Journal of global antimicrobial resistance最新文献

{"title":"Clinical positioning of voriconazole, posaconazole, and isavuconazole in the treatment of invasive pulmonary aspergillosis: A global real-world database study","authors":"Eriko Hashimoto,&nbsp;Sayaka Yoshida,&nbsp;Taito Kitano","doi":"10.1016/j.jgar.2026.08.012","DOIUrl":"10.1016/j.jgar.2026.08.012","url":null,"abstract":"<div><h3>Introduction</h3><div>This study evaluated the clinical outcomes of invasive pulmonary aspergillosis (IPA) treated with voriconazole (VRCZ), posaconazole (PSCZ), or isavuconazole (ISCZ) using a large-scale real-world database.</div></div><div><h3>Materials and methods</h3><div>A retrospective study using the TriNetX database (2010–2025) identified patients with invasive pulmonary aspergillosis initiated on VRCZ, PSCZ, or ISCZ. Background factors were adjusted using propensity score matching (PSM). The primary endpoint was 6-week all-cause mortality.</div></div><div><h3>Results</h3><div>Of 8746 patients identified, 3603 met selection criteria (VRCZ: 2836; PSCZ/ISCZ: 767). Propensity score matching identified 738 matched pairs of balanced covariates. The 6-week mortality was 18.6% for VRCZ and 16.4% for PSCZ/ISCZ (OR 1.16; 95% CI 0.89–1.52; <em>P</em> = 0.273). No significant differences were observed in the primary, subgroup, or sensitivity analyses. Notably, the PSCZ/ISCZ group initially included more severe cases and patients with renal impairment.</div></div><div><h3>Conclusion</h3><div>No significant differences in all-cause mortality were observed among the three drugs. Despite the higher baseline risk in the PSCZ and ISCZ groups, the outcomes were comparable to those in the VRCZ group, suggesting that these agents are effective alternatives in high-risk real-world settings. PSCZ and ISCZ are valuable options in personalized medicine. Therefore, further prospective studies are warranted.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"50 ","pages":"Pages 547-551"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic characterisation of ST233 Pseudomonas aeruginosa co-producing KPC-2 and VIM-2 in Northeastern Brazil during the COVID-19 pandemic: Evidence of independent horizontal acquisition events","authors":"Joanderson Cadena da Silva,&nbsp;Ivson Cassiano de Oliveira Santos,&nbsp;Orlando Carlos da Conceição-Neto,&nbsp;Melise Chaves Silveira,&nbsp;Bruna Ribeiro Sued-Karam,&nbsp;Daiana Cristina Silva Rodrigues,&nbsp;Gabriela Alves da Silva,&nbsp;Stefany Mendes Dimas,&nbsp;Irys Hany Lima Gonzalez,&nbsp;Bruno Rocha Pribul,&nbsp;Ana Paula D’Alincourt Carvalho-Assef,&nbsp;Cláudio Marcos Rocha-de-Souza","doi":"10.1016/j.jgar.2026.08.014","DOIUrl":"10.1016/j.jgar.2026.08.014","url":null,"abstract":"&lt;div&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;ST233 &lt;em&gt;Pseudomonas aeruginosa&lt;/em&gt; isolates co-produced KPC-2 and VIM-2 during COVID-19.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Distinct architectures: chromosomal &lt;em&gt;bla&lt;/em&gt;&lt;sub&gt;VIM-2&lt;/sub&gt; and diverse plasmid-borne &lt;em&gt;bla&lt;/em&gt;&lt;sub&gt;KPC-2&lt;/sub&gt;.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;•&lt;/span&gt;&lt;span&gt;&lt;div&gt;Recurrent horizontal gene transfer, not clonal expansion and drives resistance.&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;/ul&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Dual-carbapenemase-producing &lt;em&gt;Pseudomonas aeruginosa&lt;/em&gt; poses a major therapeutic and epidemiological challenge worldwide, yet systematic data on KPC and VIM co-production in Brazil remain limited. The COVID-19 pandemic intensified antimicrobial use, a period temporally associated with increased carbapenemase detection globally.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Dual-carbapenemase-producing &lt;em&gt;Pseudomonas aeruginosa&lt;/em&gt; poses a major therapeutic and epidemiological challenge worldwide, yet systematic data on KPC and VIM co-production in Brazil remain limited. The COVID-19 pandemic intensified antimicrobial use, a period temporally associated with increased carbapenemase detection globally.