Prospective characterisation of drug-resistant bloodstream infections in Africa and Asia (ACORN2): a surveillance network assessment

作者：Jill Hopkins, Sue J. Lee, Naomi Waithira, Chris Painter, Clare Ling, Tamalee Roberts, Thyl Miliya, Noah Obeng‐Nkrumah, Japheth A. Opintan, Emmanuel Parbie Abbeyquaye, Raph L Hamers, Yulia Rosa Saharman, Robert Sinto, Mulya Rahma Karyanti, R Fera Ibrahim, Samuel Akech, Elizabeth A. Ashley, Anousone Douangnouvong, Khamla Choumlivong, Nicholas Feasey, Diana Kululanga, Samantha Lissauer, Abhilasha Karkey, Narayan Kunwar, Justice Enosetale Erakhaiwu, Iruka N. Okeke, Ini Adebiyi, Olukemi Adekanmbi, Abiodun Bolarinwa Oduola, Babatunde O. Ogunbosi, Kehinde Ojifinni, Olukemi Oluwatoyin Tongo, Ifeoma Azuka Ude, Aaron O. Aboderin, Olusegun Adekanle, Adeyemi T Adeyemo, Sylvester S Edward, Ugowe Osagie, Thi Hoa Nguyen, Ngoc Thach Pham, Van Giang Tran, Thị Lan Hương Hoàng, Hữu Tùng Trịnh, H. Rogier van Doorn, Paul Turner, Paul Turner, Jill Hopkins, Sue J Lee, Naomi Waithira, Chris Painter, Clare Ling, Tamalee Roberts, Thyl Miliya, Noah Obeng‐Nkrumah, Japheth A. Opintan, Emmanuel Parbie Abbeyquaye, Raph L Hamers, Yulia R. Saharman, Robert Sinto, Mulya R Karyanti, R Fera Ibrahim, Samuel Akech, Elizabeth A. Ashley, Anousone Douangnouvong, Khamla Choumlivong, Nicholas A Feasey, Diana Kululanga, Samantha Lissauer, Abhilasha Karkey, Narayan Kunwar, Justice Enosetale Erakhaiwu, Iruka N. Okeke, Ini Adebiyi, Olukemi A Adekanmbi, Abiodun B Oduola, Babatunde O. Ogunbosi, Kehinde A Ojifinni, Olukemi O Tongo, Ifeoma Azuka Ude, Aaron O. Aboderin, Olusegun Adekanle, Adeyemi T Adeyemo, Sylvester S Edward, Ugowe Osagie, Hoa Nguyen Thi, Ngoc Thach Pham, Van Giang Tran, Lan Huong Hoang Thi, Huu Tung Trinh, H Rogier van Doorn, Paul Turner, Paul Turner, Yoel Lubell, O. Celhay, Vanapol Chamsukhee, Prapass Wannapinij, Sambou Bran, Chanpheaktra Ngoun, Poda Sar, Antoinette Bediako‐Bowan, Appiah-Korang Labi, Thomas Dankwah, Maud Fandoh, Margaret Gakpo, Esther N. Okine, Francis M Tetteh, Fitri Agustia Dewi, Michelle M Karman, Nunung N Mahpud, T Valleri, Kevin Brevian, Erika Indrajaya, Ikhlima P Janaria, Lili H Pangulu, Samuel Theodorus Sutanto, Martha F A Tatodi, Cliff C Haliman, Anis Karuniawati, Aulia Khatib, Djiwa Margono, Aghnia N Tsaniy, Agustin Indracahyani, Iqbal A Makarim, Ro R R Roza, Uci R Saputri, Adityo Susilo, Anne V Amulele, Jackline Gachoki, Wilson Gumbi, Stephen Kamau, Joyce Kigo, Robert Musyimi, Benedict Mvera, Salim Mwarumba, Linnytiffan M Ndumba, Brian M Nyamwaya, Rachel Inginia, James M Njuguna, Anthony S Katayi, Dickens Lubanga, Ko Chang, Vilada Chansamouth, Viengmon Davong, Douangkham Phommachanh, Manoloth Sayarath, Keovongmany Senesouphonh, Peeyanout Thammavongsa, Khamphong Thanadabouth, Susath Vongphachanh, Manivanh Vongsouvath, Khamloune Choumlivong, Loungnilanh Manivanh, Souphalack Sibounheuang, Phoutmany Vongxay, Sonesavanh Xayyalarth, Patrick Musicha, Sabina Dongol, Sushma Gyawali, Basudha Shrestha, Basudha Khanal, Jola-Ade J Ajiboye, Veronica O. Ogunleye, Faith Adekola, Abdulmumin A