Journal of global antimicrobial resistance最新文献

{"title":"Prevalence, Clinical Characteristics, and Mortality Impact of Metallo-β-Lactamase-Producing Enterobacter Cloacae Complex Infections: A Retrospective Cohort Study","authors":"Yi-Pei Lee ,&nbsp;Yu-Chieh Liao ,&nbsp;Feng-Jui Chen ,&nbsp;Ting-Wei Lin ,&nbsp;Hsien-Po Huang ,&nbsp;Hui-Hsien Pan ,&nbsp;Po-Yu Liu","doi":"10.1016/j.jgar.2025.08.014","DOIUrl":"10.1016/j.jgar.2025.08.014","url":null,"abstract":"<div><h3>Objectives</h3><div>Metallo-β-lactamase (MBL)-producing <em>Enterobacter cloacae</em> complex (ECC) is an emerging threat associated with limited treatment options and increased mortality. This study aimed to describe the clinical and molecular characteristics, risk factors, and outcomes of MBL-producing ECC infections in Taiwan.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study at a tertiary hospital in central Taiwan from July 2022 to December 2023. Hospitalised patients with ECC infections were included. MBL production was determined using multiplex PCR for <em>bla</em>_IMP-1, <em>bla</em>_IMP-2, <em>bla</em>_VIM, and <em>bla</em>_NDM genes. We compared clinical characteristics, antibiotic susceptibility profiles, and outcomes between MBL-producing and non-MBL-producing ECC infections.</div></div><div><h3>Results</h3><div>Among 239 patients with ECC infections, 9.2% (22/239) were MBL-producing. <em>bla</em>_NDM was the predominant MBL gene (72.7%, 16/22). MBL-producing ECC showed significantly lower antibiotic susceptibility compared to non-MBL-producing ECC, except for amikacin and tigecycline. Patients with MBL-producing ECC infections had higher rates of ICU admission (50.0% vs. 11.1%, <em>p</em> &lt; 0.001), prolonged hospitalisation exceeding four weeks (54.5% vs. 29.5%, <em>p</em> = 0.030), and 30-day all-cause mortality (22.7% vs. 5.1%, adjusted HR: 2.95, 95% CI: 1.02–8.52, <em>p</em> = 0.035). MBL production was an independent risk factor for mortality in bloodstream infections.</div></div><div><h3>Conclusions</h3><div>MBL-producing ECC infections are associated with high antibiotic resistance, increased healthcare resource utilisation, and significantly higher mortality, particularly in bloodstream infections. The predominance of <em>bla</em>_NDM among MBL genes aligns with recent regional trends. These findings underscore the urgent need for enhanced surveillance, rapid diagnostics, and targeted management strategies to address this emerging threat.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 77-83"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992637","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":"Successful use of cefepime/zidebactam in deep-seated infections due to extensively drug-resistant Pseudomonas aeruginosa: A case series","authors":"Pooja Shah ,&nbsp;Ayyanraj Neeravi ,&nbsp;Rajiv Karthik ,&nbsp;Christy Merin Mathew ,&nbsp;Julie Hephzibah ,&nbsp;Hanna Elizabeth Johnson ,&nbsp;Balaji Veeraraghavan ,&nbsp;Abi Manesh","doi":"10.1016/j.jgar.2025.07.009","DOIUrl":"10.1016/j.jgar.2025.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>There is a paucity of safe and effective treatment options for extensively drug resistant (XDR) Gram-negative pathogens that often harbor varied resistance mechanisms concurrently. Cefepime/zidebactam (FEP/ZID) is a novel β-lactam/β-lactam enhancer (BL-BLE) combination, currently in Phase 3 trials, that has been shown to be effective against such difficult to treat resistant isolates in-vitro studies and scattered case reports. We present a series of deep seated infections due to XDR Pseudomonas Aeruginosa (PsA), successfully treated with FEP/ZID under compassionate use.</div></div><div><h3>Methods</h3><div>Between September 2023 and May 2024, using clinico-radiographic and microbiologic (phenotypic drug susceptibility and whole genome sequencing) data, we identified five XDR PsA related infections that could not be safely treated with currently available antibiotics. All patients received FEP/ZID after obtaining informed consent and necessary approvals.