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To characterise the molecular epidemiology and resistance profiles of KPC and VIM co-producing &lt;em&gt;P. aeruginosa&lt;/em&gt; isolates from Brazil (2019–2023).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;To characterise the molecular epidemiology and resistance profiles of KPC and VIM co-producing &lt;em&gt;P. aeruginosa&lt;/em&gt; isolates from Brazil (2019–2023).&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Between 2019 and 2023, 1489 multidrug-resistant &lt;em&gt;P. aeruginosa&lt;/em&gt; isolates were screened by multiplex PCR for carbapenemase-encoding genes. Co-producing isolates underwent pulsed-field gel electrophoresis (PFGE) for clonal profiling, followed by whole-genome sequencing (WGS) for high-resolution phylogenomic analysis. Antimicrobial susceptibility testing and plasmid characterisation using next-generation sequencing platforms were also performed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Between 2019 and 2023, 1489 multidrug-resistant &lt;em&gt;P. aeruginosa&lt;/em&gt; isolates were screened by multiplex PCR for carbapenemase-encoding genes. Co-producing isolates underwent pulsed-field gel electrophoresis (PFGE) for clonal profiling, followed by whole-genome sequencing (WGS) for high-resolution phylogenomic analysis. Antimicrobial susceptibility testing and plasmid characterisation using next-generation sequencing platforms were also performed.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Forty-two isolates (2.8%) harboured both &lt;em&gt;bla&lt;/em&gt;&lt;sub&gt;KPC-2&lt;/sub&gt; and &lt;em&gt;bla&lt;/em&gt;&lt;sub&gt;VIM-2&lt;/sub&gt;, with detection occurring exclusively between 2020 and 2023, temporally coinciding with the COVID-19 pandemic. PFGE identified eight distinct clonal groups, providing evidence for independent horizontal gene transfer (HGT) events, whilst WGS confirmed all isolates as the high-risk ST233 lineage. Chromosomally integrated &lt;em&gt;bla&lt;/em&gt;&lt;sub&gt;VIM-2&lt;/sub&gt; within class 1 integrons predominated;","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"50 ","pages":"Pages 528-536"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polyclonal multidrug-resistant Acinetobacter baumannii circulation in eight wards of the Tripoli University Hospital, Libya","authors":"Nada Elgriw,&nbsp;Thibault Destanque,&nbsp;Wejdene Mansour,&nbsp;Sana Azaiez,&nbsp;Inas Alhudiri,&nbsp;Fatma Mukhter Habas,&nbsp;Seddik Mohamed Eltroug,&nbsp;Eman Gusbi,&nbsp;Jean-Yves Madec,&nbsp;Cherifa Chaouch,&nbsp;Marisa Haenni,&nbsp;Agnese Lupo","doi":"10.1016/j.jgar.2026.08.007","DOIUrl":"10.1016/j.jgar.2026.08.007","url":null,"abstract":"<div><h3>Objective</h3><div><em>Acinetobacter baumannii</em> is an opportunistic pathogen infecting immunocompromised patients, including the pediatric population. Treatment options for severe infections are challenged by the dissemination of carbapenem-resistant <em>A. baumannii</em> (CRAB), mostly belonging to 11 international clones (ICs 1–11). We characterized gene contents, genetic elements, and phylogenetic relationships of CRAB isolates.</div></div><div><h3>Methods</h3><div>Unlike neighbouring countries, the characterization of CRAB from Libya is rare. In this study, 38 CRAB isolates collected during 2020–2021 from patients treated in the Tripoli University Hospital (TUH) were characterized by whole-genome sequencing for their antibiotic resistance genes content, their genetic elements, and their phylogenetic relationship to international isolates.</div></div><div><h3>Results</h3><div>The 38 isolates belonged to IC1, IC2, IC6, IC7, and IC11, the latter being the most frequently identified. All isolates harboured a <em>bla</em>_OXA-23 gene, except IC6 isolates, which carried a plasmid-located <em>bla</em>_OXA-72. The <em>bla</em>_NDM-1 gene occurred only in IC1 isolates. The phylogenetic analysis including publicly available genomes evidenced a clustering according to the continent of origin. Isolates from TUH were phylogenetically close to isolates from North Africa or the Middle East. Most of the CRAB (22 of 38, 58%) came from children, eight of whom died (36%). Circulation among adult and paediatric wards of the same clone was observed.