Pub Date : 2026-01-01Epub Date: 2025-12-16DOI: 10.1016/j.jgar.2025.12.011
Melina Rapoport , Nahir Gattoni , Celeste Lucero , Juan Manuel de Mendieta
Objective
This study describes the phenotypic, molecular, and genomic characterisation of emerging blaNDM-1-producing Pseudomonas aeruginosa in Argentina, mainly driven by ST308 and ST274 clones.
Methods
Nineteen clinical isolates submitted to the National and Regional Reference Laboratory on Antimicrobial Resistance between 2018 and 2024 from nine hospitals were analysed. Antimicrobial susceptibility and carbapenemase activity were evaluated. In-house PCR assays were used to detect relevant resistance determinants. Genetic relatedness was assessed by SpeI-PFGE, and whole-genome sequencing was performed on nine isolates using Illumina and Oxford Nanopore technologies.
Results
All isolates were resistant to all β-lactams tested, except two, M28149 and M28715, that remained susceptible to aztreonam. All carried blaNDM-1. PFGE identified six pulsotypes, with 13 isolates in one dominant type. Whole-genome sequencing revealed six ST308, two ST274, and one ST3243; five ST308 isolates also harboured the rmtD 16S methylase gene. Phylogenetic analysis of ST308 isolates showed they formed a distinct cluster compared with those from other countries.
Conclusions
The emergence of blaNDM-1-producing P. aeruginosa associated with ST308 and ST274 clones represents a public health concern, particularly given the scarcity of effective treatment options for severe infections caused by these high-risk clones.
{"title":"Dissemination of NDM-1-producing Pseudomonas aeruginosa ST308 and ST274 high-risk clones in Argentina","authors":"Melina Rapoport , Nahir Gattoni , Celeste Lucero , Juan Manuel de Mendieta","doi":"10.1016/j.jgar.2025.12.011","DOIUrl":"10.1016/j.jgar.2025.12.011","url":null,"abstract":"<div><h3>Objective</h3><div>This study describes the phenotypic, molecular, and genomic characterisation of emerging <em>bla</em><sub>NDM-1</sub>-producing <em>Pseudomonas aeruginosa</em> in Argentina, mainly driven by ST308 and ST274 clones.</div></div><div><h3>Methods</h3><div>Nineteen clinical isolates submitted to the National and Regional Reference Laboratory on Antimicrobial Resistance between 2018 and 2024 from nine hospitals were analysed. Antimicrobial susceptibility and carbapenemase activity were evaluated. In-house PCR assays were used to detect relevant resistance determinants. Genetic relatedness was assessed by SpeI-PFGE, and whole-genome sequencing was performed on nine isolates using Illumina and Oxford Nanopore technologies.</div></div><div><h3>Results</h3><div>All isolates were resistant to all β-lactams tested, except two, M28149 and M28715, that remained susceptible to aztreonam. All carried <em>bla</em><sub>NDM-1</sub>. PFGE identified six pulsotypes, with 13 isolates in one dominant type. Whole-genome sequencing revealed six ST308, two ST274, and one ST3243; five ST308 isolates also harboured the <em>rmtD</em> 16S methylase gene. Phylogenetic analysis of ST308 isolates showed they formed a distinct cluster compared with those from other countries.</div></div><div><h3>Conclusions</h3><div>The emergence of <em>bla</em><sub>NDM-1</sub>-producing <em>P. aeruginosa</em> associated with ST308 and ST274 clones represents a public health concern, particularly given the scarcity of effective treatment options for severe infections caused by these high-risk clones.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 187-194"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781085","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}
Pub Date : 2026-01-01Epub Date: 2026-01-08DOI: 10.1016/j.jgar.2025.12.017
Antonio Vitiello , Andrea Zovi , Michela Sabbatucci , Elisa Fabbro , Walter Ricciardi , Leonardo Villani , Giovanni Rezza , Mariarosaria Boccellino , Annalisa Capuano , Francesco Rossi , Marcello Gelormini , Danilo Lo Fo Wong , Francesco Blasi , Cristiana Bellan , Maurizio Acampa , Matteo Bassetti
Objective
Antimicrobial resistance (AMR) poses a significant and growing threat to public health globally, with Italy facing some of the highest resistance rates in Europe. This manuscript reviewed recent Italian intervention studies aimed at mitigating AMR across bacterial, fungal, and viral domains.
Methods
Strategies including antimicrobial stewardship (AMS), infection prevention and control (IPC), antifungal stewardship (AFS), and diagnostic advancements were evaluated. The evidence highlighted both the promise and limitations of Italy's current approach.
Results
While AMS and IPC programs have reduced antibiotic use, healthcare-associated infections, and costs, regional disparities, inconsistent implementation, and limited longitudinal surveillance remain critical challenges. The fungal resistance landscape is marked by rising threats like Candida auris, requiring urgent expansion of AFS programs. Italy's AMR strategy would benefit from improved IPC infrastructure, realtime data integration, and alignment with One Health principles.
Conclusions
Strengthening national coordination, supportinginnovation, and translating surveillance into action at the local level are crucial for turning policy into measurable progress. This review provides actionable insights to guide a more unified and responsive national AMR framework.
