Global Survey on the Management of Multidrug-resistant Gram-negative Bacilli: Divergence of Practice Between High-Income Countries and the Rest of the World
5
Issued Date
2026-05-15
Resource Type
ISSN
10584838
eISSN
15376591
Scopus ID
2-s2.0-105040843039
Pubmed ID
42227055
Journal Title
Clinical Infectious Diseases
Volume
82
Start Page
S105
End Page
S115
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Infectious Diseases Vol.82 (2026) , S105-S115
Suggested Citation
Manesh A., Aslan A.T., Mohan George M., Sulaiman H., Huttner A., Mathers A.J., Zavascki A.P., Mo Y., Yahav D., Rando E., Boyles T., Wang M., Palanikumar P., Varghese G.M., Paterson D.L. Global Survey on the Management of Multidrug-resistant Gram-negative Bacilli: Divergence of Practice Between High-Income Countries and the Rest of the World. Clinical Infectious Diseases Vol.82 (2026) , S105-S115. S115. doi:10.1093/cid/ciag025 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/117254
Title
Global Survey on the Management of Multidrug-resistant Gram-negative Bacilli: Divergence of Practice Between High-Income Countries and the Rest of the World
Author's Affiliation
National University of Singapore
Fudan University
Tel Aviv University
Universidade Federal do Rio Grande do Sul
Universiti Malaya
University of the Witwatersrand, Johannesburg
University of Virginia School of Medicine
Università Cattolica del Sacro Cuore, Campus di Roma
Hôpitaux Universitaires de Genève
Chaim Sheba Medical Center Israel
NUS Yong Loo Lin School of Medicine
Nuffield Department of Medicine
National University Hospital
Christian Medical College, Vellore
UQ Centre for Clinical Research
Mahidol Oxford Tropical Medicine Research Unit
Department of Medicine
Hospital Moinhos de Vento
Fudan University
Tel Aviv University
Universidade Federal do Rio Grande do Sul
Universiti Malaya
University of the Witwatersrand, Johannesburg
University of Virginia School of Medicine
Università Cattolica del Sacro Cuore, Campus di Roma
Hôpitaux Universitaires de Genève
Chaim Sheba Medical Center Israel
NUS Yong Loo Lin School of Medicine
Nuffield Department of Medicine
National University Hospital
Christian Medical College, Vellore
UQ Centre for Clinical Research
Mahidol Oxford Tropical Medicine Research Unit
Department of Medicine
Hospital Moinhos de Vento
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Multidrug-resistant gram-negative bacterial (MDR GNB) infections are associated with high mortality. The evidence base for the management of these infections is weak. Major international bodies have recently offered guidance on managing these infections. Their impact on real-life practice is unknown. Methods: We conducted an online survey utilizing a 123-item questionnaire among healthcare professionals managing patients with serious MDR GNB infections via national societies and professional networks. Results: A total of 1320 respondents from 76 countries completed the survey. The primary area of practice was adult infectious diseases (56.2%; 739/1320), followed by clinical microbiology (13.0%; 171/1320). There were significant differences among preferred first-choice agents (assuming all drugs were available) across infection syndromes in all regions (eg, polymyxins as first choice for carbapenem-resistant Enterobacterales [CRE] KPC; 5/381 in high-income countries [HICs] vs 24/390 in the rest of the world; P < .001), but more pronounced in low- and middle-income countries (LMICs). The greatest disparities in antibiotic availability were seen with cefiderocol, ceftolozane–tazobactam, eravacycline, meropenem–vaborbactam, and imipenem–cilastatin–relebactam. Conclusions: Management practices for carbapenem-resistant gram-negative pneumonia and bacteremia vary widely, complicated by limited access to new antimicrobial agents in the LMICs. Evaluations of the potential impact of these new antimicrobial agents on the outcome of infections in LMICs are urgently needed.