London Resolution on Antimicrobial Resistance – 2025

Effects of laboratory capabilities on combating antimicrobial resistance, 2013-2016: A static model panel data analysis.

Simple SummaryThe objective of this study was to evaluate the knowledge, attitudes, and practices (KAP) of broiler poultry farmers (BPF) in Nepal concerning the use of antimicrobials (AMU) and the issue of antimicrobial resistance (AMR). A total of 500 farmers from all seven provinces of Nepal, spanning 40 districts, participated in this study. The collected data, encompassing AMU, demographic distribution, and KAP regarding AMU and AMR among BPF, underwent descriptive statistic and logistic regression analysis. This study’s results revealed that BPF possessed limited understanding and engagement in practices related to AMU and AMR, whereas they exhibited positive attitudes. This highlights the importance of implementing effective regulatory measures, improving veterinary services, and providing training and awareness programs to address the issue of AMR in the poultry farming sector.The purpose of this study was twofold: first, to conduct a situational analysis, and second, to assess the knowledge, attitudes, and practices (KAP) of broiler poultry farmers (BPF) regarding antimicrobial use (AMU) and antimicrobial resistance (AMR). Data were collected from 500 BPF across 40 districts, representing 88.1% of Nepal’s broiler poultry population. Among these farmers, 81.0% were male, 59.6% had up to 4 years of experience in poultry farming, and 50.8% had completed at least a high school education. The most used antimicrobials on the farms were doxycycline (23.5%), neomycin (17.1%), and colistin sulfate (9.6%) out of 27 reported antimicrobials. While the BPF exhibited limited knowledge (62.6%) and practice (55.5%) related to AMU and AMR, their overall attitude toward these issues was positive (91.6%). This study also identified significant factors influencing farmers’ attitudes toward AMU and AMR. Farmers aged 31–40 showed a stronger inclination compared to other age groups (OR = 4.2, p = 0.02), and those using antimicrobials for preventive purposes had a more favorable attitude compared to those using them for other purposes (OR = 5.9, p = 0.02). In light of these findings, this study recommends the implementation of effective regulatory measures for drug usage, along with awareness programs addressing AMU and AMR to address the issue of AMR in poultry production.

Objective. Development and validation of a suite of mathematical models to predict national-level antimicrobial resistance (AMR) trends by integrating antimicrobial consumption (AMC) and current AMR data. Materials and Methods. Data on systemic antimicrobial consumption across 82 regions of the Russian Federation (2008–2022; source: IQVIA) and AMR levels (2013–2022; source: AMRmap.ru) were analyzed. The workflow included regional name normalization, exclusion of antimicrobials with low clinical relevance, calculation of moving averages (3–10 years) for AMR parameters, and AMC quantification in Defined Daily Doses (DDD). Principal Component Analysis (PCA) was applied for feature dimensionality reduction. Within the «model pair» framework (microorganism–antibiotic), machine learning algorithms were tested: LightGBM, Random Forest, logistic regression, and Support Vector Machines (SVM) with linear and Gaussian kernels. Hyperparameter optimization was performed via k-fold cross-validation, with model performance assessed using accuracy and recall metrics. AMR forecasting was conducted under two scenarios: optimized (COBYLA) and realistic (ETS model). Results. For the «Escherichia coli / cefotaxime» pair, the LightGBM model achieved the highest accuracy (67.5% training, 66.6% validation) without overfitting. Key predictors included historical AMR moving averages and infection type (community-acquired/hospital-acquired). Optimized consumption patterns projected a 15–20% reduction in AMR over a decade, whereas the realistic scenario predicted a 5–10% increase, particularly among community isolates. An online platform (AMCmodel.ru) was developed for data visualization, model access, and forecast generation. Conclusions. The developed system enables accurate AMR trend forecasting and supports antimicrobial stewardship strategy design. Consumption optimization, as demonstrated by simulations, could reduce resistance by 15–20%. The AMCmodel.ru platform provides real-time decision-making tools. Further work will involve extending the suite of models to new microorganism-antibiotic pairs and incorporating international data to increase the predictive power of the models.

Estimating antimicrobial resistance burden in Europe—what are the next steps?

