Antimicrobial resistance (AMR) threatens global health, and understanding resistance patterns aids in effective treatment and promotes responsible antimicrobial use. Despite the urgency of resistant pathogens, systematic reviews focusing specifically on Tanzania are limited, and while several studies report resistance patterns for individual pathogens, a consolidated analysis of overall prevalence is needed to inform policymaking and public health interventions. Therefore, this review and meta-analysis assessed the prevalence of antimicrobial resistance among clinically relevant pathogens in Tanzania, providing a comprehensive overview to support surveillance, infection control, and stewardship efforts. A total of 1865 studies identified from Google Scholar (1600), PubMed (13), and Science Direct (252) underwent screening and full article review. Finally, 28 studies were included. A subgroup analysis was performed to evaluate the resistance patterns within antibiotic classes for specific pathogens. Descriptive statistics were used to describe the characteristics of the studies, while the prevalence of antimicrobial resistance was estimated through Meta-analysis. Inconsistency and heterogeneity between studies were quantified by the I2 index. Among the included studies, most isolates (25.0%) were obtained from urine samples. Of these studies, 75% were cross-sectional studies and 92.9% were conducted in hospital settings. The analysis revealed high resistance to penicillin, particularly amoxicillin-clavulanic and ampicillin, with Klebsiella pneumoniae (0.96 [0.83-0.99]), Acinetobacter baumannii (0.94 [0.67-0.99]) and Escherichia coli (0.90 [0.81-0.95]). Similarly, erythromycin resistance was most prevalent in Campylobacter spp. (0.85 [0.80-0.89]). Ciprofloxacin resistance was highest in Acinetobacter baumannii (0.54 [0.33-0.73]), whereas amikacin resistance was highest in Proteus spp. (0.86 [0.35-0.99]). Ceftriaxone resistance was particularly high in Acinetobacter baumannii (0.91 [0.70-0.98]) and Pseudomonas aeruginosa (0.85 [0.74-0.92]). Meropenem resistance was lowest among Escherichia coli (0.04 [0.01-0.10]) and Klebsiella spp. (0.07 [0.03-0.15]), while the pooled resistance across ESKAPE-E pathogens was (0.11[0.06-0.19]). Imipenem and clindamycin each had an overall pooled resistance of (0.06[0.02-0.14]) against both Escherichia coli and Klebsiella pneumoniae. The findings highlight widespread resistance among bacterial pathogens, ESKAPE-E, particularly in the Access and Watch groups of antibiotics. The variability in resistance patterns underscores the need for the Ministry of Health to re-evaluate empirical treatment protocols (STG/NEMLIT) to ensure effective treatment regimens, strengthen antimicrobial stewardship, enhance surveillance systems, and promote rational antibiotic use.

This cross-sectional observational pilot study evaluated microbial quality, bacterial contaminants, their virulence determinants, and antimicrobial resistance profiles in RTE foods sold during MGs in Pakistan. A total of 74 RTE food samples were collected from 26 different festivals using convenience sampling approach. Based on Punjab Food Authority criteria (>105 CFU/g), 63.5% (47/74) of samples were deemed unsatisfactory for consumption. Golgappa samples exhibited the highest polymicrobial contamination. Higher median microbial loads were found in outdoor (3.3 × 103–1.7 × 107CFU/g),single-day events with uncovered food and inadequate hygiene practices. Microbial loads differed significantly across MG categories (p = 0.015). Logistic regression revealed that RTE collected from religious (OR = 7.81, 95% CI: 1.39–56.87) and social gatherings (OR = 8.29, 95% CI: 1.51–57.78) had significantly higher odds of exceeding microbial safety limits. Enterobacter spp. (48.6%; 36/74) was predominantly isolated, while Shigella spp. (6.7%; 5/74) was least prevalent. Enterobacter spp. showed significant association with cooked pulses (p = 0.0132), whereas cooked rice samples showed fourfold higher odds of Staphylococcus spp. detection compared to other food categories (p = 0.012, OR = 4.05, 95%CI = 1.3–12.5). Network analysis identified Enterobacter spp. as dominant hub contaminant, exhibiting strong tendency to form biofilms (p = 0.0006) with significantly increased likelihood of gentamicin (OR = 3.9) and ciprofloxacin (OR = 1.6) resistance. Overall, 78.9% (15/19) of Staphylococcus spp., 66.6% (10/15) of E. coli, and 5.5% (2/36) of Enterobacter spp. showed virulence potential.