{"title":"Intervention studies and antimicrobial resistance in Italy: An overview of the latest evidence","authors":"Antonio Vitiello , Andrea Zovi , Michela Sabbatucci , Elisa Fabbro , Walter Ricciardi , Leonardo Villani , Giovanni Rezza , Mariarosaria Boccellino , Annalisa Capuano , Francesco Rossi , Marcello Gelormini , Danilo Lo Fo Wong , Francesco Blasi , Cristiana Bellan , Maurizio Acampa , Matteo Bassetti","doi":"10.1016/j.jgar.2025.12.017","DOIUrl":"10.1016/j.jgar.2025.12.017","url":null,"abstract":"<div><h3>Objective</h3><div>Antimicrobial resistance (AMR) poses a significant and growing threat to public health globally, with Italy facing some of the highest resistance rates in Europe. This manuscript reviewed recent Italian intervention studies aimed at mitigating AMR across bacterial, fungal, and viral domains.</div></div><div><h3>Methods</h3><div>Strategies including antimicrobial stewardship (AMS), infection prevention and control (IPC), antifungal stewardship (AFS), and diagnostic advancements were evaluated. The evidence highlighted both the promise and limitations of Italy's current approach.</div></div><div><h3>Results</h3><div>While AMS and IPC programs have reduced antibiotic use, healthcare-associated infections, and costs, regional disparities, inconsistent implementation, and limited longitudinal surveillance remain critical challenges. The fungal resistance landscape is marked by rising threats like Candida auris, requiring urgent expansion of AFS programs. Italy's AMR strategy would benefit from improved IPC infrastructure, realtime data integration, and alignment with One Health principles.</div></div><div><h3>Conclusions</h3><div>Strengthening national coordination, supportinginnovation, and translating surveillance into action at the local level are crucial for turning policy into measurable progress. This review provides actionable insights to guide a more unified and responsive national AMR framework.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 288-296"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948907","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}
To evaluate the prevalence of pretreatment HIV-1 resistance to integrase inhibitors in newly diagnosed patients in the general population prior to commencement of the dolutegravir era as the first-line treatment regimen in Benin.
Methods
This retrospective study employed samples described in the 2020 study by Tchiakpe and colleagues. Genotyping was carried out using both Agence nationale de recherches sur le Sida or National AIDS Research Agency (ANRS) and Applied Biosystems (Foster City, California, USA) HIV-1 Genotyping Kit PR/RT with integrase technologies. Sequences were used for viral subtype assignment and identification of resistance mutation positions using the Stanford algorithm.
Results
A total of 161 samples were correctly sequenced. The predominant HIV-1 strain isolated was CRF02_AG (118/161; 73.3%), with 4/161 (2.5%) and 21/161 (13%) patients carrying at least one drug resistance mutation associated with PIs (1/161; 0.6%), NRTIs (1/161; 0.6%), non-nucleoside reverse transcriptase inhibitors (1/161; 0.6%) and NRTIs+NNRTIs (1/161; 0.6%) on the entire protease plus part of the reverse transcriptase and one accessory integrase strand transfer inhibitor (INSTI)-associated resistance mutation, respectively. Resistance mutations associated with the protease plus part of the reverse transcriptase—I85V, K103N, M184V, and M41L—were observed in proportions of 1/161 (0.6%), 2/161 (1.2%), 1/161 (0.6%), and 1/161 (0.6%), respectively. One patient (0.6%) carried both mutations (M41L and K103N). Among the INSTI-associated resistance mutations, E157Q represented 16/161 (9.9%), followed by T97A at 2/161 (1.2%) and 1/161 (0.6%) of each H51Y, D232N, and Q95K mutation. No major INSTI-associated mutations were found.
Conclusions
The prevalence of pretreatment HIV-1 resistance to integrase in this study was zero. This study reinforces the World Health Organization vision of improving patient outcomes by introducing INSTIs as first-line treatment regimens.
