Trends and correlations in antimicrobial resistance indicators in 110 hospitals in Thailand, 2022-2024.

Werayingyong P., Chamawan P., Tuamsuwan K., Srisuphan V., Limmathurotsakul D.

OBJECTIVE: To evaluate trends and correlations in antimicrobial resistance (AMR) indicators METHODS: We conducted a cross-sectional study analyzing summary AMR data from 110 public hospitals in Thailand in 2022 and 2024. RESULTS: In 2022 and 2024, the total number of hospital admissions were 3,856,503 and 3,901,396, respectively. The total number of patients with hospital-origin carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infection (BSI) decreased from 4,925 in 2022 to 4,375 in 2024, corresponding to a 12% decline in AMR frequency per 100,000 admissions (adjusted rate ratio 0.88; 95%CI 0.84-0.91; p<0.001). However, changes in AMR frequency and AMR proportion were weakly correlated (Spearman's rho=0.27). Declines in the total number of patients (from 1,630 to 1,281) and AMR frequencies were also observed for hospital-origin BSI due to carbapenem-resistant Klebsiella pneumoniae (CRKP) (all p<0.001). Nonetheless, the total number of patients with hospital-origin BSI due to carbapenem-resistant Escherichia coli (CREC) was 298 in 2022 and 336 in 2024, and increases in some but not all AMR frequencies were observed. No significant changes were observed in most AMR indicators for methicillin-resistant Staphylococcus aureus (MRSA). CONCLUSIONS: At the national level, the burden of hospital-origin BSI due to CRAB and CRKP declined in Thailand during the study period. However, at the hospital level, changes in AMR indicators could be discordant. We emphasize the need for cautious interpretation of changes in multiple AMR indicators, including their underlying numerators and denominators, when assessing AMR burden at both hospital and national levels.

DOI

10.1016/j.ijid.2026.108830

Type

Journal article

Publication Date

2026-05-26T00:00:00+00:00

Keywords

Acinetobacter baumannii, Antimicrobial resistance, Klebsiella pneumoniae, bloodstream infection, frequency, proportion

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