There are limited oral treatment options available for resistant Gram-negative bacterial (GNB) infections. Minocycline, a second-generation tetracycline antibiotic, offers good bioavailability and broad-spectrum coverage that may be an option for GNB infections. We conducted a retrospective review of minocycline susceptibility testing performed on GNB isolates at the Mayo Clinic reference lab between 2013 and 2022. Minocycline susceptibility was evaluated with a focus on difficult-to-treat organisms and relevant anatomic source. Organisms included resistant isolates of Escherichia coli and Klebsiella pneumoniae; high-risk ampC-derepressors, including Citrobacter freundii, Enterobacter cloacae, and K. aerogenes; and clinically challenging non-Enterobacterales, Acinetobacter species, Achromobacter species, and Stenotrophomonas maltophilia. Of 217,206 GNB isolates, 18,148 Enterobacterales (EB) and 8,190 non-Enterobacter isolates were tested for minocycline susceptibility. Of these, 80% of all EB and 92% of non-EB isolates were susceptible. Among E. coli isolates with ceftriaxone, ciprofloxacin, meropenem, or multidrug resistance, minocycline susceptibility was 78%, 76%, 70%, and 70.9%, respectively. Among the K. pneumoniae isolates with ceftriaxone, ciprofloxacin, meropenem, or multidrug resistance, minocycline susceptibility was 46%, 38%, 37%, and 39.3%, respectively. 85% of C. freundii, 81% of E. cloacae, and 85% of K. aerogenes isolates were susceptible to Minocycline. 83.5% of Achromobacter species isolates, 66% of Acinetobacter species isolates, and 99.1% of S. maltophilia isolates were susceptible. Our study reports the largest collection of minocycline susceptibility findings in GNB. Minocycline showed in vitro activity against many difficult-to-treat GNB isolates, including ceftriaxone- and multidrug-resistant E. coli and some K. pneumoniae isolates, common Amp-C-producing species, and non-fermenting GNB, including Stenotrophomonas, Acinetobacter, and Achromobacter.

The recent introduction of mosaic mtr-carrying Neisseria gonorrhoeae lineages boosts local transmission.

We describe a case of meningococcal bloodstream infection complicated by purpura fulminans in a 49-year-old woman in Tunisia in May 2025, caused by a ciprofloxacin-resistant Neisseria meningitidis. The patient presented with rapidly progressive purpura and septic shock requiring intensive care and empirical cefotaxime therapy. Blood cultures, molecular testing, and whole-genome sequencing (WGS) were investigated to characterize the N. meningitidis isolate. The strain was non-groupable and belonged to ST-175 (cc175), with BAST profile 3645 and a MenDeVAR Index indicating insufficient evidence for vaccine coverage. WGS identified penA mutations (F504L, A510V, I515V, H541N, I566V) associated with reduced amoxicillin susceptibility and a gyrA T91I mutation conferring ciprofloxacin resistance. Comparative genomic analysis showed close relatedness to European isolates, representing the first genomic documentation of cc175 in Tunisia. This case underscores the value of genomic analysis for detecting emerging antimicrobial resistance and monitoring unusual meningococcal lineages in adult patients.

The oral cavity may act as a reservoir for antibiotic resistance. This study aimed to directly isolate and identify phenotypically resistant bacteria from the oral biofilm of healthy individuals and patients with periodontitis, using tetracycline, and ciprofloxacin containing selective agar. Furthermore, resistance of selected bacteria towards ampicillin was also evaluated. Plaque samples were collected from 12 patients (six healthy, six with periodontitis). Bacteria were cultured on selective agar containg defined antibiotic concentration and non-selective media under aerobic and anaerobic conditions, identified by MALDI-TOF mass spectrometry and 16S rDNA sequencing. The selected bacteria were subsequently tested for susceptibility using disk diffusion, E-test, and β-lactamase assay. 495 strains representing 106 species were isolated, including 54 aerobes/facultative anaerobes and 52 obligate anaerobes. Antibiotic resistance was observed in all subjects: 15.2% of isolates were resistant to tetracycline, 32.9% to ciprofloxacin, and 0.6% to ampicillin, with no significant differences between healthy and periodontitis groups. Tetracycline resistance was most frequent in the Streptococcus mitis group and Eubacterium spp., while ciprofloxacin resistance was dominated by Actinomyces-Schaalia group. Concluding, prevalence of antibiotic-resistance was comparable between healthy and periodontitis patients. Resistance was most prevalent against ciprofloxacin and tetracycline, highlighting the oral cavity as a relevant reservoir for antibiotic resistance.