Antimicrobial resistance in poultry production is currently a serious concern. The overuse or abuse of antimicrobials, along with inadequate hygiene in the poultry production chain, has increasedantimicrobial resistance of zoonotic bacteria, which are widely transferred through the handling and ingestion of poultry products. These bacteria represent a major threat to the environment and human health, leading to negative economic consequences. This review focused on antimicrobial usage and resistance in Zimbabwe poultry value chain. The review explored research studies published between 2000 to 2023. Searching tools included PubMed, Google Scholar, Web of Science, and African Journal Online databases. Thirteen papers out of 11508 were retained for this review, two on antibiotics use and 11 on antimicrobial resistance in poultry, with chickens being the most researched, followed by ducks, geese, and turkeys. Tetracyclines were the most used antibiotics in Zimbabwe, followed by sulfonamides, fluoroquinolones, and penicillins. Escherichia coli was the most common bacterium isolated, followed by Salmonella species, Clostridium difficile, and Campylobacter. All E. coli isolates were resistant to tetracycline, cefotaxime, aztreonam, cefpodoxime, and piperacillin-tazobactam. Also, all C. difficile isolates were resistant to gentamycin, cefotaxime, ciprofloxacin, norfloxacin, and nalidixic acid. Salmonella and Campylobacter bacteria were the least resistant. Surveillance of antimicrobial use and resistance in Zimbabwe is suboptimal, the overall picture shows an acceleration in resistance rates due to the misuse of antimicrobials.

Background/Objectives: The COVID-19 pandemic has been reported to impact antimicrobial consumption (AMC) and antimicrobial resistance (AMR) worldwide. We aimed to assess this correlation in Klebsiella pneumoniae before and during the COVID-19 pandemic and to estimate the burden of each antibiotic. Methods: We collected data on AMC of penicillins and beta-lactamase inhibitors (PBIs), anti-pseudomonal activity penicillins and beta-lactamase inhibitors (AAPBIs), cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, and AMR in K. pneumoniae strains. The correlation between AMC and AMR was studied using dynamic regression models. Results: Overall, AMC of AAPBIs and fourth-generation cephalosporin increased, while fluoroquinolone consumption and AMR in the 2862 K. pneumoniae strains analyzed decreased. However, during the first year of the pandemic, we reported an increase in AMC and AMR. We found that 46% to 48% of the increase in cephalosporin, AAPBI, and fluoroquinolone resistance was explained by increased cephalosporin and fluoroquinolone consumption, 55% of the increase in PBI resistance was explained by increased PBI, cephalosporin, and fluoroquinolone consumption, and 58% of the increase in aminoglycoside resistance was explained by increased aminoglycoside consumption. Conclusions: During the COVID-19 pandemic, the increase in AMR in K. pneumoniae was correlated with the increase in AMC of several antibiotics, mainly cephalosporins and especially fluoroquinolones.

Antimicrobial resistance is part of a perfect storm of health crises

Objective To analyze the bacterial distribution and resistance of clinical isolates from exacerbation of COPD patients in C and D classification in our emergency department.Methods The sputums were taken to culture and antimicrobial susceptibility test.VITEK-2 compact automicrobe system was used to identify bacteria.Disc diffusion test was used to determine the antimicrobial resistance.Results Of 222 clinical isolates,27.0％ were Gram positive bacteria,73.0％ were Gram negative bacteria.The Gram positive bacteria mainly was Staphylococcus aureus and Streptococcus pneumoniae.The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) were 50.00％.The MRSA were more resistant than methicillin-sensitive Staphylococcus aureus (MSSA),and they were all sensitive to vancomycin,linezolid or tigecycline.The Gram negative bacteria mainly was Pseudomonas aeruginosa,Escherichia coli,Klebsiella spp and Acinetobacter baumannii.Pseudomonas aeruginosa and Acinetobacter baumannii had high resistant rates.The extended spectrum β-lactamases (ESBLs) producing strains in Escherichia coli were higher than in Klebsiella spp,which had multiple drug resistance.Conclusions The bacterial resistance situation is very severely in exacerbation of COPD patients in C and D classification in our emergency department.The first isolating rate was Pseudomonas aeruginosa.Surveillance of bacterial resistance is very important and effective control measures to reduce resistance is very necessary. Key words: Bacterial resistance; Antimicrobial agent; Chronic obstructive pulmonary disease; Bacterial distribution; Emergency department; Exacerbation; Surveillance of bacterial resistance; Reduce resistance