{"title":"Prevalence of pretreatment HIV-1 resistance to integrase strand transfer inhibitors in newly diagnosed and antiretroviral therapy-naive adults in Benin, West Africa","authors":"Edmond Tchiakpe , Rene K. Keke , Abou Abdallah Malick Diouara , Nicole Vidal , Halimatou Diop-Ndiaye , Coumba Toure-Kane , Akadiri Yessoufou","doi":"10.1016/j.jgar.2025.11.011","DOIUrl":"10.1016/j.jgar.2025.11.011","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the prevalence of pretreatment HIV-1 resistance to integrase inhibitors in newly diagnosed patients in the general population prior to commencement of the dolutegravir era as the first-line treatment regimen in Benin.</div></div><div><h3>Methods</h3><div>This retrospective study employed samples described in the 2020 study by Tchiakpe and colleagues. Genotyping was carried out using both Agence nationale de recherches sur le Sida or National AIDS Research Agency (ANRS) and Applied Biosystems (Foster City, California, USA) HIV-1 Genotyping Kit PR/RT with integrase technologies. Sequences were used for viral subtype assignment and identification of resistance mutation positions using the Stanford algorithm.</div></div><div><h3>Results</h3><div>A total of 161 samples were correctly sequenced. The predominant HIV-1 strain isolated was CRF02_AG (118/161; 73.3%), with 4/161 (2.5%) and 21/161 (13%) patients carrying at least one drug resistance mutation associated with PIs (1/161; 0.6%), NRTIs (1/161; 0.6%), non-nucleoside reverse transcriptase inhibitors (1/161; 0.6%) and NRTIs+NNRTIs (1/161; 0.6%) on the entire protease plus part of the reverse transcriptase and one accessory integrase strand transfer inhibitor (INSTI)-associated resistance mutation, respectively. Resistance mutations associated with the protease plus part of the reverse transcriptase—I85V, K103N, M184V, and M41L—were observed in proportions of 1/161 (0.6%), 2/161 (1.2%), 1/161 (0.6%), and 1/161 (0.6%), respectively. One patient (0.6%) carried both mutations (M41L and K103N). Among the INSTI-associated resistance mutations, E157Q represented 16/161 (9.9%), followed by T97A at 2/161 (1.2%) and 1/161 (0.6%) of each H51Y, D232N, and Q95K mutation. No major INSTI-associated mutations were found.</div></div><div><h3>Conclusions</h3><div>The prevalence of pretreatment HIV-1 resistance to integrase in this study was zero. This study reinforces the World Health Organization vision of improving patient outcomes by introducing INSTIs as first-line treatment regimens.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 112-116"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564280","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}
Pub Date : 2026-01-01Epub Date: 2026-01-08DOI: 10.1016/j.jgar.2025.12.015
Xiang-Dong Wang , Dongmei Niu , Wei Lv , Lei Wang , Chen-Yu Zhang , Chunni Zhang , Jiaxi Song , Xueling Hu , Cheng Wang
Objective
Circulating non-coding small RNAs (sRNAs) have recently emerged as promising biomarkers for Mycobacterium tuberculosis (Mtb). However, little is known about the expression patterns and combined diagnostic potential of M. tuberculosis-derived sRNA (TB-sRNA) and endogenous miRNA in the circulation of patients with multidrug-resistant tuberculosis (MDR-TB).
Methods
Illumina sequencing by synthesis technology and quantitative real-time polymerase chain reaction were used to identify TB-sRNAs in serum and sputum from patients infected with drug-resistant TB, drug-sensitive TB (DS-TB), and controls. Simultaneously, four endogenous miRNAs – miR-29c, miR-132, miR-320b, and miR-548e – were chosen for further study. The diagnostic performance of significantly altered sRNAs and miRNAs was analysed using receiver operating characteristic (ROC) curves.
Results
Illumina sequencing by synthesis combined with individual quantitative real-time polymerase chain reaction verification successfully identified one TB-encoded sRNA, named TB-sRNA015, and endogenous miR-132 were significantly elevated in patients with MDR-TB compared to patients with DS-TB and controls (P < 0.01). ROC analyses showed that the area under the ROC curve (AUC) for serum sRNA015 discriminating patients with MDR-TB from controls and patients with DS-TB were 0.774 (95% confidence interval [CI], 0.653–0.895) and 0.692 (95% CI, 0.560–0.825), respectively. For serum miR-132, the AUCs were 0.841 (95% CI, 0.735–0.946) for MDR-TB vs. controls and 0.655 (95% CI, 0.518–0.793) for MDR-TB vs. DS-TB. Importantly, combining sRNA015 with miR-132 increased the AUC to 0.860 (95% CI, 0.760–0.960) for discriminating MDR-TB from controls.
Conclusions
The combination of serum sRNA015 and miR-132 may serve as an auxiliary diagnostic tool for MDR-TB infection.
{"title":"A combination of Mycobacterium tuberculosis-derived sRNA and endogenous miRNA in circulation as novel auxiliary diagnostic markers for patients with multidrug-resistant tuberculosis","authors":"Xiang-Dong Wang , Dongmei Niu , Wei Lv , Lei Wang , Chen-Yu Zhang , Chunni Zhang , Jiaxi Song , Xueling Hu , Cheng Wang","doi":"10.1016/j.jgar.2025.12.015","DOIUrl":"10.1016/j.jgar.2025.12.015","url":null,"abstract":"<div><h3>Objective</h3><div>Circulating non-coding small RNAs (sRNAs) have recently emerged as promising biomarkers for <em>Mycobacterium tuberculosis</em> (Mtb). However, little is known about the expression patterns and combined diagnostic potential of <em>M. tuberculosis</em>-derived sRNA (TB-sRNA) and endogenous miRNA in the circulation of patients with multidrug-resistant tuberculosis (MDR-TB).</div></div><div><h3>Methods</h3><div>Illumina sequencing by synthesis technology and quantitative real-time polymerase chain reaction were used to identify TB-sRNAs in serum and sputum from patients infected with drug-resistant TB, drug-sensitive TB (DS-TB), and controls. Simultaneously, four endogenous miRNAs – miR-29c, miR-132, miR-320b, and miR-548e – were chosen for further study. The diagnostic performance of significantly altered sRNAs and miRNAs was analysed using receiver operating characteristic (ROC) curves.</div></div><div><h3>Results</h3><div>Illumina sequencing by synthesis combined with individual quantitative real-time polymerase chain reaction verification successfully identified one TB-encoded sRNA, named TB-sRNA015, and endogenous miR-132 were significantly elevated in patients with MDR-TB compared to patients with DS-TB and controls (<em>P</em> < 0.01). ROC analyses showed that the area under the ROC curve (AUC) for serum sRNA015 discriminating patients with MDR-TB from controls and patients with DS-TB were 0.774 (95% confidence interval [CI], 0.653–0.895) and 0.692 (95% CI, 0.560–0.825), respectively. For serum miR-132, the AUCs were 0.841 (95% CI, 0.735–0.946) for MDR-TB vs. controls and 0.655 (95% CI, 0.518–0.793) for MDR-TB vs. DS-TB. Importantly, combining sRNA015 with miR-132 increased the AUC to 0.860 (95% CI, 0.760–0.960) for discriminating MDR-TB from controls.</div></div><div><h3>Conclusions</h3><div>The combination of serum sRNA015 and miR-132 may serve as an auxiliary diagnostic tool for MDR-TB infection.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 264-272"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948922","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}
Pub Date : 2026-01-01Epub Date: 2025-11-22DOI: 10.1016/j.jgar.2025.11.014
Carla Rivero , Melina M.B. Martínez , Nicole G. Picinin , Eduardo G. Martins , Claudio Paolazzi , Alejandra Capozzo , Denise da Silva Oliveira , Johana Becerra , Benedito M. dos Santos , Lucio H.G. de Freitas-Junior , Andrea Balan , Nilton Lincopan , Rita de Cassia Café Ferreira , Luis Carlos de Souza Ferreira , Leticia Verónica Bentancor
Objective
Bacteriophage-encoded endolysins have emerged as novel antibacterial strategies against antibiotic-resistant bacteria. We identified a bacteriophage-derived conserved sequence encoding an endolysin specific to Staphylococcus aureus. A recombinant endolysin (LysNOVA-I) was then produced, characterised and evaluated against methicillin-resistant Staphylococcus aureus (MRSA).
