Citation

BibTex format

@article{Shah:2026,
author = {Shah, A},
journal = {Thorax},
title = {International epidemiology of antimicrobial resistance in people living with chronic lung infection},
year = {2026}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Antimicrobial resistance (AMR) is a global threat for people with chronic lung infection, however international AMR epidemiology in bronchiectasis and Cystic Fibrosis (CF) is poorly characterised. In this study we retrospectively analyse international longitudinal AMR epidemiology in bronchiectasis and CF.Methods: Microbiology data was analysed from 110323 respiratory samples in 19143 individuals with bronchiectasis or CF across 11 cities, 8 countries, 3 continents between 2011-2024. Longitudinal AMR prevalence, multi-drug and extensive-drug resistance (MDR,XDR) and multiple antibiotic resistance (MAR) index was analysed by disease and country. Pilot analysis of concurrent/disjoint resistance in antimicrobial pairs and triplets in regional datasets was performed to inform combination or cyclical antimicrobial choice.Findings: Geographic AMR differences were noted across pathogens in bronchiectasis and CF with increased Pseudomonas aeruginosa resistance in central/southern Europe and increased Klebsiella pneumoniae resistance in Hong Kong. MDR burden was high in emergent pathogens Escherichia coli (CF:MDR-32.6%;XDR-12.4%; Bronchiectasis:MDR-39.2%;XDR-4.9%) and K.pneumoniae (CF:MDR-22.7%;XDR-15.6%; A longitudinal rise in P.aeruginosa AMR was seen in bronchiectasis across 4 centres for antipseudomonal aminoglycosides (p=<0.001;OR/yr:1.44;(95%CI:1.24-1.67)), fluoroquinolones (p=0.002;OR/yr:1.13;(95%CI:1.05-1.23)), cephalosporins (p=0.005;OR/yr:1.17;(95%CI:1.051.30)), penicillins with beta-lactamase inhibitor (p=0.02;OR/yr:1.18;(95%CI:1.03-1.35)) and carbapenems (p=0.048;OR/yr:1.11;(95%CI:1.00-1.23)). Rising longitudinal K.pneumoniae AMR was seen for cephalosporins (p=0.01;OR/yr:1.32;(95%CI:1.06-1.65)) and carbapenems (p=0.04;OR/yr:1.64;(95%CI:1.03-2.62)). Significant increased AMR by MAR index was seen in residual culture-positive CF individuals on triple CFTR modulator therapy (p<0.001). Strong concurrent resistance was noted in bronchiectasis across
AU  - Shah,A
PY  - 2026///
SN  - 0040-6376
TI  - International epidemiology of antimicrobial resistance in people living with chronic lung infection
T2  - Thorax
ER  -
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