</div></div><div><h3>Conclusions</h3><div>At the TUH, improvement of hygiene measures is needed to lower the burden of CRAB. At the international level, surveillance of this pathogen remains crucial to prevent its further spread from endemic regions or from conflict zones where injuries are more frequent and hygiene conditions are more precarious.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"50 ","pages":"Pages 442-450"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic timing as a quality-of-care metric in ICU pneumonia: Association with in-hospital mortality and microbiological confirmation","authors":"Josef Yayan","doi":"10.1016/j.jgar.2026.08.001","DOIUrl":"10.1016/j.jgar.2026.08.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Timely antibiotic therapy is recommended for critically ill patients with pneumonia and is widely used as a quality-of-care indicator. However, its independent association with in-hospital mortality remains uncertain after adjustment for illness severity, empirical antibiotic therapy, and microbiological confirmation.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 7515 adult ICU patients with pneumonia from the MIMIC-IV v2.2 database who received systemic antibiotic therapy. Antibiotic timing was categorized as &lt;1 h, 1–3 h, and &gt;3 h after hospital admission. The primary outcome was in-hospital mortality. Multivariable logistic regression adjusted for age, sex, SOFA score, Charlson Comorbidity Index, invasive mechanical ventilation, vasopressor therapy, microbiological confirmation, and empirical antibiotic therapy. Sensitivity, subgroup, and interaction analyses were performed.</div></div><div><h3>Results</h3><div>Crude in-hospital mortality was similar across antibiotic timing groups (21.8%, 22.4%, and 21.7% for &lt;1 h, 1–3 h, and &gt;3 h, respectively; <em>P</em> = 0.791). After adjustment, neither antibiotic administration within 1–3 h (adjusted OR: 0.98, 95% CI: 0.79–1.21; <em>P</em> = 0.873) nor after 3 h (adjusted OR: 1.02, 95% CI: 0.83–1.25; <em>P</em> = 0.847) was independently associated with in-hospital mortality. Microbiological confirmation was also not independently associated with mortality (adjusted OR: 1.10, 95% CI: 0.95–1.28; <em>P</em> = 0.198). All additional analyses produced consistent results.</div></div><div><h3>Conclusions</h3><div>After adjustment for illness severity, comorbidity burden, microbiological confirmation, organ support, and empirical antibiotic therapy, antibiotic timing was not independently associated with in-hospital mortality. Antibiotic timing alone should not be considered a comprehensive quality-of-care metric in critically ill patients with pneumonia.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"50 ","pages":"Pages 435-441"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metagenomic next-generation sequencing (mNGS) for detecting pathogens and antimicrobial resistance genes (ARGs), and guiding antimicrobial therapy in cancer patients from Southwest China","authors":"Qian Zhao,&nbsp;Qian Wan,&nbsp;Si-wei Wang,&nbsp;Pei Zhao,&nbsp;Yi Li,&nbsp;Shan-ling Xu,&nbsp;Chen Chen","doi":"10.1016/j.jgar.2026.07.026","DOIUrl":"10.1016/j.jgar.2026.07.026","url":null,"abstract":"<div><h3>Background</h3><div>Cancer patients often face etiological diagnosis challenges due to repeated hospitalizations, antibiotic exposure, and conventional microbiology tests (CMTs) limitations (low positivity, long turnaround). Metagenomic next-generation sequencing (mNGS) enables rapid and accurate pathogen detection, however, its clinical utility in cancer patients requires further investigation.