Methods
The endolysin gene from phage ФvB_SauS-phiIPLA88 was cloned, expressed, and successfully purified using affinity chromatography. The activity of pure recombinant endolysin (rLysNOVA-I) was subsequently evaluated against growing and non-growing planktonic cells and biofilm cultures of international MRSA clones. A computational analysis was conducted to elucidate protein folding and obtain insight into the molecular mechanisms.
Results
rLysNOVA-I exhibited bactericidal activity against both exponential and stationary growth phase S. aureus cells. rLysNOVA-I also prevented biofilm formation and degradation of established S. aureus biofilms. Notably, rLysNOVA-I was active against the MRSA clone ST398, which is of veterinary and clinical relevance.
Conclusions
Our findings highlight the clinical potential of rLysNOVA-I as a therapeutic or complementary alternative to antibiotics against multidrug-resistant S. aureus infections in human and veterinary medicine.
{"title":"Antibacterial activity of recombinant endolysin LysNOVA-I against growing/non-growing and planktonic/biofilm cultures of Staphylococcus aureus strains","authors":"Carla Rivero , Melina M.B. Martínez , Nicole G. Picinin , Eduardo G. Martins , Claudio Paolazzi , Alejandra Capozzo , Denise da Silva Oliveira , Johana Becerra , Benedito M. dos Santos , Lucio H.G. de Freitas-Junior , Andrea Balan , Nilton Lincopan , Rita de Cassia Café Ferreira , Luis Carlos de Souza Ferreira , Leticia Verónica Bentancor","doi":"10.1016/j.jgar.2025.11.014","DOIUrl":"10.1016/j.jgar.2025.11.014","url":null,"abstract":"<div><h3>Objective</h3><div>Bacteriophage-encoded endolysins have emerged as novel antibacterial strategies against antibiotic-resistant bacteria. We identified a bacteriophage-derived conserved sequence encoding an endolysin specific <em>to Staphylococcus aureus.</em> A recombinant endolysin (LysNOVA-I) was then produced, characterised and evaluated against methicillin-resistant <em>Staphylococcus aureus</em> (MRSA).</div></div><div><h3>Methods</h3><div>The endolysin gene from phage ФvB_SauS-phiIPLA88 was cloned, expressed, and successfully purified using affinity chromatography. The activity of pure recombinant endolysin (rLysNOVA-I) was subsequently evaluated against growing and non-growing planktonic cells and biofilm cultures of international MRSA clones. A computational analysis was conducted to elucidate protein folding and obtain insight into the molecular mechanisms.</div></div><div><h3>Results</h3><div>rLysNOVA-I exhibited bactericidal activity against both exponential and stationary growth phase <em>S. aureus</em> cells. rLysNOVA-I also prevented biofilm formation and degradation of established <em>S. aureus</em> biofilms. Notably, rLysNOVA-I was active against the MRSA clone ST398, which is of veterinary and clinical relevance.</div></div><div><h3>Conclusions</h3><div>Our findings highlight the clinical potential of rLysNOVA-I as a therapeutic or complementary alternative to antibiotics against multidrug-resistant <em>S. aureus</em> infections in human and veterinary medicine.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 117-125"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587775","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}
Pub Date : 2026-01-01Epub Date: 2025-10-24DOI: 10.1016/j.jgar.2025.10.016
Hanyu Wang , Xinyue Han , Aoxiao Chen , Zelin Yan , Rong Zhang , Yang Wang
Objectives
Antimicrobial resistance (AMR) in high-altitude environments remains understudied despite its growing global concern. This study investigates the molecular epidemiology of the optrA gene, which confers resistance to oxazolidinones and phenicols, in Enterococcus species isolated from herders and yak faecal samples in Nagqu, Tibet, China.
