Rehab El-SokkarySerhat UysalHakan ErdemRavina KullarAbdullah Umut PekokFatma AmerSvjetlana GrgićBiljana CarevicAmani El-KholyAnna LiskovaMehmet ÖzdemirEjaz Ahmed KhanYesim Uygun-KizmazNenad PandakNirav PandyaJurica ArapovićRıdvan KaraaliNefise OztoprakMichael M. PetrovRami AlabadlaHandan AlayJehan Ali El KholyCaroline LandelleReham KhedrDhruv MamtoraGorana DragovacRicardo FernandezEmine Unal EvrenLul RakaAntonio CascioNicolas DaubyAhsen OnculSafak Ozer BalinYasemin CagNatalia DiraniMustafa DoganIrina Magdalena DumitruMaha Ali GadIlad Alavi DarazamBehrouz NaghiliRosa Fontana Del VecchioMonica LickerAndrea MarinoNasim AkhtarMostafa KamalGoffredo AngioniDeana MedićAliye EsmaoğluSzabo Balint GergelyAndré Silva-PintoLurdes SantosIonela Larisa MiftodeRecep TekinPhunsup WongsurakiatMumtaz Ali KhanYesim KurekciHema Prakash PilliKrsto GrozdanovskiEgidia MiftodeRusmir BaljicHaluk VahabolguJordi RelloShifa Tameer-e-Millat UniversitySiriraj HospitalUniversity of Health SciencesUniversity of KyreniaChildren's Cancer Hospital 57357ATS Sardegna, ASSL Cagliari SS. TrinitàVall d'Hebron Institut de RecercaNational Institute of Public Health of KosovoUniversity of MostarUniversite Grenoble AlpesNecmettin Erbakan ÜniversitesiIstanbul Medeniyet UniversityBhailal Amin General HospitalNamik Kemal ÜniversitesiRoyal HospitalKlinicki Centar SrbijeMEDICINSKI FAKULTETPakistan Institute of Medical SciencesNational Institute of Health PakistanMedical University of PlovdivTabriz University of Medical SciencesErciyes University, Faculty of MedicineGandhi Institute of Technology and Management, VisakhapatnamKasr El-Aini School of MedicineOvidius University of ConstantaShahid Beheshti University of Medical SciencesDicle University, Faculty of MedicineUniversità degli Studi di PalermoUniversitatea de Medicina si Farmacie Victor Babes din TimisoaraAtaturk University, Faculty of MedicineZagazig University, Faculty of Medicineİstanbul University-Cerrahpaşa Cerrahpaşa Faculty of MedicineUniversità degli Studi di CataniaFirat Üniversitesi Tip FakültesiUniversité Libre de BruxellesSouth-Pest Central HospitalSt. Elisabeth University of Health Care and Social Work“Sf. Parascheva” Infectious Diseases Clinical HospitalDar Al Amal University HospitalID-IRI Lead CoordinatorArnavutkoy State HospitalKanuni Training and Research HospitalUniversity Clinical Hospital MostarUniversity Clinic for Infectious DiseasesSisli Hamidiye Etfal Education and Research HospitalCentro Hospitalar Universitário de São JoãoKCU Sarajevo.Kartal Koşuyolu High Speciality Training and Research HospitalEuropean Gaza HospitalRMCHHospital Municipal de San JuanPendik State HospitalUmberto I HospitalS.L. Raheja Hospital2022-08-042022-08-042021-11-01European Journal of Clinical Microbiology and Infectious Diseases. Vol.40, No.11 (2021), 2323-233414354373093497232-s2.0-85117479837https://repository.li.mahidol.ac.th/handle/20.500.14594/77718Evaluating trends in antibiotic resistance is a requisite. The study aimed to analyze the profile of multidrug-resistant organisms (MDROs) among hospitalized patients with bacteremia in intensive care units (ICUs) in a large geographical area. This is a 1-month cross-sectional survey for blood-borne pathogens in 57 ICUs from 24 countries with different income levels: lower-middle-income (LMI), upper-middle-income (UMI), and high-income (HI) countries. Multidrug-resistant (MDR), extensively drug-resistant (XDR), or pan-drug-resistant isolates were searched. Logistic regression analysis determined resistance predictors among MDROs. Community-acquired infections were comparable to hospital-acquired infections particularly in LMI (94/202; 46.5% vs 108/202; 53.5%). Although MDR (65.1%; 502/771) and XDR (4.9%; 38/771) were common, no pan-drug-resistant isolate was recovered. In total, 32.1% of MDR were Klebsiella pneumoniae, and 55.3% of XDR were Acinetobacter baumannii. The highest MDR and XDR rates were in UMI and LMI, respectively, with no XDR revealed from HI. Predictors of MDR acquisition were male gender (OR, 12.11; 95% CI, 3.025–15.585) and the hospital-acquired origin of bacteremia (OR, 2.643; 95%CI, 1.462–3.894), and XDR acquisition was due to bacteremia in UMI (OR, 3.344; 95%CI, 1.189–5.626) and admission to medical-surgical ICUs (OR, 1.481; 95% CI, 1.076–2.037). We confirm the urgent need to expand stewardship activities to community settings especially in LMI, with more paid attention to the drugs with a higher potential for resistance. Empowering microbiology laboratories and reports to direct prescribing decisions should be prioritized. Supporting stewardship in ICUs, the mixed medical-surgical ones in particular, is warranted.Mahidol UniversityMedicineArticleSCOPUS10.1007/s10096-021-04288-1