ABSTRACTBackground and Aim:Antimicrobial resistance (AMR) presents a critical global health threat, compromising the efficacy of treatments across human, animal, and environmental health domains. While efforts have predominantly focused on livestock and human medicine, the role of pet owners remains underexplored, despite their direct involvement in antimicrobial administration and influence on veterinary decisions. This study aimed to assess perceptions, knowledge, and practices regarding antimicrobial use and resistance among pet owners in Chile, providing a baseline to inform future education and policy initiatives under a One Health framework.Materials and Methods:A cross-sectional survey targeting adult dog and cat owners was conducted from May 19 to 21, 2023, in Santiago, Chile, during a large public pet-focused event. Using a validated questionnaire, data were collected on demographics, pet characteristics, knowledge, attitudes, and practices related to antibiotics and AMR. A total of 378 valid responses were analyzed. Descriptive statistics and Chi-square tests were applied to examine associations, particularly between education level and reported practices.Results:Most respondents were female (74.4%) with professional degrees (64%) and aged between 21 and 50 years. Dogs were more commonly owned (73.8%) than cats (26.2%). While 86.2% reported their pet had received antibiotics, only 68.2% recalled veterinarians confirming proper administration understanding. A strong majority agreed that antibiotics should only be used for bacterial infections and opposed acquiring them without a prescription. Notably, 92.4% stated that they would stop treatment early if improvement was observed. Approximately 52% had used human antibiotics for pets, and 38% were open to substituting prescribed veterinary antibiotics with human ones. No significant association was found between education level and antibiotic use behaviors (p > 0.05).Conclusion:Findings reveal important gaps in owner understanding and adherence to antimicrobial guidelines, particularly regarding treatment completion and human antibiotic use in pets. Strengthening veterinarian-owner communication, promoting species-specific antibiotic use, and enhancing awareness of AMR’s broader implications are essential. These insights support targeted educational efforts and integration of pet owner perspectives into national AMR strategies to advance One Health goals.

Antimicrobial resistance (AMR) is an emerging threat to both human and animal health. Antimicrobial use and resistance in food animal production, including swine, has received increased scrutiny as a source of resistant foodborne pathogens. Continuous surveillance of AMR in bacterial isolates of swine origin can guide in conservation of antimicrobials used in both human and swine medicine. The objective of this study was to evaluate the prevalence and trends of the phenotypic AMR in Escherichia coli of swine origin isolated from clinical samples at the Minnesota Veterinary Diagnostic laboratory between 2006 and 2016. The prevalence of resistance to ampicillin, tetracyclines and sulphadimethoxine remained greater than 50% throughout the period. There was a drastic change in enrofloxacin resistance, increasing from less than 1% to more than 20% between 2006 and 2016 (annual relative increase of 57% between 2006 and 2013 and 16% between 2013 and 2016). The prevalence of resistance to other antimicrobials remained constant (ceftiofur, oxytetracycline and chlortetracycline) or changed significantly (annual relative changes of less than 10%) for at least some time-period between 2006 and 2016 (ampicillin, florfenicol, gentamicin, neomycin, sulphadimethoxine, trimethoprim-sulphamethoxazole and spectinomycin). Rarefaction analysis revealed an increase in the number of unique combinations of AMRs per year. Network analysis was performed by estimating and plotting partial correlations between minimum inhibitory concentrations (MICs) of various antimicrobials. An increase in strength of these networks was observed, particularly in networks created after 2010, which can be indicative of increased multiple AMR in these isolates. These results provide valuable insight into the trends in AMR in E. coli of swine origin in the USA and act as supplementary information to the existing active AMR surveillance systems.