</div></div><div><h3>Results</h3><div>Four cases involved osteoarticular disease while the fifth was an endovascular graft infection. Clinical specimens yielded XDR PsA isolates that harbored varied (enzymatic and non-enzymatic) resistance mechanisms to anti-pseudomonal cephalosporins, carbapenems, aminoglycosides, fluoroquinolones and newer β-lactam/β-lactamase inhibitors. All isolates were susceptible to FEP/ZID and were treated with the same for 2–6 wk. Clinico-radiographic assessments confirmed significant resolution of lesions in all cases. There were with no drug-related adverse events.</div></div><div><h3>Conclusions</h3><div>The in-vitro susceptibility of our XDR PsA isolates to FEP/ZID translated to a successful clinical outcome in our series of deep-seated infections. FEP/ZID is a potential safe and effective treatment option for such serious Gram-negative infections.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"44 ","pages":"Pages 464-469"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618586","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":"Whole genome sequencing reveals novel resistance-conferring mutations and large genome deletions in drug-resistant Mycobacterium tuberculosis isolates from Indonesia.","authors":"Htin Lin Aung, Lidya Chaidir, Dian Ayu Eka Pitaloka, Yugen Miyahara, Narender Kumar, Arto Yuwono Soeroto, Greg M Cook, Reinout van Crevel, Bachti Alisjahbana, Sharon J Peacock, Philip C Hill","doi":"10.1016/j.jgar.2025.07.017","DOIUrl":"10.1016/j.jgar.2025.07.017","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated drug resistance profiles of Mycobacterium tuberculosis (Mtb) isolates in West Java, Indonesia through phenotypic and genomic approaches.</p><p><strong>Methods: </strong>We performed phenotypic drug-susceptibility testing (DST), coupled with whole-genome sequencing (WGS) of 142 Mtb isolates identified as RIF-R (Rifampicin resistant) using the Xpert MTB/RIF platform.</p><p><strong>Results: </strong>We found 107/142 (75%) isolates had high-level isoniazid resistance (INH-R) and rifampicin resistance (RIF-R). Of 107 isolates, we found two had novel katG mutations and three had large genome deletions encompassing the katG gene conferring INH-R. We also did not detect pre-existing mutations resistant to new and repurposed oral drugs bedaquiline (BDQ), pretomanid (Pa) and linezolid (LZD).</p><p><strong>Conclusions: </strong>Known drug-resistance conferring mutations reported in this study can be detected by the newly launched Xpert MTB/XDR together with Xpert MTB/RIF, providing clinicians with an expanded drug-susceptibility report without the need for culturing and WGS. On the other hand,the novel mutations and deletions found in this study are escaping routine diagnostics and could drive outbreaks of MDR-TB in Indonesia. The mass rollout of new and repurposed drugs for the treatment of drug-resistant TB in Indonesia is reassured by the absence of pre-existing mutations in this study. However, tools for rapid detection of resistance to these new drugs are urgently required to circumvent treatment-emergent resistance.</p>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":" ","pages":"314-318"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707760","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":"Genetic analysis of azole-resistant Aspergillus fumigatus isolated from domestic and imported tulip bulbs in Japan.","authors":"Satomi Uehara, Hiroki Takahashi, Yukari Nishino, Yumi Takahashi, Takashi Chiba, Keiko Yokoyama, Hirofumi Miyake, Kenji Sadamasu, Daisuke Hagiwara","doi":"10.1016/j.jgar.2025.07.006","DOIUrl":"10.1016/j.jgar.2025.07.006","url":null,"abstract":"<p><strong>Objective: </strong>Azole-resistant Aspergillus fumigatus (ARAF) poses a significant clinical threat and is increasingly being isolated from agricultural environments. ARAF was recently reported to be able to attach to plant bulbs and to cross national borders through international trade. In this study, we investigated the ARAF isolation rate of imported and domestic tulip bulbs that were sold in Japan.</p><p><strong>Methods: </strong>A. fumigatus was sought from tulip bulbs purchased in Japan. The cyp51A gene was sequenced to determine possession of tandem repeats (TRs) and single-nucleotide variants for the isolates. Whole genome analysis was conducted to compare clinical strains, and drug susceptibility testing for itraconazole, voriconazole, and posaconazole were performed.