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Review
. 2025 Jan 18;405(10474):257-272.
doi: 10.1016/S0140-6736(24)02081-6.

Multidrug-resistant Gram-negative bacterial infections

Nenad Macesic  1 , Anne-Catrin Uhlemann  2 , Anton Y Peleg  3
Affiliations
Review

Multidrug-resistant Gram-negative bacterial infections

Nenad Macesic et al. Lancet. .

Abstract

Multidrug-resistant Gram-negative bacterial infections cause significant morbidity and mortality globally. These pathogens easily acquire antimicrobial resistance (AMR), further highlighting their clinical significance. Third-generation cephalosporin-resistant and carbapenem-resistant Enterobacterales (eg, Escherichia coli and Klebsiella spp), multidrug-resistant Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumannii are the most problematic and have been identified as priority pathogens. In response, several new diagnostic technologies aimed at rapidly detecting AMR have been developed, including biochemical, molecular, genomic, and proteomic techniques. The last decade has also seen the licensing of multiple antibiotics that have changed the treatment landscape for these challenging infections.

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Conflict of interest statement

Declaration of interests NM received research support from the Joint Programme Initiative on AMR and National Health and Medical Research Council Australia (APP2032022) and the Medical Research Future Fund (FSPGN000048), outside the submitted work, and National Health and Medical Research Council of Australia (Emerging Leader 1 Fellowship APP1176324); and consulting fees from Bridger Consulting. AYP received research funding from Merck Sharp & Dohme for an investigator-initiated research project and from the National Health and Medical Research Council of Australia (Practitioner Fellowship APP1117940). A-CU received funding from the National Institutes of Health (U54 DK104309). The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

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