The purpose of this study was to examine current nurse practitioner (NP) curricula in the United States with regard to antibiotics and antimicrobial resistance and assess the need for a web-based module for instruction on antimicrobial resistance and appropriate prescribing of antibiotics. A 22-item, anonymous, self-administered, web-based survey was sent to 312 NP programs; 149 (48%) responded. Survey items included questions related to NP specialties offered, program accreditation, format of pharmacology course(s), lecture hours related to antimicrobial therapy, and whether the participant would use a Web-based module to teach NP students about antimicrobial resistance, if one were available. Most NP programs (99.3%) required a pharmacology course, and 95% had lectures dedicated to antimicrobial therapy. Half of the programs (53.5%) devoted >or=4 lecture hours to antimicrobial therapy in the pharmacology course, and most (84.8%) reported covering antimicrobial therapy in nonpharmacology courses as well. Approximately half of the programs (45.3%) reported <4 h of lecture on antimicrobial therapy in nonpharmacology courses. Many programs (51.9%) did not offer a microbiology course; 39.2% required microbiology as a prerequisite. Most respondents (86.7%) were familiar with the Centers for Disease Control and Prevention antimicrobial resistance program, and 92.6% reported that they would use an electronic module regarding resistance. NP curricula generally include <10 h of content on antimicrobial therapy. An electronic module regarding antimicrobial resistance is likely to be a useful and relevant adjunct to current curricula.

Antibiotics are critical weapons that were used for combating human pathogens. However, the heavy use of antibiotics leads to the increased and widely spread of antimicrobial resistance. The antimicrobial resistance is not only a medical problem, but also social and economic concerns, involving public health, environmental pollution, food safety, etc. This special issue reviewed and discussed the recent progress on antimicrobial resistance regarding the fields of clinical drug resistance and epidemiology, animal and environmental drug resistance, drug resistance mechanisms, antimicrobial drug development and drug resistance prevention and control, hoping to give a comprehensive view on basic antimicrobial resistance questions, future research directions and prevention and control strategies.

Surveillance of antimicrobial use and antimicrobial resistance is a critical component of the “Global Action Plan” to tackle antimicrobial resistance. However, there is a paucity of such surveillance in communal farming areas in South Africa. This study investigated knowledge and antimicrobial use practices by cattle farmers and antimicrobial resistance levels of indicator bacteria in cattle in a rural communal farming area in South Africa. Seventy (70) farmers were interviewed at five cattle inspection sites using structured questionnaires. Rectal swabs were collected from apparently healthy cattle (n = 100) for culture of Escherichia coli and Enterococcus species, and antimicrobial susceptibility testing using broth microdilution. The farmers indicated predominantly using tetracyclines. Although 42% of the farmers indicated hearing about antimicrobial resistance, none of them clearly understood what it involves. Seventy‐nine (79) E. coli and 71 Enterococcus species were isolated with E. faecium being the dominant species among the Enterococcus isolates. E. coli isolates were resistant to colistin (16%; 13/79), chlortetracycline (8%; 6/79) and amoxicillin (8%; 6/79). Enterococcus isolates were resistant to enrofloxacin (55%; 39/71) and amoxycillin (3%; 2/71). We observed knowledge gaps in prudent antimicrobial use practices and antimicrobial resistance among the farmers. Farmer tailored education programmes on primary animal health care and prudent antimicrobial use practices must be developed and implemented to improve antimicrobial stewardship among farmers with limited veterinary supervision. The level of colistin resistance detected among E. coli isolates from rural communal cattle in this study was unexpected and warrants further molecular investigation to check if the resistance is plasmid mediated.

Understanding farmers' and veterinarians' behavior in relation to antimicrobial use and resistance in dairy cattle: A systematic review

World is in the middle of the pandemic (COVID-19), caused by SARS-COV-2 virus, which is a significant global health crisis after Spanish influenza in the beginning of 20th century. Progressive drastic steps have been enforced to minimize the transmission of the disease. Likewise, in the current years, antimicrobial resistance (AMR) has been referred as one of the potential perils to the global economy and health; however, it is now veiled under the present pandemic. During the current pandemic, AMR to available frontline antibiotics may prove fatal and life threatening to bacterial and fungal infections during routine procedures like elective surgery, C-sections, etc. Currently, a swift elevation in multidrug-resistant organisms (MDROs), like carbapenem-resistant New Delhi metallo-β-lactamase (NDM)-producing Acinetobacter baumannii, Enterobacterales, extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus (MRSA), multi-triazole-resistant Aspergillus fumigatus and pan-echinocandin-resistant Candida glabrata has been seen. Thereupon, the global outbreak of COVID-19 also offers some important ramification for developing antimicrobial drug resistance. This article aims to highlights episodes and aspects of AMR prevalence, impact of management and mismanagement of COVID-19 crisis, hospital settings, community, environment, and travel on the AMR during the current pandemic.