Salmonella enterica subspecies enterica serovar Minnesota (S. Minnesota) is an emerging serovar in Brazilian poultry production. This study aimed to characterize the antimicrobial resistance profile of 20S. Minnesota strains isolated from broiler chicken litter in Paraná, southern Brazil, between 2021 and 2023, and to confirm these findings with whole-genome sequencing. Antimicrobial susceptibility testing showed all isolates were multidrug resistant. High resistance rates were observed against ciprofloxacin (100%), ceftazidime (95%), and gentamicin (70%). Genomic analysis confirmed the resistance profiles, revealing key resistance determinants: the beta-lactamase gene blaCMY-2 was present in all isolates; parC p.T57S mutation was present in all isolates, along with plasmid-borne qnrB genes in some, correlating with ciprofloxacin resistance; and aminoglycoside resistance genes such as aac(6')-Iy, aph(3)-Ia, and aadA1 were detected. Additionally, all isolates belonged to sequence type ST548 and carried tet(A), sul2, and acrB resistance genes. A major finding was a discrepancy in in-silico serotyping. While SISTR identified all strains as S. Minnesota, SeqSero2 identified one as S. Minnesota and 19 as inconclusive, a difference that highlights the limitations of serological and in silico methods. These results emphasize the spread of MDR S. Minnesota in poultry and the necessity of genomic surveillance for accurate resistance monitoring and public health protection.

Trends in antimicrobial resistance among Enterobacter isolates in an Australian local health district.

Wound infections are becoming increasingly difficult to treat due to rising antibiotic-resistant bacteria. β-Lactamase-producing bacteria are among the most common pathogens implicated in these infections. Here, we report a bacterial enzyme-responsive hydrogel formulated with a cephalosporin-derived, β-lactamase-cleavable crosslinker that undergoes selective degradation in the presence of bacterial β-lactamases. This degradation triggers the on-demand release of encapsulated ciprofloxacin-loaded liposomes, ensuring that antibiotic delivery occurs only at the site of infection. This selective degradation and release was demonstrated in both ex vivo and in vivo models of Pseudomonas aeruginosa wound infections. In a murine skin abrasion infection model, a single application of the hydrogel led to complete bacterial eradication and enhanced wound healing, outperforming a commercial silver-based hydrogel wound dressing. These responsive hydrogels did not induce ciprofloxacin resistance in non-β-lactamase-producing bacteria. These findings demonstrate that β-lactamase-responsive hydrogels provide a precise, infection-triggered antibiotic delivery platform that can improve the treatment of wound infections and mitigate antimicrobial resistance.

Background/Objectives: We analyzed the whole-genome sequences of ciprofloxacin-resistant (CIP-R) enteropathogenic Escherichia coli (EPEC) ST752 isolates in South Korea to characterize their molecular epidemiology. This lineage has emerged as the predominant CIP-R EPEC clone in South Korea, accounting for 28.8% of human clinical isolates and circulating within the One Health interface. Methods: We performed whole-genome sequencing (WGS) and reference-based core-genome single-nucleotide polymorphism (SNP) analysis on 26 CIP-R EPEC ST752 isolates (19 human clinical and 7 poultry-derived isolates). To elucidate their evolutionary history and transmission dynamics, Bayesian phylodynamic and phylogeographic reconstructions were implemented by integrating domestic isolates with a global genome dataset (n = 508). Results: Isolates from human and poultry sources clustered together with an identical virulence profile and minimal genetic distance. The Bayesian molecular clock analysis estimated that the time to the most recent common ancestor of the South Korean clade was 2000.65. Moreover, the phylogeographic analysis supported statistical evidence (Bayes factor 32.16) for the introduction of this lineage into South Korea from Denmark and revealed a strongly supported host transition from humans to poultry (Bayes factor > 10,000), although this requires cautious interpretation due to limited temporal sampling of poultry isolates. Conclusions: Continued integrated One Health surveillance across human, animal, and environmental reservoirs is needed to monitor and prevent the spread of high-risk antimicrobial-resistant clones.

