TY - JOUR
T1 - Antimicrobial resistance among Gram-negative agents of bacteraemia in the UK and Ireland
T2 - trends from 2001 to 2019
AU - Reynolds, Rosy
AU - Mushtaq, Shazad
AU - Hope, Russell
AU - Horner, Carolyne
AU - Adkin, Rachael
AU - Chaudhry, Aiysha
AU - Nsonwu, Olisaeloka
AU - Allen, Michael
AU - Longshaw, Christopher
AU - Parcell, Benjamin J.
AU - Livermore, David M.
N1 - Publisher Copyright:
© The Author(s) 2025. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.
PY - 2025/10/27
Y1 - 2025/10/27
N2 - Objectives: The BSAC Bacteraemia Resistance Surveillance Programme collected isolates from UK and Irish hospitals for central testing. Concurrent UKHSA surveillance collected English hospitals’ own susceptibility data. Results were reviewed and compared. Methods: The BSAC surveillance collected fixed quotas of isolates per site annually from 2001 to 2019. MIC testing was by BSAC agar dilution. Resistance mechanisms were investigated by synergy tests, interpretive reading and PCR. The UKHSA seeks data on all bacteraemia isolates in England. Results: For Escherichia coli, which now causes >30% of all bacteraemias, there were marked early (2002–06) rises in resistance to cephalosporins, fluoroquinolones and gentamicin, followed by small falls, stabilization, then from around 2015, very slow rises, with similar patterns seen for Klebsiella pneumoniae. Most cephalosporin resistance in these two species involved ESBLs, principally CTX-M types. Both species had frequent co-amoxiclav resistance. Cephalosporin resistance—mostly AmpC-mediated—declined in Enterobacter and Serratia spp., as did fluoroquinolone resistance, likely reflecting reduced use and selection pressure. Proteeae showed few changes; increasing dominance of Proteus mirabilis in the BSAC collection was not confirmed by the UKHSA dataset. Resistance in Pseudomonas aeruginosa was uncommon and showed little temporal change in either dataset. Carbapenemases remained extremely rare in all species. Newer and developmental agents covered many resistance types, but none covered all types. Conclusions: Except for early rises of cephalosporin, fluoroquinolone and gentamicin resistance in E. coli and K. pneumoniae, there was little evidence for rising resistance and some evidence of declining resistance, notably in species where it predominantly involves AmpC derepression.
AB - Objectives: The BSAC Bacteraemia Resistance Surveillance Programme collected isolates from UK and Irish hospitals for central testing. Concurrent UKHSA surveillance collected English hospitals’ own susceptibility data. Results were reviewed and compared. Methods: The BSAC surveillance collected fixed quotas of isolates per site annually from 2001 to 2019. MIC testing was by BSAC agar dilution. Resistance mechanisms were investigated by synergy tests, interpretive reading and PCR. The UKHSA seeks data on all bacteraemia isolates in England. Results: For Escherichia coli, which now causes >30% of all bacteraemias, there were marked early (2002–06) rises in resistance to cephalosporins, fluoroquinolones and gentamicin, followed by small falls, stabilization, then from around 2015, very slow rises, with similar patterns seen for Klebsiella pneumoniae. Most cephalosporin resistance in these two species involved ESBLs, principally CTX-M types. Both species had frequent co-amoxiclav resistance. Cephalosporin resistance—mostly AmpC-mediated—declined in Enterobacter and Serratia spp., as did fluoroquinolone resistance, likely reflecting reduced use and selection pressure. Proteeae showed few changes; increasing dominance of Proteus mirabilis in the BSAC collection was not confirmed by the UKHSA dataset. Resistance in Pseudomonas aeruginosa was uncommon and showed little temporal change in either dataset. Carbapenemases remained extremely rare in all species. Newer and developmental agents covered many resistance types, but none covered all types. Conclusions: Except for early rises of cephalosporin, fluoroquinolone and gentamicin resistance in E. coli and K. pneumoniae, there was little evidence for rising resistance and some evidence of declining resistance, notably in species where it predominantly involves AmpC derepression.
UR - https://www.scopus.com/pages/publications/105019999819
U2 - 10.1093/jac/dkaf250
DO - 10.1093/jac/dkaf250
M3 - Article
C2 - 41140275
AN - SCOPUS:105019999819
SN - 0305-7453
VL - 80
SP - iv36-iv48
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
IS - Issue Supplement_4
ER -