</div></div><div><h3>Methods</h3><div>Two years of mNGS results and clinical data of cancer patients in Sichuan Cancer Hospital were collected. The pathogens and antimicrobial resistance genes (ARGs) were analyzed. The diagnostic performance was evaluated via sensitivity, specificity, accuracy, positive and negative predictive value. The clinical significance in guiding antimicrobial therapy was assessed by comparing outcomes between mNGS-guided and empirical therapy groups. Multivariable logistic regression analysis was performed to explore risk factors for multidrug-resistant organisms (MDROs) and opportunistic pathogens infections in cancer population.</div></div><div><h3>Results</h3><div>The study included 340 mNGS results from 267 cancer patients. <em>Streptococcus pneumoniae, Pseudomonas aeruginosa, Candida albicans</em> and Epstein-Barr virus were the most common Gram-positive and Gram-negative bacteria, fungus and virus, respectively. The main ARGs were ESBLs and aminoglycoside resistance genes. mNGS showed high pathogen diagnostic sensitivity (97.50%) and moderate ARGs diagnostic sensitivity (64.29%). The mNGS-guided group had lower mortality (29.5% vs. 34.1%, <em>P</em> = 0.65) and shorter duration of mechanical ventilation (39.34 ± 81.15 vs. 42.30 ± 102.39 h, <em>P</em> = 0.88). Age (<em>P</em> = 0.028) and prior 90-day antibiotic use (<em>P</em> = 0.047) independently predicted MDROs infections; immunodeficiency predicted <em>Pneumocystis jirovecii</em> (<em>P</em> = 0.005) and <em>Aspergillus</em> spp. (<em>P</em> = 0.010) infections.</div></div><div><h3>Conclusion</h3><div>mNGS was reliable for pathogen diagnosis in cancer patients. However, its clinical significance on guiding antimicrobial therapy requires more prospective multicenter studies to confirm.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"50 ","pages":"Pages 479-487"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and clinical outcomes of infections caused by carbapenemase-producing Enterobacterales at a secondary-care hospital in China","authors":"Wen Zhu,&nbsp;Yi Liang,&nbsp;Feifei Dai","doi":"10.1016/j.jgar.2026.08.010","DOIUrl":"10.1016/j.jgar.2026.08.010","url":null,"abstract":"<div><h3>Objective</h3><div>To analyse clinical characteristics of carbapenemase-producing <em>Enterobacterales</em> (CPE) infection and explore factors associated with their short-term (30-day) and long-term (90-day) prognostic outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study enrolled 192 nonduplicate patients with microbiologically confirmed CRE infection between January 2023 and June 2025 at a secondary-care hospital. All isolates underwent carbapenemase detection. Demographic data, clinical features, laboratory findings, treatment interventions, and 30-day/90-day prognostic outcomes were collected. Kaplan–Meier survival curves were generated, and the Log-rank tests were used for intergroup survival comparison. Univariate and multivariate Cox proportional hazards regression models were employed to identify independent prognostic factors for 30-day and 90-day mortality.</div></div><div><h3>Results</h3><div>All CRE isolates were confirmed as carbapenemase producers, with significant antimicrobial susceptibility differences. The 30-day and 90-day all-cause mortality rates were 23.43% (95% CI: 17.39%–29.48%) and 27.60% (95% CI: 21.22%–33.98%), respectively. Multivariate analyses revealed independent associations with 30-day mortality, including septic shock/sepsis (aHR = 2.528, 95% CI: 1.126–5.678), fasting plasma glucose (aHR = 1.113, 95% CI: 1.034–1.197), and hospital-onset infection (aHR = 2.246, 95% CI: 1.145–4.406). For 90-day mortality, additional factors included albumin infusion (aHR = 3.081, 95% CI: 1.350–7.096) and MBL type (aHR = 2.410, 95% CI: 1.301–4.465). Appropriate antimicrobial therapy was significantly associated with reduced 30-day (aHR = 0.424, 95% CI: 0.219–0.823) and 90-day (aHR = 0.346, 95% CI: 0.182–0.659) mortality risk.