</p><p><strong>Results: </strong>A total of 129 A. fumigatus strains were isolated from 204 imported the Netherlands bulbs purchased in Japan in 2020-2022, whereas 58 strains were isolated from 209 domestic Japanese bulbs. A TR in the cyp51A promoter (azole resistance-related mutation) was detected in 24.0% of the isolates (31/129) from the Netherlands bulbs and 51.7% of the isolates (30/58) from Japanese bulbs. Phylogenetic clustering using genomic data of isolates from imported the Netherlands and Japanese tulip bulbs showed that TR-harbouring and non-TR isolates were clearly separated into different clusters. Japanese bulb isolates with TR were genetically close to environmental and clinical isolates from the Netherlands as well as isolates from bulbs imported from the Netherlands.</p><p><strong>Conclusions: </strong>The high frequency of ARAF isolation from the bulb bred in Japan was observed through multiple-year survey.</p>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":" ","pages":"306-313"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618583","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":"ISAC – Standing Up for Reliable Information and Science in Public Health and Healthcare","authors":"","doi":"10.1016/j.jgar.2025.08.016","DOIUrl":"10.1016/j.jgar.2025.08.016","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"44 ","pages":"Page ii"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095128","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":"Advancing clinical bacteriology in humanitarian settings: The collaborative role of Médecins Sans Frontières","authors":"Pilar Garcia-Vello ,&nbsp;Donal Doyle ,&nbsp;Simone Vollmer ,&nbsp;Amrish Baidjoe ,&nbsp;Rupa Kanapathipillai ,&nbsp;Anna Farra ,&nbsp;Justine Michel ,&nbsp;Fabiola Gordillo Gomez","doi":"10.1016/j.jgar.2025.08.006","DOIUrl":"10.1016/j.jgar.2025.08.006","url":null,"abstract":"<div><div>Antimicrobial resistance (AMR) is a growing global health threat, particularly in resource-limited and conflict-affected settings. Access to Diagnostics and Surveillance (D&amp;S) is one of the key pillars to address AMR yet remains critically limited in many of these settings. Médecins Sans Frontières (MSF, Doctors Without Borders) has over a decade of experience in building and supporting bacteriology laboratories worldwide. A pragmatic model centred on manual culture-based bacteriology, innovation and capacity building is promoted, always integrated with Infection Prevention and Control (IPC) and Antimicrobial Stewardship (AMS) programs and collaboration with Ministries of Health. Moreover, innovative strategies such as the Mini-Lab or Antibiogo have been successfully integrated into numerous settings. Effective and sustainable AMR diagnostics are feasible in humanitarian settings with the right approach. However, without actionable steps, the gap in equitable access to AMR interventions will persist, leaving vulnerable populations at continued risk.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"44 ","pages":"Pages 449-452"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873471","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":"Optimising personalised antibiotic treatment for methicillin-resistant Staphylococcus aureus bloodstream infections in ICU patients using a deep learning–based causal inference approach","authors":"Min Woo Kang,&nbsp;Shin Young Ahn","doi":"10.1016/j.jgar.2025.08.012","DOIUrl":"10.1016/j.jgar.2025.08.012","url":null,"abstract":"<div><h3>Objective</h3><div>Methicillin‑resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs) in intensive care units (ICUs) carry high mortality, and although vancomycin remains standard treatment, daptomycin and linezolid may benefit specific subgroups. This study evaluates the mortality reduction associated with vancomycin, daptomycin, and linezolid using a deep learning–based causal inference model.