Researchers from the London School of Hygiene and Tropical Medicine project that bloodstream infections caused by resistant bacteria will spike among adults aged 74 and older by 2030.
For laboratory leaders, new modeling research underscores a mounting challenge in infectious disease surveillance: the rise of drug-resistant bloodstream infections (BSIs) across Europe. According to a study published in PLOS Medicine, the rate of BSIs caused by antimicrobial-resistant bacteria is expected to climb sharply over the next five years—driven largely by an aging population.
A news release from CIRAP explained that researchers from the London School of Hygiene and Tropical Medicine analyzed data from more than 12 million blood cultures collected across 29 European countries between 2010 and 2019. Using those findings, they projected BSI rates through 2050 across 38 bacteria–antibiotic combinations, revealing what they called a “clear and consistent relationship” between infection rates, age, and sex. “With substantial sub- and national-variation, the consistency and clear shape of some relationships provide evidence for the inclusion of age and sex in any predictions of future AMR burden,” the authors wrote.
BSI Rates Expected to Increase
The study’s forecasts are sobering. By 2030, BSI rates are expected to increase dramatically among older adults (74 years and up), while stabilizing or even declining among younger groups. Incidence is also predicted to rise faster in men than in women across most bacterial species. Even under optimistic public health scenarios, the team found that achieving a 10% reduction in infections by 2030 would only be feasible for about two-thirds of bacteria–antibiotic pairings.
Senior study author Gwen Knight, PhD, noted, “Combining these factors with demographic and infection trends really highlighted how challenging it will be to reverse the steady rise in bloodstream infections across Europe.” (Photo credit: London School of Hygiene and Tropical Medicine)
For laboratories, the findings highlight the growing importance of targeted surveillance, age-stratified reporting, and real-time resistance data to guide treatment and public health interventions. As Knight and her colleagues conclude, intervention strategies must account for demographic shifts—because the burden of resistance, much like the population it affects, is rapidly aging.
This article was created with the assistance of Generative AI and has undergone editorial review before publishing.
Drug-resistant infections are outpacing treatments, and WHO says laboratory leaders are vital to protecting antibiotic effectiveness.
For laboratory leaders, the latest WHO report on antimicrobial resistance (AMR) underscores just how critical diagnostic testing, data accuracy, and surveillance capacity have become in the global fight against drug-resistant infections. With one in six bacterial infections now resistant to antibiotics, labs stand on the front lines. They are responsible not only for detecting resistant strains but also for generating the data that informs national and international response strategies.
According to a press release, the “Global antibiotic resistance surveillance report 2025”warns that between 2018 and 2023, “antibiotic resistance rose in over 40% of the pathogen-antibiotic combinations monitored,” with “an average annual increase of 5–15%.”
Data from over 100 countries reported to the WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) show that growing resistance to essential antibiotics “poses a growing threat to global health.” For the first time, the report presents “resistance prevalence estimates across 22 antibiotics used to treat infections of the urinary and gastrointestinal tracts, the bloodstream and those used to treat gonorrhea.” It examines eight common bacterial pathogens—Acinetobacter spp., Escherichia coli, Klebsiella pneumoniae, Neisseria gonorrhoeae, non-typhoidal Salmonella spp., Shigella spp., Staphylococcus aureus, and Streptococcus pneumoniae—each linked to these major infections.
Resistance Highest in South-East Asia and Eastern Mediterranean
WHO found that the “risk of antibiotic resistance varies across the world.” The highest resistance levels are in the WHO South-East Asian and Eastern Mediterranean Regions, “where 1 in 3 reported infections were resistant.” In the African Region, “1 in 5 infections was resistant.”
According to the report, resistance “is also more common and worsening in places where health systems lack capacity to diagnose or treat bacterial pathogens.”
Tedros Adhanom Ghebreyesus, PhD, WHO director-general noted, “As countries strengthen their AMR surveillance systems, we must use antibiotics responsibly, and make sure everyone has access to the right medicines, quality-assured diagnostics, and vaccines. Our future also depends on strengthening systems to prevent, diagnose and treat infections and on innovating with next-generation antibiotics and rapid point-of-care molecular tests.” (Photo credit: WHO)
Gram-Negative Bacteria Present the Greatest Threat
The WHO report highlights that drug-resistant Gram-negative bacteria are becoming increasingly dangerous worldwide, with the heaviest impact seen in countries least equipped to manage the threat. Among these pathogens, E. coli and K. pneumoniae remain the most common causes of drug-resistant bloodstream infections—serious conditions that can lead to sepsis, organ failure, and death.
