Avian flu virus detected in South Dakota dairy herd – University of Minnesota Twin Cities

Stephanie Rossow / CDC

Carbapenem-resistant and difficult-to-treat (DTR) gram-negative priority pathogens are increasing in most regions of the world, according to ananalysis of global surveillance data published yesterday in the Journal of Global Antimicrobial Resistance.

Using isolates collected by the Antimicrobial Testing Leadership and Surveillance (ATLAS) global surveillance program from 157 medical centers in 49 countries from 2018 to 2022, an international team of researchers conducted antimicrobial susceptibility testing on 79,214 Enterobacterales, 30,504 Pseudomonas aeruginosa, and 13,500 Acinetobacter baumannii-calcoaceticus complex isolates, which are all on the World Health Organization's list of critical priority pathogens.

They focused on carbapenem resistance and the DTR phenotype, defined as non-susceptibility to all first-line antibiotics used to treat serious infections.

Percentages of carbapenem-resistant Enterobacterales (CRE) resistance increased in the Asia Pacific, Europe, Latin America, Middle East-Africa regions but declined in North America, while annual DTR percentages increased in all five regions. Rates of carbapenem-resistant P aeruginosa (CRPA) and carbapenem-resistant A baumannii-calcoaceticus complex (CRAB) remained stable across all regions, but rates of CRAB and DTR A baumannii-calcoaceticus complex were consistently more than 25 percentage points lower in North America.

Analysis of countries from each region found significant and consistent increases in CRE (10.3% in 2018 to 35.6% in 2022) and CRPA (16.5% to 55.6%) in Brazil, high CRAB rates (more than 84% each year), and increasing detection of CRE (4.4% to 15.4%) in South Africa. For all regions except North America, most changes in CRE rates could be attributed to hospital-acquired infections.

The study authors say that while the findings may have been influenced by the COVID-19 pandemic, which saw increased inappropriate antibiotic use and disruption of infection prevention and control (IPC) measures, the global increase in gram-negative antimicrobial resistance indicates that current antimicrobial stewardship and IPC initiatives aren't getting the job done.

"Decisive action is needed to prevent and control the spread of antimicrobial-resistant pathogens," they wrote. "All initiatives to curb antimicrobial resistance must be supported by continued surveillance at local, national, regional, and global levels."

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Avian flu virus detected in South Dakota dairy herd - University of Minnesota Twin Cities