume 43 (2025) Pages 372-389","authors":"Vathsala Mohan ,&nbsp;Nikolaos Strepis ,&nbsp;Konstantinos Mitsakakis ,&nbsp;Karsten Becker ,&nbsp;Leonid Chindelevitch ,&nbsp;Nirajmohan Shivaperumal ,&nbsp;Khine Swe Swe-Han ,&nbsp;John P. Hays","doi":"10.1016/j.jgar.2025.08.007","DOIUrl":"10.1016/j.jgar.2025.08.007","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"44 ","pages":"Pages 453-454"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective analysis of antimicrobial resistance among Escherichia coli causing community-acquired urinary tract infections in the United States from 2010 to 2022","authors":"Stephen James Ryan Arends ,&nbsp;Erin K. McCreary ,&nbsp;Matthew Helgeson ,&nbsp;Gina Morgan ,&nbsp;Shilpa Patkar ,&nbsp;Rodrigo Mendes","doi":"10.1016/j.jgar.2025.08.003","DOIUrl":"10.1016/j.jgar.2025.08.003","url":null,"abstract":"<div><h3>Objective</h3><div>A retrospective analysis of <em>Escherichia coli</em> isolates collected from community-acquired urinary tract infections (UTIs) in the United States for the years 2010–2022 was performed. The data originated from accessing the SENTRY Antimicrobial Surveillance Program, which is a global monitoring program that has been ongoing since 1997 with a purpose of tracking and reporting susceptibility of clinical isolates collected from various infection sources.</div></div><div><h3>Methods</h3><div>Isolates meeting the Centers for Disease Control and Prevention definition for community-acquired UTI were tested for antimicrobial susceptibility against 17 antimicrobial agents using broth microdilution methodology specified by the Clinical &amp; Laboratory Standards Institute guidelines. Isolates were interpreted as susceptible, intermediate, or resistant as appropriate using Clinical &amp; Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing breakpoints and characterized for extended-spectrum <em>β</em>-lactamase and multidrug-resistant phenotypes.</div></div><div><h3>Results</h3><div>The percentage of isolates susceptible to the oral agents amoxicillin-clavulanate, trimethoprim-sulfamethoxazole, and fluoroquinolones was 70%–85% throughout the study period, which crosses the acceptable threshold of 80% for empiric use of trimethoprim-sulfamethoxazole per the 2010 Infectious Disease Society of America guidelines. Higher susceptibility (&gt;90%) was observed for all agents administered via intravenous or intramuscular route. Variation in susceptibility profiles was observed by census region, with the highest resistant rates commonly found in the Middle Atlantic.</div></div><div><h3>Conclusions</h3><div>These data highlight the need for more oral options when treating community-acquired UTIs.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"44 ","pages":"Pages 442-448"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological insights into global metallo-β-lactamases-producing pseudomonas aeruginosa: A comprehensive analysis based on NCBI database","authors":"Junbin Zhai ,&nbsp;Ruyu Yan ,&nbsp;Xiaoli Cao ,&nbsp;Chang Liu ,&nbsp;Fengyan Li ,&nbsp;Han Shen ,&nbsp;Xuejing Xu","doi":"10.1016/j.jgar.2025.05.023","DOIUrl":"10.1016/j.jgar.2025.05.023","url":null,"abstract":"<div><div>This study aims to analyze the distribution of metallo-β-lactamase (MβLs) encoding genes in global <em>Pseudomonas aeruginosa</em>. Genomes of <em>P. aeruginosa</em> (21,788 in total) were obtained from the NCBI database and annotated using Prodigal to ensure consistency. Blastn analysis was conducted to compare the structured <em>bla</em>_MβL databases with annotated genomes to obtain detailed distribution of all <em>bla</em>_MβL genes in all genomes. A self-written sequence typing tool was utilized for sequence typing analysis on <em>bla</em>_MβL carrying <em>P. aeruginosa</em>, and meta-information of strains was extracted for further analysis. Out of 21,788 genomes, 2,639 (12.1%) contained 4,014 <em>bla</em>_MβL, with <em>bla</em>_VIM being the most prevalent (51.2%), followed by <em>bla</em>_IMP (24.1%) and <em>bla</em>_NDM (23.4%). Twenty-four <em>bla</em>_VIM variants, with <em>bla</em>_VIM-2 being the most common, accounting for 73.2%; There are 39 variants of <em>bla</em>_IMP, mainly <em>bla</em>_IMP-1 and <em>bla</em>_IMP-7, accounting for 16.1% and 14.5%, respectively. Among 2,639 <em>P. aeruginosa</em> carrying <em>bla</em>_MβL, 109 distinct sequence types (STs) were identified, with ST235 (16.8%) and ST111 (16.7%) being the predominant types, followed by ST308 (372, 14.1%), ST233 (190, 7.2%), ST357 (144, 5.5%), ST1203 (108, 4.1%), and ST773 (105, 4.0%). Notably, <em>bla</em>_MβL-producing <em>P. aeruginosa</em> showed a continuous increase, peaking in 2019 since first detection in 1997. These strains were predominantly isolated from human sources (1,836, 69.6%), primarily from urine samples (21.9%). The predominant metalloenzymes in global <em>P. aeruginosa</em> are <em>bla</em>_VIM-2, <em>bla</em>_IMP-1, and <em>bla</em>_IMP-7, primarily associated with epidemic high-risk clones ST235, ST111, and ST308. Given the rising trend of <em>bla</em>_MβL-producing <em>P. aeruginosa</em>, enhanced infection prevention and control measures are warranted.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"44 ","pages":"Pages 455-463"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram to predict bloodstream infections caused by third-generation cephalosporin-resistant Enterobacteriaceae.","authors":"Chun-Lin Liu, Rui-Hang Huang, Zhi-Ying Deng, Qing-Nian Wu, Ping Chen, Zhi-Ting Huo, Jie Yao","doi":"10.1016/j.jgar.2025.07.015","DOIUrl":"10.1016/j.jgar.2025.07.015","url":null,"abstract":"<p><strong>Objectives: </strong>Third-generation cephalosporin resistance (3GCR) in Enterobacteriaceae bloodstream infections (BSIs) challenges clinical management in China. This study aimed to develop a predictive tool to guide antibiotic stewardship.</p><p><strong>Methods: </strong>A retrospective cohort of 459 patients with Enterobacteriaceae BSIs (185 3GCR, 274 third-generation cephalosporin-sensitive [3GCS]) from a tertiary hospital (2021-2023) was analysed. Multivariate logistic regression with backward selection identified predictors, integrated into a nomogram.</p><p><strong>Results: </strong>Independent 3GCR predictors included advanced age ( (Odds Ratio (OR) = 1.02, 95% Confidence Interval (CI): 1.01-1.04), liver cirrhosis (OR = 2.18, 1.26-3.77), solid tumours (OR = 2.04, 1.19-3.50), prior third-generation cephalosporin use (OR = 2.44 1.47-4.08), and elevated procalcitonin (OR = 1.01, 1.01-1.02). The nomogram showed moderate discrimination (Area Under Curve (AUC) = 0.751, 95% CI: 0.67-0.83) and good calibration (Hosmer-Lemeshow P = 0.757).</p><p><strong>Conclusions: </strong>This nomogram, incorporating readily available clinical variables, facilitates rapid 3GCR risk stratification. Its implementation may optimize empirical antibiotic selection, improve outcomes, and mitigate resistance escalation in Enterobacteriaceae BSIs.</p>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":" ","pages":"319-322"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}