Globally, resistance to third-generation cephalosporins—the standard treatment for these infections—has climbed above 40% for E. coli and 55% for K. pneumoniae, and in parts of Africa, it exceeds 70%. Other essential antibiotics, including carbapenems and fluoroquinolones, are also losing effectiveness against E. coli, K. pneumoniae, Salmonella, and Acinetobacter. Once rare, carbapenem resistance is now emerging more frequently, reducing available treatment options and forcing reliance on last-resort antibiotics that are expensive, difficult to obtain, and often unavailable in low- and middle-income countries.
Progress in Surveillance but Major Gaps Remain
Despite these concerning trends, the report noted progress in global surveillance.
“Country participation in GLASS has increased over four-fold, from 25 countries in 2016 to 104 countries in 2023.” However, challenges persist: “48% of countries did not report data to GLASS in 2023,” and “about half of the reporting countries still lacked the systems to generate reliable data.” Many nations facing the highest burden of resistance “lacked the surveillance capacity to assess their antimicrobial resistance (AMR) situation.”
The report links its findings to the “political declaration on AMR adopted at the United Nations General Assembly in 2024,” which set global targets for combating antimicrobial resistance.
The declaration emphasizes strengthening health systems and working with a ‘One Health’ approach coordinating across human health, animal health, and environmental sectors.
WHO is calling on countries to strengthen laboratory systems and build reliable surveillance networks, particularly in underserved regions, to better guide treatment decisions and public health policies. The organization has set a goal for all nations to submit high-quality data on antimicrobial resistance and antibiotic use to the GLASS platform by 2030. Achieving this target will require coordinated efforts to improve data quality, expand geographic coverage, and enhance information sharing. WHO also encourages countries to implement comprehensive strategies to address antimicrobial resistance across all levels of healthcare and to ensure that treatment guidelines and essential medicines lists reflect local resistance trends.
The report is accompanied by expanded digital content available in the WHO’s GLASS dashboard, offering global and regional summaries, country profiles based on unadjusted surveillance coverage and AMR data, and detailed information on antimicrobial use.
With resistance trends worsening across regions, laboratory leaders are pivotal to turning the tide on AMR. Expanding diagnostic capabilities, improving data quality, and sharing timely resistance information will be key to shaping effective treatment guidelines and national policies. By advancing surveillance and stewardship from within the lab, clinical professionals can help preserve the power of antibiotics for future generations.
This article was created with the assistance of Generative AI and has undergone editorial review before publishing.
A UCLA microbiology lab used whole-genome sequencing to trace a carbapenem-resistant Pseudomonas outbreak to a single ICU sink, revealing how biofilm and plumbing can silently harbor superbugs.
A routine culture from an ICU patient at UCLA Health sparked an investigation that ultimately uncovered a silent, domestic outbreak of a highly resistant strain of Pseudomonas aeruginosa. The discovery was led by the Molecular Microbiology and Pathogen Genomics Laboratory and highlights the critical role clinical laboratories play in outbreak detection, antimicrobial resistance surveillance, and environmental tracking.
The initial isolate appeared typical: P. aeruginosa, a common hospital-associated pathogen. But further analysis revealed something more troubling, the presence of NDM-1 (New Delhi metallo-β-lactamase), an enzyme that breaks down carbapenems and other powerful beta-lactam antibiotics, rendering them ineffective.
“This was the first time we’d ever seen an NDM-1-producing Pseudomonas strain in our hospital—and in a patient with no international travel,” said Shangxin Yang, PhD, director of UCLA Health’s Molecular Microbiology and Pathogen Genomics Laboratory.
Shangxin Yang, PhD, director of UCLA Health’s Molecular Microbiology and Pathogen Genomics Laboratory noted, “While NDM-1 is prevalent in Asia, Europe and the Middle East, it remains rare in the United States. That’s when we knew this wasn’t imported. This was something domestic—and very concerning.” (Photo credit: UCLA)
Sporadic Cases, Elusive Source
Over the next 18 months, seven additional patients were identified with the same rare resistance pattern. The cases were sporadic—spread across time and units—and did not follow conventional outbreak patterns, complicating source identification.
In collaboration with UCLA Health’s infection prevention team, the lab launched a detailed investigation. Routine epidemiologic methods failed to identify commonalities between the cases. Shared equipment, staffing patterns, and care protocols were ruled out. With limited leads, the microbiology team turned to whole-genome sequencing (WGS).