</div></div><div><h3>Methods</h3><div>Data were extracted from the Medical Information Mart for Intensive Care (MIMIC)-III and MIMIC-IV databases, including 270 ICU patients with MRSA BSI. A deep learning-based causal inference model was used to assess the treatment effect of linezolid, daptomycin, and vancomycin on in-hospital mortality. Multivariable logistic regression was employed to identify patient characteristics associated with the effectiveness of each antibiotic.</div></div><div><h3>Results</h3><div>The deep learning-based model predicted that vancomycin, daptomycin, and linezolid reduced mortality by 15.86% (17.90% to 13.82%), 9.68% (11.83% to 7.53%), and 10.74% (12.64% to 8.84%), respectively, with vancomycin showing the greatest reduction. The average treatment effect for in-hospital mortality reduction with vancomycin was significantly greater than that with linezolid and daptomycin (both <em>P</em> &lt; 0.001). Multivariable logistic regression for treatment effects revealed that vancomycin was particularly effective in patients of advanced age, those with chronic liver disease, and those with end-stage kidney disease, while it was less effective in patients with congestive heart failure or cancer. Daptomycin exhibited superior efficacy over vancomycin in patients with cancer, and linezolid was more effective in patients with cancer, hypertension, and congestive heart failure.</div></div><div><h3>Conclusion</h3><div>This study highlights linezolid and daptomycin treatment in select subgroups, while a deep learning–based model enables personalised antibiotic recommendations for ICU treatment strategies.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 70-76"},"PeriodicalIF":3.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956947","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":"First report of chromosomal co-occurrence of blaAFM-3 and blaIMP-45 genes in a multidrug-resistant Pseudomonas aeruginosa clinical isolate","authors":"Yu-Xia Zhong ,&nbsp;Gui-Jun Cai ,&nbsp;Li-Ting Dai ,&nbsp;Ling Yang ,&nbsp;Ding-Qiang Chen ,&nbsp;Pei-Bo Yuan","doi":"10.1016/j.jgar.2025.08.013","DOIUrl":"10.1016/j.jgar.2025.08.013","url":null,"abstract":"<div><h3>Background</h3><div>Multidrug-resistant (MDR) <em>Pseudomonas aeruginosa</em>, especially carbapenemase-producing strains, poses major clinical challenges due to their widespread dissemination and limited treatment options.</div></div><div><h3>Case and Methods</h3><div>A 65-y-old patient with intracranial infection was hospitalized. An MDR <em>P. aeruginosa</em> strain isolated from her cerebrospinal fluid was analysed using MALDI-TOF mass spectrometry, antimicrobial susceptibility testing, and whole genome sequencing.</div></div><div><h3>Results</h3><div><em>P. aeruginosa</em> strain YB1 was resistant to carbapenems, cephalosporins, quinolones, and aminoglycosides, except colistin. Its genome comprised a 6.41-Mb chromosome and a 448-kb IncP-like plasmid. Six β-lactamase genes were identified on the chromosome: <em>bla</em>_PER-1, <em>bla</em>_OXA-1, <em>bla</em>_IMP-45, and <em>bla</em>_AFM-3 in the MDR region, with <em>bla</em>_OXA-488 and <em>bla</em>_PAO-201 located outside it. The chromosomal MDR region shared high homology with plasmid-borne Tn<em>6485e</em>, which originated from multiple plasmids. Specifically, the novel carbapenemase gene <em>bla</em>_AFM-3 resided in a conserved transposon (IS<em>CR27n3</em>-<em>groL</em>-<em>△floR</em>-<em>bla</em>_AFM-3-<em>ble</em>_MBL-<em>trpF</em>-IS<em>CR27n2</em>), identical to that originally characterized in the <em>Alcaligenes faecalis</em> plasmid. Additionally, <em>bla</em>_IMP-45 was located in a conserved type I integron <em>(IntI</em>-<em>aac(6′)-Ib</em>-<em>bla</em>_IMP-45-<em>bla</em>_OXY-1-<em>catB3</em>-<em>△qacE</em>-<em>sul1</em>). Notably, the 3′-terminal sequence of Tn<em>6485e</em> (IS<em>26</em>-<em>aph(3′)</em>-<em>Ia</em>-IS<em>26</em>-<em>tet(C)</em>-<em>tetR(C)</em>-IS<em>26</em>-IS<em>6100</em>), absent from the chromosomal MDR region, was found on YB1’s plasmid. Moreover, IS<em>26</em> flanked the 71 600-bp chromosomal fragment covering the MRD region, with a 14-bp inverted repeat (5′-GGCACTGTTGCAAA-3′) on their outer sides in the same orientation, implying potential IS26-facilitated plasmid-chromosome recombination.