</div></div><div><h3>Conclusions</h3><div>Secondary-care hospitals present high prevalence of CPE, accompanied by a substantial mortality burden among infected patients. This study provides evidence-based guidance for optimising CPE management.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"50 ","pages":"Pages 488-495"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acinetobacter bereziniae co-producing NDM-1 and OXA-58 causing pneumonia and stomatitis in a Burmese python (Python bivittatus)","authors":"Gabriel Siqueira dos Santos,&nbsp;Julia de Menezes Macedo Pausa,&nbsp;Caroline da Costa Abrahão,&nbsp;Alice Soares de Oliveira,&nbsp;João Pessoa Araújo Junior,&nbsp;Amanda Haisi,&nbsp;Luciana Sartori,&nbsp;José Soares Ferreira Neto,&nbsp;Marcos Bryan Heinemann","doi":"10.1016/j.jgar.2026.08.008","DOIUrl":"10.1016/j.jgar.2026.08.008","url":null,"abstract":"<div><div>Carbapenemase-producing <em>Acinetobacter</em> are multidrug-resistant pathogens mainly associated with healthcare infections but are increasingly detected in wildlife exposed to human environments. In this study, we report and characterize a carbapenem-resistant <em>Acinetobacter bereziniae</em> strain related to fatal pneumonia and stomatitis in a rescued Burmese python (<em>Python bivittatus</em>) in São Paulo, Brazil. Whole genome sequencing revealed plasmid-borne <em>bla</em>_NDM-1 and <em>bla</em>_OXA-58 genes, and phylogenomic analysis clustered the strain with human clinical isolates. These findings highlight the threat of carbapenemase-producing bacteria to wildlife and reinforce the need for a One Health surveillance approach.</div></div><div>Carbapenemase-producing <em>Acinetobacter</em> are multidrug-resistant pathogens mainly associated with healthcare infections but are increasingly detected in wildlife exposed to human environments. In this study, we report and characterize a carbapenem-resistant <em>Acinetobacter bereziniae</em> strain related to fatal pneumonia and stomatitis in a rescued Burmese python (<em>Python bivittatus</em>) in São Paulo, Brazil. Whole genome sequencing revealed plasmid-borne <em>bla</em>_NDM-1 and <em>bla</em>_OXA-58 genes, and phylogenomic analysis clustered the strain with human clinical isolates. These findings highlight the threat of carbapenemase-producing bacteria to wildlife and reinforce the need for a One Health surveillance approach.</div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"50 ","pages":"Pages 496-498"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inappropriate antimicrobial prescribing patterns and associated factors among outpatients in private hospitals in Southwest China: A retrospective study (2022–2025)","authors":"Xinchen Li,&nbsp;Junli Yang,&nbsp;Yuxing Yan,&nbsp;Yun Lu,&nbsp;Yutong Fu,&nbsp;Jiao Chen,&nbsp;Yue Chang","doi":"10.1016/j.jgar.2026.08.015","DOIUrl":"10.1016/j.jgar.2026.08.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Inappropriate antimicrobial use is a primary driver of antimicrobial resistance. This study examines outpatient antimicrobial prescribing patterns and their associated factors in Chinese private hospitals from January 2022 to April 2025.</div></div><div><h3>Methods</h3><div>We analysed antimicrobial prescriptions from seven private hospitals in southwest China, classifying them as appropriate or inappropriate. Chi-square tests and generalized estimating equations were applied to identify factors associated with inappropriate prescribing.</div></div><div><h3>Results</h3><div>Of 147 415 antimicrobial prescriptions, respiratory (44.4%) and genitourinary disorders (39.0%) were the leading indications, while cephalosporins (33.2%) and nitroimidazoles (23.1%) were the most commonly prescribed antimicrobial classes. The overall inappropriate prescribing rate was 63.6%, with the highest rates for genitourinary (69.6%) and respiratory (61.1%) disorders. Aminoglycosides (99.5%) and lincosamides (85.0%) showed the highest inappropriateness rates. Female patients (odds ratio [<em>OR</em>] = 1.181, <em>P</em> &lt; 0.001) and those receiving injectable therapy (<em>OR</em> = 1.396, <em>P</em> &lt; 