Klebsiella pneumoniae is a World Health Organization priority pathogen because of its rapidly accumulating resistance to multiple drug classes. Over-expression of the AcrAB and OqxAB Resistance-Nodulation-Division (RND) efflux pumps is a key mechanism, yet genomic data on these systems in Peruvian strains are scarce. Sixteen non-duplicate K. pneumoniae isolates obtained from hospitalised patients in Lima (2019–2020) were tested for ciprofloxacin and amikacin susceptibility by broth microdilution, with and without the efflux-pump inhibitors carbonyl cyanide m-chlorophenylhydrazone (CCCP) and phenylalanine-arginine β-naphthylamide (PAβN). AcrA, AcrB, OqxA and OqxB were detected by PCR, and the resulting amplicons were sequenced on the Oxford Nanopore platform. Reads were analysed with Epi2me (Amplicon workflow); single nucleotide polymorphisms (SNPs) were identified by aligning to reference sequences in MEGA, and all sequences were deposited in GenBank. Resistance to ciprofloxacin and amikacin was evaluated in all isolates; 93.8% were resistant to ciprofloxacin and 18.8% to amikacin. PAβN produced a ≥ 4-fold MIC reduction in 18.8% (ciprofloxacin) and 100% (amikacin) of resistant strains; CCCP yielded a ≥ 3-fold decrease in 75% of ciprofloxacin resistant isolates. AcrB and AcrA were detected in 56.3% and 43.8% of isolates, while OqxB and OqxA occurred in 25.0% and 31.3%, respectively. Nanopore sequencing con-firmed gene identity and revealed 12 SNPs detected, OqxB c.56 G > T (V19F) and c.356 C > A (P119H), which may modulate efflux efficiency. Efflux-mediated resistance to ciprofloxacin and amikacin in clinical isolates of K. pneumoniae is underpinned by genetic variants in the AcrAB and OqxAB pumps. The incorporation of long-read amplicon sequencing exposes SNP-level variation missed by conventional PCR studies and underscores the value of routine genomic surveillance. The MIC reversals observed with PAβN and CCCP against these two antibiotics highlight efflux pump inhibition as a promising complementary strategy against resistant K. pneumoniae.

Microplastics are particles of synthetic and biodegradable polymers with a size of up to 5mm that have been detected in almost every part of the environment and the food chain. Research has linked microplastics to the dissemination of antibiotic-resistant bacteria in the environment and the food chain. The objectives of this paper were to evaluate the mutagenicity and toxicity of model microplastics to Salmonella enterica subsp. enterica serotype Typhimurium, to evaluate the impact of model microplastics on the emergence and dissemination of antimicrobial resistance to ciprofloxacin in S. Typhimurium, and to assess the behavior of microplastics in contact with different bacteria and DNA. Model microplastics of acrylonitrile butadiene styrene, polylactic acid, polyvinyl chloride, polyethylene terephthalate, a polylactic acid/polyhydroxybutyrate blend, and glitter, as well as their leachates in phosphate buffer or wastewater, had no mutagenic effects on S. Typhimurium TA98 and TA100. Smaller microplastics (0.09-1.25mm and 0.5mm in size) had a more pronounced effect on the emergence and development of ciprofloxacin resistance in S. Typhimurium. The highest increase in mutation frequency and mutation rate was observed with polylactic acid microplastics and 7-day glitter leachate. Plasmid DNA containing the ampicillin resistance gene was minimally adsorbed onto microplastics; the highest adsorption rate was observed after 6h on acrylonitrile butadiene styrene microplastics. The model strain of Pseudomonas aeruginosa and four resistant isolates of Escherichia coli and Staphylococcus aureus formed biofilms on all model microplastics, with the most pronounced biofilm formation observed on polyvinyl chloride microplastics.

Development of ciprofloxacin resistance coincides with non-cognate plasmid loss during biological wastewater treatment.

CRISPR-Cas-based diagnostics for point-of-care detection of sexually transmitted infections: a laboratory development and evaluation study.