</div></div><div><h3>Conclusions</h3><div>This study first identified the coexistence of the <em>bla</em>_AFM-3 and <em>bla</em>_IMP-45 genes on the chromosome of <em>P. aeruginosa</em>. Monitoring gene transfer from plasmids to chromosomes is crucial, as it boosts bacterial survival against antibiotics and enables heritable resistance, threatening human health.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 35-40"},"PeriodicalIF":3.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956980","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":"Towards an interpretable machine learning model for predicting antimicrobial resistance","authors":"Mohamed Mediouni,&nbsp;Vladimir Makarenkov,&nbsp;Abdoulaye Baniré Diallo","doi":"10.1016/j.jgar.2025.08.011","DOIUrl":"10.1016/j.jgar.2025.08.011","url":null,"abstract":"<div><div>This article explores the main stages of developing an interpretable machine learning (ML) model for predicting antimicrobial resistance (AMR), highlighting the importance of model interpretability in enhancing the prediction performance. By integrating phenotype-genotype synergy, our goal is to better understand AMR mechanisms. Such an approach combines ML with biological insights, offering a pathway towards more reliable AMR predictions and advancing the discovery of effective treatments against resistant pathogens. The challenges and opportunities related to incorporating this synergy into an ML model are discussed.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 47-51"},"PeriodicalIF":3.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956924","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":"Trends in prevalence and antibiotic non-susceptibility of Acinetobacter baumannii–calcoaceticus complex in Thailand (2000–2022): A secondary data analysis","authors":"Panisara Kasemteerasomboon ,&nbsp;Wiriya Mahikul ,&nbsp;Nontaphat Leerach ,&nbsp;Peerapon Siripongwutikorn ,&nbsp;Kulsumpun Krobanan ,&nbsp;Phimrata Leethongdee ,&nbsp;Watcharaporn Kamjumphol ,&nbsp;Aekkawat Unahalekhaka ,&nbsp;Nuntaporn Rukluarh ,&nbsp;Supalerk Sreesuk ,&nbsp;Jiraphan Premsuriya","doi":"10.1016/j.jgar.2025.08.010","DOIUrl":"10.1016/j.jgar.2025.08.010","url":null,"abstract":"<div><h3>Objectives</h3><div>Antimicrobial resistance (AMR) is a significant global health concern. Due to its high prevalence in nosocomial infections and its increasing resistance to multiple antibiotics, <em>Acinetobacter baumannii–calcoaceticus</em> complex (ABC) is listed as a critical pathogen. This study aimed to determine the prevalence and antibiotic non-susceptibility trends of ABC in Thailand over two decades using national surveillance data.</div></div><div><h3>Methods</h3><div>We analysed secondary data from the National Antimicrobial Resistance Surveillance Thailand (NARST) from 2000 to 2022, covering 529 538 ABC isolates. Linear regression was used to evaluate trends in overall ABC prevalence and antibiotic non-susceptibility rates across ward types (ICU, inpatient, outpatient) and specimen types (sputum, blood, urine).</div></div><div><h3>Results</h3><div>The prevalence of ABC increased from 8% in 2000 to 14% in 2022, with inpatient wards and sputum specimens showing the highest occurrence. By 2022, the majority of tested antibiotics showed antibiotic non-susceptibility rates exceeding 70%, with increasing trends. ICU isolates had the highest non-susceptibility, followed by inpatient and outpatient settings. Although non-susceptibility rates were lower in the outpatient setting, it exhibited the steepest increasing trends. Among specimen types, urine isolates had the highest non-susceptibility, followed by sputum and blood. Carbapenem non-susceptibility increased significantly across all ward types.</div></div><div><h3>Conclusions</h3><div>The increasing prevalence and high non-susceptibility of ABC in Thailand highlight a growing threat to public health. These findings underscore the urgent need for enhanced infection control, robust antibiotic stewardship, and further research into molecular epidemiology and alternative therapies.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 20-29"},"PeriodicalIF":3.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956938","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}