Methods
A total of 161 faecal samples from herders and 42 from yaks were collected and analysed for the presence of optrA-positive Enterococcus strains. Antimicrobial susceptibility testing (AST) was performed to determine resistance patterns. Whole-genome sequencing (WGS) and phylogenetic analysis were used to assess genetic relationships and the potential for clonal spread and horizontal gene transfer.
Results
The optrA gene was detected in 6.2% (10/161) of human samples and 9.5% (4/42) of yak samples, indicating a higher prevalence in yaks. Resistance was highest for tetracycline (100%), erythromycin (92.9%), and linezolid (92.9%). Phylogenetic analysis revealed clonal dissemination, with some isolates exhibiting high genetic homology. Notably, one E. faecalis strain belonged to ST16, a sequence type commonly found in low-altitude cities, suggesting potential transmission between regions. The optrA gene was frequently associated with mobile genetic elements, indicating a risk of horizontal gene transfer and further dissemination of resistance.
Conclusion
The presence of optrA-positive Enterococcus in both human and animal populations in this high-altitude region underscores the role of human-animal interactions in AMR transmission. The increasing prevalence of resistant strains in yaks, coupled with genetic evidence of clonal expansion, highlights the need for a comprehensive One Health approach to AMR surveillance and mitigation in remote, high-altitude environments.
{"title":"Prevalence and molecular epidemiology of optrA-positive Enterococcus in herders and yaks from high-altitude Tibet, China","authors":"Hanyu Wang , Xinyue Han , Aoxiao Chen , Zelin Yan , Rong Zhang , Yang Wang","doi":"10.1016/j.jgar.2025.10.016","DOIUrl":"10.1016/j.jgar.2025.10.016","url":null,"abstract":"<div><h3>Objectives</h3><div>Antimicrobial resistance (AMR) in high-altitude environments remains understudied despite its growing global concern. This study investigates the molecular epidemiology of the <em>optrA</em> gene, which confers resistance to oxazolidinones and phenicols, in <em>Enterococcus</em> species isolated from herders and yak faecal samples in Nagqu, Tibet, China.</div></div><div><h3>Methods</h3><div>A total of 161 faecal samples from herders and 42 from yaks were collected and analysed for the presence of <em>optrA</em>-positive <em>Enterococcus</em> strains. Antimicrobial susceptibility testing (AST) was performed to determine resistance patterns. Whole-genome sequencing (WGS) and phylogenetic analysis were used to assess genetic relationships and the potential for clonal spread and horizontal gene transfer.</div></div><div><h3>Results</h3><div>The <em>optrA</em> gene was detected in 6.2% (10/161) of human samples and 9.5% (4/42) of yak samples, indicating a higher prevalence in yaks. Resistance was highest for tetracycline (100%), erythromycin (92.9%), and linezolid (92.9%). Phylogenetic analysis revealed clonal dissemination, with some isolates exhibiting high genetic homology. Notably, one <em>E. faecalis</em> strain belonged to ST16, a sequence type commonly found in low-altitude cities, suggesting potential transmission between regions. The <em>optrA</em> gene was frequently associated with mobile genetic elements, indicating a risk of horizontal gene transfer and further dissemination of resistance.</div></div><div><h3>Conclusion</h3><div>The presence of <em>optrA</em>-positive <em>Enterococcus</em> in both human and animal populations in this high-altitude region underscores the role of human-animal interactions in AMR transmission. The increasing prevalence of resistant strains in yaks, coupled with genetic evidence of clonal expansion, highlights the need for a comprehensive One Health approach to AMR surveillance and mitigation in remote, high-altitude environments.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 1-5"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370299","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}
Pub Date : 2026-01-01Epub Date: 2025-12-16DOI: 10.1016/j.jgar.2025.12.009
Jee Hong KIM , Hyunkeun KIM , Kwan Soo KO
Objective
DNA methylation, catalysed by DNA methyltransferases (MTases), plays a crucial role in bacterial physiology. In this study, we investigated the effects of the DNA MTases, DNA adenine methyltransferase (Dam) and DNA cytosine methyltransferase (Dcm), on bacterial fitness and mutation rates in Escherichia coli.
Methods
We constructed an E. coli K-12 MG1655 strain lacking both the dam and dcm genes (ΔdamΔdcm). The bacterial fitness was assessed using growth curves and competition assays. Antibiotic susceptibility and persister cell formation were also evaluated. Additionally, the spontaneous mutation rates and mutation types in response to rifampicin and colistin were analysed.
Results
The MTase-deficient mutant ΔdamΔdcm exhibited significantly reduced growth rates and competitiveness compared to the wild-type (WT) strain. However, no significant differences in antibiotic resistance or persister cell formation rates were observed between the mutant and WT strains. Mutation frequencies in ΔdamΔdcm were significantly higher than in the WT when exposed to both rifampicin and colistin. Furthermore, a higher ratio of transition mutations in the rpoB and pmrAB genes was observed in rifampicin-resistant and colistin-resistant colonies derived from ΔdamΔdcm, respectively. DNA methylation influences bacterial growth and competitiveness, and the absence of MTases leads to increased spontaneous mutation rates under antibiotic pressure.
Conclusions
These findings suggest that DNA methylation plays a critical role in maintaining genomic stability and contributing to the development of antibiotic resistance.
