Trends in Acinetobacter Aminoglycoside Resistance: ECDC Twelve-Year Surveillance Data

Abstract The emergence of antimicrobial resistance (AMR) in Acinetobacter species represents a critical threat to global health security, particularly within intensive care settings. This study analysed twelve years of European Centre for Disease Prevention and Control (ECDC) surveillance data to characterise temporal trends, geographic heterogeneity, and demographic determinants of aminoglycoside resistance across 30 European nations. Our analysis reveals a pronounced North-South divide, with resistance rates exceeding 40% in Romania and Bulgaria compared to less than 10% in Nordic countries. Temporal analysis indicates persistent high-burden scenarios in Eastern Europe, while Western European nations demonstrate more stable, albeit concerning, resistance profiles. Age-stratified analysis demonstrated significantly higher resistance among elderly populations (65+ years), suggesting nosocomial transmission dynamics. These findings underscore the urgent need for harmonised surveillance frameworks, targeted stewardship interventions, and cross-border collaborative responses to mitigate the escalating burden of multidrug-resistant Acinetobacter infections. Keywords: Antimicrobial resistance, Acinetobacter baumannii, aminoglycosides, ECDC surveillance, epidemiology, healthcare-associated infections