Whole-Genome Sequencing Connects the Dots
WGS became the turning point. By sequencing all eight patient isolates and comparing them to environmental samples, Yang’s lab determined that seven of the eight clinical isolates and two environmental strains shared an almost identical genomic profile. Only one isolate, from a patient previously treated in Iran, was genetically distinct.
“Whole-genome sequencing gave us the clarity we needed,” said Yang. “It allowed us to move from hypothesis to high-resolution confirmation—pinpointing the genetic relatedness of these organisms with certainty.”
The team had uncovered a clonal outbreak of NDM-1-producing P. aeruginosa, likely stemming from a single environmental reservoir.
Unexpected Reservoir: An ICU Sink
During a third round of environmental testing, the lab isolated the same NDM-1-producing strain from a contaminated sink drain and P-trap in one ICU room. Notably, two of the eight patients had been admitted to that room more than a year apart.
The persistence of the organism was attributed to biofilm formation in the sink plumbing. Pseudomonas is known for forming robust biofilms that adhere to moist surfaces and resist standard disinfection methods.
“This wasn’t just about surface contamination,” said Yang. “This was a deeply embedded reservoir that conventional cleaning protocols couldn’t touch.”
Lab-Driven Response and Mitigation
Once the lab identified the environmental source, targeted interventions were put in place:
Weekly disinfection of ICU sinks using Virasept, a biofilm-effective agent
Plumbing replacement, including P-trap components known to harbor persistent biofilms
Engineering modifications to faucet angles to reduce splash-back and droplet spread
Expanded environmental surveillance to monitor other sinks for colonization
The lab continued to monitor the situation post-intervention, and no further cases of NDM-1-producing P. aeruginosa have been identified since the changes were implemented.
Lessons Learned
This case reinforces the value of whole-genome sequencing in resolving complex outbreaks, linking patient isolates to an environmental source that traditional methods missed. It highlights the need to include plumbing and other biofilm-prone areas in environmental sampling. Most importantly, it shows how microbiology labs through genomic, phenotypic, and molecular tools can lead outbreak investigations, especially when paired with strong cross-department collaboration.
“This is a clear example of the power of the clinical lab when genomic tools and environmental surveillance are used strategically,” said Yang. “Without WGS, this would have remained an unsolved mystery.”
Lab leaders can now align with WHO’s new product profile to develop innovative diagnostics that address gaps in newborn infection detection and antimicrobial resistance prevention.
The World Health Organization (WHO) has unveiled a new target product profile aimed at guiding the development of in vitro diagnostic tests for detecting serious bacterial infections in newborns and young infants, including neonatal sepsis—a major cause of infant mortality worldwide. This initiative comes in response to alarming statistics: 2.3 million newborns die every year, with around 15% of these deaths linked to sepsis. The burden is heaviest in low- and middle-income countries, where access to timely diagnosis and treatment remains limited.
Current diagnostic methods such as blood cultures and molecular diagnostics are often inaccessible, expensive, or unreliable, particularly in resource-limited settings. They suffer from low sensitivity, long turnaround times, and high infrastructure demands, making them poorly suited for the urgent needs of frontline healthcare facilities.
Lab Leaders See Shift in Global Standards
For laboratory leaders, WHO’s newly released target product profile for diagnosing serious bacterial infections in newborns and young infants could represent a pivotal shift in global diagnostic standards. As the demand for timely, accurate, and affordable diagnostic tools grows—particularly in low-resource settings—lab leaders have a unique opportunity to play a central role in shaping the next generation of in vitro diagnostics.
The new profile to is designed to define the essential and desirable characteristics of diagnostic tools needed to improve early detection of infections in infants aged 0–59 days. The profile covers two major clinical scenarios: use in primary health care settings and in higher-level hospitals. It’s intended to assist developers, regulators, and public health officials in designing effective tools tailored to diverse healthcare environments.
Yvan Hutin, MD, PhD, Director of the Department of Antimicrobial Resistance at WHO, emphasized the urgency of the effort, stating, “Timely and accurate diagnosis tests for serious bacterial infection is critical to reducing newborn mortality.”
Hutin’s areas of expertise include epidemiology, prevention, care and treatment of viral hepatitis, public health training, economic analyses, and financing. He has co-authored more than 120 articles in peer-reviewed journals. (Photo credit: WHO)
Silvia Bertagnolio, MD, Head of the Antimicrobial Resistance Surveillance, Evidence and Laboratory Strengthening Unit at WHO noted, “This new target product profile outlines the essential features needed in diagnostic tools to improve clinical decision-making, reduce unnecessary antibiotic use and prevent antimicrobial resistance, especially in low-resource settings where the burden of neonatal sepsis remains critical.”