{"title":"Impact of DNA methyltransferases on bacterial fitness and genome stability in Escherichia coli","authors":"Jee Hong KIM , Hyunkeun KIM , Kwan Soo KO","doi":"10.1016/j.jgar.2025.12.009","DOIUrl":"10.1016/j.jgar.2025.12.009","url":null,"abstract":"<div><h3>Objective</h3><div>DNA methylation, catalysed by DNA methyltransferases (MTases), plays a crucial role in bacterial physiology. In this study, we investigated the effects of the DNA MTases, DNA adenine methyltransferase (Dam) and DNA cytosine methyltransferase (Dcm), on bacterial fitness and mutation rates in <em>Escherichia coli.</em></div></div><div><h3>Methods</h3><div>We constructed an <em>E. coli</em> K-12 MG1655 strain lacking both the <em>dam</em> and <em>dcm</em> genes (Δ<em>dam</em>Δ<em>dcm</em>). The bacterial fitness was assessed using growth curves and competition assays. Antibiotic susceptibility and persister cell formation were also evaluated. Additionally, the spontaneous mutation rates and mutation types in response to rifampicin and colistin were analysed.</div></div><div><h3>Results</h3><div>The MTase-deficient mutant Δ<em>dam</em>Δ<em>dcm</em> exhibited significantly reduced growth rates and competitiveness compared to the wild-type (WT) strain. However, no significant differences in antibiotic resistance or persister cell formation rates were observed between the mutant and WT strains. Mutation frequencies in Δ<em>dam</em>Δ<em>dcm</em> were significantly higher than in the WT when exposed to both rifampicin and colistin. Furthermore, a higher ratio of transition mutations in the <em>rpoB</em> and <em>pmrAB</em> genes was observed in rifampicin-resistant and colistin-resistant colonies derived from Δ<em>dam</em>Δ<em>dcm</em>, respectively. DNA methylation influences bacterial growth and competitiveness, and the absence of MTases leads to increased spontaneous mutation rates under antibiotic pressure.</div></div><div><h3>Conclusions</h3><div>These findings suggest that DNA methylation plays a critical role in maintaining genomic stability and contributing to the development of antibiotic resistance.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 203-208"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781070","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}
Pub Date : 2026-01-01Epub Date: 2025-10-24DOI: 10.1016/j.jgar.2025.10.013
Emre Yucel , Alex Soriano , David L. Paterson , Florian Thalhalmmer , Stefan Kluge , Pierluigi Viale , Mike Allen , Brune Akrich , Jessica Levy , Huina Yang , Sunny Kaul
Objectives
Infections by antimicrobial-resistant, Gram-negative bacteria present significant global challenge, resulting in difficult treatment scenarios and poor clinical outcomes. Although ceftolozane/tazobactam (C/T) has been approved for the treatment of hospital-acquired HABP/VABP, cUTI, and cIAI, data on real-world use remains limited. This study presents real-world use of C/T across various countries.
Methods
The Study of Prescribing patterns and Effectiveness of Ceftolozane/Tazobactam: Real-world Analysis (SPECTRA) was a retrospective, observational study involving 617 adult inpatients across seven countries who were treated with C/T for at least 48 hours between 2016 and 2020. The primary objective was to describe real-world utilisation of C/T, focusing on sociodemographic and clinical characteristics, treatment patterns, clinical outcomes, and resource utilisation.
Results
617 patients from seven countries were included. Prevalence of at least one comorbidity ranged from 55.9% (Mexico) to 91.7% (Austria), with mean number of comorbidities from 1.0 (Mexico) to 2.7 (UK). Culture results from 72.7% patients identified MDR Pseudomonas aeruginosa, ranging from 55.9% (Italy) to 80.6% (Spain). Median hospital length of stay ranged from 23 (Mexico) to 53.5 (Austria) days. Clinical success rate for treating the index infection with C/T was 64.8%, with 51.1% of cases treated within the ICU.
Conclusions
This multi-national, retrospective, observational study demonstrates the real-world use and healthcare resource utilisation (HCRU) of C/T in patients with Gram-negative infections across seven countries. These findings provide valuable insights into prescribing patterns and resource implications of C/T treatment, underscoring the importance of real-world data to inform clinical practice and optimise antimicrobial therapy in diverse healthcare settings.