0.001) had higher odds of inappropriate prescribing. Male physicians with lower education (<em>OR</em> = 2.971, <em>P</em> &lt; 0.001) had higher odds. Among older (≥35 y) and more experienced (≥10 work y) physicians, technical secondary school education conferred the highest risk (<em>OR</em> = 3.310 and 4.810, respectively, <em>P</em> &lt; 0.001). Attending and chief physicians shifted from protective to risk factors with increasing work experience, while associate chief physicians showed a markedly elevated risk (<em>OR</em> = 2.770, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Antimicrobial stewardship efforts should prioritize genitourinary infections, with particular attention to injectable therapies and female patients. Interventions should target male physicians with higher professional titles or lower education, especially those with more experience. This necessitates enhanced regulatory oversight and tailored training programs that address the specific needs of private hospitals.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"50 ","pages":"Pages 537-546"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro activity of cefiderocol against highly resistant Gram-negative pathogens collected in the SENTRY Surveillance Program between 2020 and 2024","authors":"Boudewijn L.M. DeJonge,&nbsp;Christopher Longshaw,&nbsp;Frank Kung,&nbsp;Sean T. Nguyen,&nbsp;Rodrigo E. Mendes,&nbsp;Yoshinori Yamano","doi":"10.1016/j.jgar.2026.08.011","DOIUrl":"10.1016/j.jgar.2026.08.011","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigated the in vitro activity of cefiderocol and comparator antibiotics against Gram-negative bacterial isolates with highly resistant phenotypes collected in the SENTRY Antimicrobial Surveillance Program.</div></div><div><h3>Methods</h3><div>Between 2020 and 2024, consecutive Gram-negative bacterial isolates were collected from hospitalized patients in the USA and Europe, Turkey and Israel. Minimum inhibitory concentrations (MICs) were determined by broth microdilution method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Susceptibility was interpreted, as applicable, by CLSI M100 (2026), European Committee on Antimicrobial Susceptibility Testing (EUCAST) (2026), and US Food and Drug Administration (FDA 2026) criteria.</div></div><div><h3>Results</h3><div>Cefiderocol was the only antibiotic that inhibited &gt;90% of carbapenem-non-susceptible isolates by CLSI breakpoints (95.5% of 1229 Enterobacterales, 98.8% of 2807 <em>Pseudomonas aeruginosa</em>, 93.7% of 2254 <em>Acinetobacter baumannii-calcoaceticus</em> species complex, and 99.3% of 2341 <em>Stenotrophomonas maltophilia</em>), and susceptibilities to cefiderocol were &gt;90% across various infection sites. Against multidrug-resistant (MDR) Enterobacterales (N = 10 606) and <em>P. aeruginosa</em> (N = 1817), cefiderocol susceptibility rates were 99.1% and 98.1%, respectively. Susceptibilities to comparator antibiotics ranged between 73.2% (ceftolozane-tazobactam) and 99.8% (aztreonam-avibactam) for MDR Enterobacterales, and between 18.3% (meropenem) and 77.5% (imipenem-relebactam) for MDR <em>P. aeruginosa</em>. 97.4% of 459 difficult-to-treat resistant <em>P. aeruginosa</em> were susceptible to cefiderocol. Additionally, cefiderocol displayed low MIC_50/90 values against <em>Burkholderia cepacia</em> species complex and <em>Achromobacter</em> spp. (0.06/0.5 mg/L and 0.03/0.25 mg/L, respectively).</div></div><div><h3>Conclusions</h3><div>Cefiderocol showed potent in vitro activity against contemporary isolates of Gram-negative bacteria displaying challenging resistance phenotypes.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"50 ","pages":"Pages 462-469"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ISAC News and Updates","authors":"","doi":"10.1016/j.jgar.2026.06.002","DOIUrl":"10.1016/j.jgar.2026.06.002","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"49 ","pages":"Pages ii-iii"},"PeriodicalIF":3.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}