Aderinto, Fatima Adeyemi, Blessing Ajakaiye, Victoria Alonge, Folasade Bamidele, Benedicta Chike, Oluseyi O Elaturoti, Oluwatobiloba S Kazeem, Aderemi Kehinde, Aishetu Nwankwo, Suliat Oladokun, Regina Oladokun, Chinyelo Ololo, Okainemen P Oluwalusi, Olamide Omolawal, Oluwapelumi M Oni, Isaiah Adewale, Anthony Chinemere Anuforo, A.O. Ibrahim, Taiwo S Ogunbiyi, Oluwafemi Popoola, Thomas Kesteman, Phuong Mai Nguyen, Quynh Mai Nguyen, Tam Nguyen Thi, Hong Thuong Nguyen Thi, Agilakumari Pragasam, Son Tung Trinh, Chau Thi, Viet Dung Vu Tien, Thanh Hai Dao, Duy Thanh Doan, Phu Khiem Dong, Thuy Trang Hoang, Huong Giang Luong, Quoc Phuong Nguyen, Ha Nguyen Thi, Ngoc Ninh Thi, Dung Thi, Manh Cuong Phan, Van Bac Tran, Dinh Trang Van, T Duong, Van Long Hoang, Thu Le Thi, Van Tuan Mai, Tat Dung Nguyen, T.D. Nguyen, Dieu Doan Nguyen Thi, Bach Oanh Nguyen Thi, Yen Mai Thi, Huong Nguyen Thi, Yen Mai Thi, Quynh Thi Phan Le, Phuong Phan Thi, Duc Huy Tran, Quang Nhat Tran, Duc Huy Tran, Huyen Tran Tran Thi, The Trung Bui, K. Ho, Minh Thao Ho Thi, Ngoc Anh Le, Hong Hanh Le Thi, Thanh Thien Nguyen, Ha Nam Nguyen, Thanh Thien Nguyen, Minh Uyen Nguyen Cao, Quynh Anh Nguyen Thi, Dieu Truong Nguyen Thi, Kim Anh Nguyen Thi, Lan Pham Thi, Thủy Nguyễn Thị, Duc Loi Pham Thi, Thuy Trang Nguyen Thi, Duc Loi Pham Thi, Bich Ngoc Can Thi, Hong Thi · 发表于：The Lancet Microbe · 年份：2025 · DOI：10.1016/j.lanmic.2025.101228 · 被引用次数：4 · 研究领域：Antibiotic Use and Resistance、Bacterial Identification and Susceptibility Testing、Pneumocystis jirovecii pneumonia detection and treatment

BACKGROUND: Antimicrobial resistance (AMR) is a major global health threat, but there is scarcity of laboratory surveillance data linked to clinical information to determine burden and inform interventions, especially from low-income and middle-income countries. The ACORN2 study sought to address this through prospective case-based surveillance in 19 hospitals across Africa and Asia to characterise drug-resistant infections by origin, clinical syndrome, patient age, outcome, and geographical location. METHODS: Patients were enrolled on selected wards and clinical data were collected daily for community-acquired infections (CAIs). Point prevalence surveys for hospital-acquired infections (HAIs) were conducted weekly. Mortality was assessed at discharge and after 28 days. Linked microbiology data were extracted from local laboratory databases. Primary descriptive analyses focused on WHO Global Antimicrobial Resistance and Use Surveillance System pathogen (target organism) bloodstream infections (BSIs). Comparisons were adjusted for clustering by site using random effects models. FINDINGS: Over 31 months, 41 907 infections were characterised from 41 032 admissions. Two-thirds were children (19 351; 47·2%) or neonates (6649; 16·2%). There were marked differences in pathogen incidence and antibiotic resistance when clinical infections were stratified by patient age category and infection origin (CAI/HAI). The highest rates of target organism AMR BSI were third-generation cephalosp...