{"title":"Ceftolozane/tazobactam in action: Prescribing patterns, effectiveness, and healthcare utilisation across seven countries","authors":"Emre Yucel , Alex Soriano , David L. Paterson , Florian Thalhalmmer , Stefan Kluge , Pierluigi Viale , Mike Allen , Brune Akrich , Jessica Levy , Huina Yang , Sunny Kaul","doi":"10.1016/j.jgar.2025.10.013","DOIUrl":"10.1016/j.jgar.2025.10.013","url":null,"abstract":"<div><h3>Objectives</h3><div>Infections by antimicrobial-resistant, Gram-negative bacteria present significant global challenge, resulting in difficult treatment scenarios and poor clinical outcomes. Although ceftolozane/tazobactam (C/T) has been approved for the treatment of hospital-acquired HABP/VABP, cUTI, and cIAI, data on real-world use remains limited. This study presents real-world use of C/T across various countries.</div></div><div><h3>Methods</h3><div>The Study of Prescribing patterns and Effectiveness of Ceftolozane/Tazobactam: Real-world Analysis (SPECTRA) was a retrospective, observational study involving 617 adult inpatients across seven countries who were treated with C/T for at least 48 hours between 2016 and 2020. The primary objective was to describe real-world utilisation of C/T, focusing on sociodemographic and clinical characteristics, treatment patterns, clinical outcomes, and resource utilisation.</div></div><div><h3>Results</h3><div>617 patients from seven countries were included. Prevalence of at least one comorbidity ranged from 55.9% (Mexico) to 91.7% (Austria), with mean number of comorbidities from 1.0 (Mexico) to 2.7 (UK). Culture results from 72.7% patients identified MDR <em>Pseudomonas aeruginosa</em>, ranging from 55.9% (Italy) to 80.6% (Spain). Median hospital length of stay ranged from 23 (Mexico) to 53.5 (Austria) days. Clinical success rate for treating the index infection with C/T was 64.8%, with 51.1% of cases treated within the ICU.</div></div><div><h3>Conclusions</h3><div>This multi-national, retrospective, observational study demonstrates the real-world use and healthcare resource utilisation (HCRU) of C/T in patients with Gram-negative infections across seven countries. These findings provide valuable insights into prescribing patterns and resource implications of C/T treatment, underscoring the importance of real-world data to inform clinical practice and optimise antimicrobial therapy in diverse healthcare settings.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 14-21"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623450","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}
Pub Date : 2026-01-01Epub Date: 2025-11-10DOI: 10.1016/j.jgar.2025.11.003
A.C. Ka’e , F. Bassani , O. El Khalili , A. Bezenchek , F. Carli , A. Pupo , E. Gentilini Cacciola , L. Pezzati , L. Duca , I. Vicenti , W. Gennari , F. Lombardi , A. Shallvari , F. Saladini , V. Micheli , A. Cozzi-Lepri , A. Lai , M.M. Santoro , S. Rusconi , the ARCA Study Group
Objective
We evaluated the prevalence of HIV-1 drug resistance in newly diagnosed individuals from 2017 to 2023, in Italy.
Methods
Transmitted drug resistance (TDR) was evaluated by using the HIVdb algorithm (https://hivdb.stanford.edu/), through two different approaches: (1) by considering the complete list of mutations included for the genotypic susceptibility score and (2) by considering only major resistant mutations. Logistic regression analysis was used to estimate the association of TDR with the calendar year.
Results
We analysed 1188 drug-naive individuals diagnosed in Italy between 2017 and 2023 enrolled in the Antiviral Response Cohort Analysis database. Most of them (∼75 %) were males; their median (IQR) age was 40 (30–50) years. Non-B subtypes were found in 43.9 % of participants and significantly increased over time (from 44.2 % in 2017 to 54.8 % in 2023, P = 0.008). TDR prevalence was 29 %, driven by non-nucleoside reverse transcriptase inhibitor resistance (19.4 %). Rates of nucleoside reverse transcriptase inhibitors, protease inhibitors, and integrase strand transfer inhibitors resistance were 4.7 %, 4.4 %, and 5.1 %, respectively, with no significant temporal trends. When only major resistant mutations were considered, TDR prevalence was definitively lower (15.8 %), primarily driven by non-nucleoside reverse transcriptase inhibitor mutations (11.8 %). Rates of resistance for major nucleoside reverse transcriptase inhibitors, protease inhibitors, and integrase strand transfer inhibitors were 4.6 %, 1.7 % and 0.7 %, respectively. Resistance to two or more drug classes was rare (1.9 %). No association of major TDR within the calendar year was found, except for 2023 (AOR: 2.33 [1.14–4.74], P = 0.019).
Conclusions
Over the period 2017–2023, the HIV-1 TDR appeared generally stable in Italy. However, the increased prevalence of major TDR in 2023 confirms the importance of continuous TDR surveillance in newly diagnosed individuals to inform clinical practice.