This study investigated the effect of the COVID-19 pandemic on the epidemiology and antimicrobial susceptibility of fecal Campylobacter spp., Salmonella enterica, and Yersinia enterocolitica strains in Southwest Finland from 2018 to 2022. Results show that the number of travel-associated S. enterica and Campylobacter spp. declined markedly from autumn 2019 to autumn 2020 and have recovered gradually. Antimicrobial susceptibility testing was performed on bacterial strains isolated from PCR-positive fecal specimens. Resistance patterns fluctuated throughout the study period. Among C. jejuni, ciprofloxacin resistance averaged 58% in domestic (n = 155) and 88% travel-associated (n = 10) strains, while tetracycline resistance averaged 36% and 63%, respectively; erythromycin resistance was not detected. In S. enterica, resistance averaged 42% and 33% to ampicillin, 33% and 45% to fluoroquinolones, 4% and 6% to cefotaxime, and 0% and 2% to co-trimoxazole, in domestic (n = 24) and travel-associated (n = 32) strains, respectively. Among domestic Y. enterocolitica strains (n = 64), resistance averaged 7% to co-trimoxazole, 2% to ciprofloxacin, and 1% to cefotaxime; no travel-associated strains were reported. This study shows that lockdowns due to the COVID-19 pandemic decreased the number of diagnosed enteropathogens and limited the emergence of resistant strains. Thus, our results reaffirm that travel remains the primary source of S. enterica infections in Finland.

Invasive meningococcal disease is a rapidly progressive infection with high mortality, for which effective antimicrobial therapy and chemoprophylaxis are essential. During national surveillance in El Salvador, invasive Neisseria meningitidis serogroup Y isolates with resistance to first-line agents were identified, prompting further investigation. Ten invasive N. meningitidis serogroup Y isolates, selected for dual resistance to penicillin and ciprofloxacin and collected between 2020 and 2025 by the National Public Health Laboratory of El Salvador, were analyzed at the Adolfo Lutz Institute, São Paulo, Brazil. Antimicrobial susceptibility testing was performed by minimum inhibitory concentration determination, and resistance mechanisms were characterized by whole-genome sequencing. All isolates were resistant to penicillin and ciprofloxacin. Genomic analysis showed that penicillin resistance was mediated by acquisition of the β-lactamase gene blaROB-1, while ciprofloxacin resistance was associated with a threonine-to-isoleucine substitution at position 91 of DNA gyrase (gyrA T91I). Two isolates additionally carried the tetB gene, defining a triple-resistance phenotype. These isolates exhibited markedly elevated tetracycline minimum inhibitory concentrations (6 μg/mL), approximately 40-fold higher than those observed in tetracycline-susceptible isolates. Increased MICs were also observed for minocycline and doxycycline, whereas susceptibility to newer tetracycline derivatives, including tigecycline and eravacycline, was preserved. All isolates belonged to sequence type 3587 within clonal complex 23. We report the first identification of N. meningitidis with concurrent resistance to penicillin, ciprofloxacin, and tetracycline, mediated by blaROB-1, gyrA T91I, and tetB, representing a critical escalation in meningococcal antimicrobial resistance.

Antimicrobial resistance (AMR) is a major global threat. The World Health Organization (WHO) has identified key organisms that carry the potential for both pathogenicity and AMR, leading to reduced treatment options and worsened outcomes, through the Global Antimicrobial Resistance and Use Surveillance System (GLASS). In Timor-Leste, surveillance is now possible due to significant gains in diagnostic capacity. In 2020-2021 a cross-sectional surveillance study was performed on inpatients and outpatients across all hospitals in Timor-Leste. Nose/axilla/groin swabs were selectively cultured for Staphylococcus aureus and methicillin-resistant S. aureus (MRSA); rectal/perianal swabs for extended spectrum beta-lactamase (ESBL) producing organisms and on MacConkey agar with ciprofloxacin and gentamicin discs. S. aureus, Escherichia coli and Klebsiella pneumoniae isolates were assessed for resistance; univariate and multivariable analyses assessed for associations. 516/517 had Gram-positive bacteria screening. S. aureus was detected in 93 (18.0%), 14 (15.1%) of which were MRSA, representing 2.7% MRSA carriage. 511/517 were screened for Gram-negative organisms; 108 (21.1%) cultured at least one ESBL-producing organism; ciprofloxacin resistance was found in 109 (21.3%) and gentamicin resistance in 77 (15.1%). Only one carbapenem-resistant organism (an Acinetobacter baumannii) was detected. Participants in Dili were more likely to be colonised with resistant Gram-negative bacteria (aOR 5.3 ESBL, aOR 3.5 ciprofloxacin resistance, aOR 2.7 gentamicin resistance). Being an inpatient was associated with gentamicin resistance (aOR 2.9); dog ownership was associated with ESBL carriage (aOR 1.9). ESBL, ciprofloxacin and gentamicin resistance carriage rates were high, particularly in Dili. MRSA carriage and carbapenem resistance were reassuringly low. Ongoing surveillance is essential to monitor AMR and inform guideline development.