Targeted Care
In many communities, healthcare workers must make critical decisions about antibiotic treatment or hospital referrals based on clinical judgment alone, without reliable diagnostics. The new tools envisioned by WHO would help identify which infants truly need antibiotics or hospitalization, allowing for more targeted and effective care.
For laboratory leaders, the release of this target product profile is more than just a technical guideline, it’s a call to action. By aligning their diagnostic development and evaluation efforts with WHO’s outlined priorities, lab leaders can help fill a critical gap in newborn and infant care, particularly in underserved regions. Their expertise will be essential in translating this profile into practical, scalable solutions that improve early detection, guide appropriate treatment, and ultimately save lives. As stewards of innovation and quality in diagnostics, lab leaders are uniquely positioned to drive meaningful progress in the global fight against neonatal infections and antimicrobial resistance.
Device provides physicians with quick insights into infant’s immune system capabilities without requiring clinical laboratory testing
International researchers have developed a revolutionary tool that rapidly assesses an infant’s immune system using a single drop of blood. The novel device provides healthcare professionals with real-time insights about a newborn’s immune response in less than 15 minutes.
Scientists from the Singapore-MIT Alliance for Research and Technology (SMART) in collaboration with colleagues from KK Women’s and Children’s Hospital (KKH) in Singapore created the Biophysical Immune Profiling for Infants (BLIPI) portable device to help alleviate potentially life-threatening illnesses in newborns. The device only uses 0.05 ml of blood.
The work was led by researchers from the Critical Analytics for Manufacturing Personalized Medicine (CAMP) and Antimicrobial Resistance (AMR) interdisciplinary research groups within SMART. SMART is a major research collaboration between the Massachusetts Institute of Technology (MIT) and the National Research Foundation of Singapore.
“BLIPI represents a major step forward by providing clinicians with fast, actionable immune health data using a noninvasive method, where it can make a real difference for newborns in critical care,” said Kerwin Kwek Zeming, PhD, research scientist at SMART CAMP and SMART AMR, and co-lead author of the study, in an MIT news release.
“Our goal was to create a diagnostic tool that works within the unique constraints of neonatal care—minimal blood volume, rapid turnaround, and high sensitivity,” said Kerwin Kwek Zeming, PhD, research scientist at SMART CAMP and SMART AMR, and co-lead author of the MIT study, in the news release. (Photo copyright: MIT.)
Bridging Gap between Science and Healthcare
To perform their study, the team used BLIPI to screen 19 infants—eight full-term and 11 preterm—and compared the differences in immune cells between the infants. The device uses microfluidic technology to measure immune cell characteristics, such as size and flexibility, to expose how the immune system is responding to changes within the cells. Traditional tests look only for the presence of germs, but BLIPI also looks at results such as C-reactive protein levels, white blood cell counts, and immature-to-total neutrophil ratios, to determine if an infant is fighting an infection.
“BLIPI exemplifies our vision to bridge the gap between scientific innovation and clinical need. By leveraging microfluidic technologies to extract real-time immune insights from whole blood, we are not only accelerating diagnostics but also redefining how we monitor immune health in fragile populations,” said Jongyoon Han, PhD, professor of electrical engineering and biological engineering at MIT and coauthor of the paper, in the news release. “Our work reflects a new paradigm in point-of-care diagnostics: rapid, precise, and patient-centric.”
Saving Infant Lives
BLIPI only needs one tiny drop of blood, which equals 1/20 of the blood volume typical lab tests require. The onsite tool removes the need for sending blood samples to clinical labs, which may enable clinicians to make earlier decisions regarding treatment options for critical situations like sepsis or necrotizing enterocolitis.
“KKH cares for about two-thirds of all babies born weighing less than 1,500 grams (52.91 ounces or 3.31 pounds) in Singapore. These premature babies often struggle to fight infections with their immature immune systems. With BLIPI, a single prick to the baby’s finger or heel can give us rapid insights into the infant’s immune response within minutes. This allows us to tailor treatments more precisely and respond faster to give these fragile babies the best chance at a healthy start not just in their early days, but throughout their lives,” said Yeo Kee Thai, MD, senior consultant in the department of neonatology at KKH, and senior author of the study, in the news release.
BLIPI also could be extremely beneficial to healthcare settings in remote areas or with limited resources.
Further research and clinical trials are needed to validate the diagnostic accuracy of BLIPI. In addition, the researchers plan to improve the design to render it usable for widespread distribution. They also hope BLIPI will someday be used by pharmaceutical companies and medical researchers to evaluate immune responses to neonatal therapies in real time.