{"title":"Evaluation of HIV-1 drug resistance in newly diagnosed individuals in Italy over the period 2017–2023","authors":"A.C. Ka’e , F. Bassani , O. El Khalili , A. Bezenchek , F. Carli , A. Pupo , E. Gentilini Cacciola , L. Pezzati , L. Duca , I. Vicenti , W. Gennari , F. Lombardi , A. Shallvari , F. Saladini , V. Micheli , A. Cozzi-Lepri , A. Lai , M.M. Santoro , S. Rusconi , the ARCA Study Group","doi":"10.1016/j.jgar.2025.11.003","DOIUrl":"10.1016/j.jgar.2025.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>We evaluated the prevalence of HIV-1 drug resistance in newly diagnosed individuals from 2017 to 2023, in Italy.</div></div><div><h3>Methods</h3><div>Transmitted drug resistance (TDR) was evaluated by using the HIVdb algorithm (<span><span>https://hivdb.stanford.edu/</span><svg><path></path></svg></span>), through two different approaches: (1) by considering the complete list of mutations included for the genotypic susceptibility score and (2) by considering only major resistant mutations. Logistic regression analysis was used to estimate the association of TDR with the calendar year.</div></div><div><h3>Results</h3><div>We analysed 1188 drug-naive individuals diagnosed in Italy between 2017 and 2023 enrolled in the Antiviral Response Cohort Analysis database. Most of them (∼75 %) were males; their median (IQR) age was 40 (30–50) years. Non-B subtypes were found in 43.9 % of participants and significantly increased over time (from 44.2 % in 2017 to 54.8 % in 2023, <em>P</em> = 0.008). TDR prevalence was 29 %, driven by non-nucleoside reverse transcriptase inhibitor resistance (19.4 %). Rates of nucleoside reverse transcriptase inhibitors, protease inhibitors, and integrase strand transfer inhibitors resistance were 4.7 %, 4.4 %, and 5.1 %, respectively, with no significant temporal trends. When only major resistant mutations were considered, TDR prevalence was definitively lower (15.8 %), primarily driven by non-nucleoside reverse transcriptase inhibitor mutations (11.8 %). Rates of resistance for major nucleoside reverse transcriptase inhibitors, protease inhibitors, and integrase strand transfer inhibitors were 4.6 %, 1.7 % and 0.7 %, respectively. Resistance to two or more drug classes was rare (1.9 %). No association of major TDR within the calendar year was found, except for 2023 (AOR: 2.33 [1.14–4.74], <em>P</em> = 0.019).</div></div><div><h3>Conclusions</h3><div>Over the period 2017–2023, the HIV-1 TDR appeared generally stable in Italy. However, the increased prevalence of major TDR in 2023 confirms the importance of continuous TDR surveillance in newly diagnosed individuals to inform clinical practice.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 38-45"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145504984","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}
Pub Date : 2026-01-01Epub Date: 2026-01-08DOI: 10.1016/j.jgar.2026.01.001
Magdalena Gatsch , Charlotte Aldridge , Kasim Allel , Hassanat Mojirola Lawal , Esmita Charani , Emma Pitchforth
Introduction
Antimicrobial resistance (AMR) is a major global health threat addressed through National Action Plans (NAPs) aligned with the WHO Global Action Plan. Despite evidence that women are disproportionately affected – receiving 27% more antibiotic prescriptions than men – gender considerations remain largely absent from AMR policies.
Methods
We conducted a mixed-methods analysis of 132 NAPs published before December 2023. A two-stage approach was used: quantitative keyword frequency analysis of 10 gender-related terms (e.g., sex, gender, women), followed by a qualitative thematic analysis of top-tier NAPs, defined as those scoring ≥3 gender-related terms on a 10-point frequency scale derived from the former quantitative analysis. We also examined the gender composition of NAP curators and assessed correlations between gender representation and keyword inclusion.
Results
Only 14 NAPs (11%) mentioned the term ‘gender’. The most frequent gender-related term was ‘urinary tract infection’ (UTI), appearing in 33% of NAPs. High-scoring NAPs were predominantly from low-income countries (mean score 2.4, SD = 2.2), especially in Africa (mean 2.5, SD = 2.3), compared to upper-middle-income countries (mean 1.1, SD = 1.07) and the Pan-American region (mean 1.0, SD = 0.9). Women were underrepresented among NAP curators: 47 NAPs were led entirely by men, while only 14 were led by women. No significant correlation was found between women’s participation and gender keyword inclusion (β ≈ 0.11, P = 0.449).
Conclusion
Gender remains insufficiently integrated into AMR NAPs. The findings highlight the need for gender awareness policy development and the adoption of an intersectional framework to address overlapping social determinants that shape AMR vulnerability and response.
{"title":"Deconstructing antimicrobial resistance national action plans: A gender-perspective driven mixed-methods analysis","authors":"Magdalena Gatsch , Charlotte Aldridge , Kasim Allel , Hassanat Mojirola Lawal , Esmita Charani , Emma Pitchforth","doi":"10.1016/j.jgar.2026.01.001","DOIUrl":"10.1016/j.jgar.2026.01.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Antimicrobial resistance (AMR) is a major global health threat addressed through National Action Plans (NAPs) aligned with the WHO Global Action Plan. Despite evidence that women are disproportionately affected – receiving 27% more antibiotic prescriptions than men – gender considerations remain largely absent from AMR policies.</div></div><div><h3>Methods</h3><div>We conducted a mixed-methods analysis of 132 NAPs published before December 2023. A two-stage approach was used: quantitative keyword frequency analysis of 10 gender-related terms (e.g., sex, gender, women), followed by a qualitative thematic analysis of top-tier NAPs, defined as those scoring ≥3 gender-related terms on a 10-point frequency scale derived from the former quantitative analysis. We also examined the gender composition of NAP curators and assessed correlations between gender representation and keyword inclusion.</div></div><div><h3>Results</h3><div>Only 14 NAPs (11%) mentioned the term ‘gender’. The most frequent gender-related term was ‘urinary tract infection’ (UTI), appearing in 33% of NAPs. High-scoring NAPs were predominantly from low-income countries (mean score 2.4, SD = 2.2), especially in Africa (mean 2.5, SD = 2.3), compared to upper-middle-income countries (mean 1.1, SD = 1.07) and the Pan-American region (mean 1.0, SD = 0.9). Women were underrepresented among NAP curators: 47 NAPs were led entirely by men, while only 14 were led by women. No significant correlation was found between women’s participation and gender keyword inclusion (β ≈ 0.11, <em>P</em> = 0.449).</div></div><div><h3>Conclusion</h3><div>Gender remains insufficiently integrated into AMR NAPs. The findings highlight the need for gender awareness policy development and the adoption of an intersectional framework to address overlapping social determinants that shape AMR vulnerability and response.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 273-282"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948968","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}
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