This study aimed to evaluate the antibiotic susceptibility profiles and resistance trends of these bacteria isolated from blood cultures at our hospital between 2021 and 2024. Bacterial identification was conducted using MALDI-TOF MS, while antibiotic susceptibility tests were performed with the Phoenix M50 system. A total of 1,054 S. aureus isolates were evaluated, including 384 MRSA and 670 MSSA. Additionally, 914 E. faecalis and 692 E. faecium isolates were assessed. The S. aureus isolates demonstrated 98-100% susceptibility to vancomycin, teicoplanin, and linezolid. However, susceptibility to ciprofloxacin significantly declined, with MRSA showing a decrease from 81% to 61% (p = 0.002) and MSSA decreasing from 94% to 74% (p < 0.001). In the case of E. faecalis, susceptibility to streptomycin fell from 63% to 52% (p=0.018). Conversely, in E. faecium, susceptibility to linezolid increased from 88% to 95% (p = 0.029). The rate of MRSA was 36.4%, and susceptibility to vancomycin and linezolid remained high at 98-100%. The increase in ciprofloxacin resistance is noteworthy. For both E. faecalis and E. faecium, susceptibility to linezolid, teicoplanin, and vancomycin was above 90%. These findings highlight the importance of infection control and the rational use of antibiotics.

Pseudomonas aeruginosa is considered a priority pathogen by the World Health Organization due to its resistance to antibiotics. Isolates resistant to ciprofloxacin (CPFX), a bactericide commonly used against P. aeruginosa, usually carry the mutations T83I or D87N in the GyrA subunit of the DNA gyrase. Yet, the molecular mechanisms by which these mutations confer CPFX-resistance to P. aeruginosa are unknown. Here we solved the crystal structure of the P. aeruginosa gyrase catalytic cleavage core and used it to carry out molecular dynamic (MD) simulations of CPFX-gyrase binding in the wild-type as well as the T83I and the D87N mutant systems. Our results show that DNA plays the most prominent stabilizing role once CPFX is bound, with relatively minor contributions from Thr83 or Asp87. Interestingly, we found a solvent cavity adjacent to these residues that may provide CPFX access to the active site. Interaction energy analysis using Umbrella Sampling indicates that Thr83 and Asp87 may influence CPFX trajectory during binding. In the mutant systems, the repulsive potential increases at the cavity site, which may hinder CPFX accessing the binding site. These results shed light on P. aeruginosa resistance to CPFX and may help provide a methodology to identify new therapeutic agents to target fluoroquinolone resistant bacteria.

The aim of this study is to analyze changing trends in isolated organisms and antibiotic resistance of bacterial keratitis (BK) over 26 years. A retrospective medical record review included 542 strains isolated from 462 BK patients between 1998 and 2023. We analyzed routinely generated in vitro antibiotic susceptibility testing results recorded in the laboratory information system and did not perform additional susceptibility testing for research purposes. The entire period was divided into two (first half: 1998-2010, 297 isolates from 255 patients; second half: 2011-2023, 245 isolates from 207 patients) and compared. During the entire period, Staphylococcus spp. (32.3%) and Pseudomonas spp. (18.1%) were common isolates, and a significant increase in Acinetobacter spp. (1.3% vs. 10.6%, p < 0.001) was observed. Among Gram-positive bacteria, methicillin resistance rates remained stable between the two periods (52.6% vs. 46.7%, p = 0.525), and an increase in vancomycin-resistant Enterococci (VRE, 0% vs. 26.1%, p = 0.074) was found. Among Gram-negative bacteria (GNB), ciprofloxacin (7.5% vs. 14.4%, p = 0.108) and imipenem (2.9% vs. 6.5%, p = 0.255) resistance increased slightly, resistance to ceftazidime (8.3% vs. 8.8%, p > 0.999) was maintained, and resistance to aminoglycosides (17.8% vs. 7.2%, p = 0.010) decreased. Our study suggests that conventional topical fortified antibiotic eye drops (tobramycin, ceftazidime) can still be considered as an empirical treatment option for BK. However, our findings revealed a long-term trend of increasing Acinetobacter spp. and VRE, as well as a slight trend of increasing resistance to ciprofloxacin and imipenem in GNB, which may present future challenges in BK treatment.