ANTIMICROBIAL resistance surveillance identified infection-specific survival patterns across 7,434 hospitalized patients treated in five countries.
A retrospective pilot study of the Comprehensive Online Database for Antimicrobial Resistance (CODAR) has provided a multinational snapshot of infection types, pathogen distribution, antimicrobial treatment patterns, and clinical outcomes among hospitalized patients. The surveillance study used electronic health records and hospital reports from 21 hospitals in India, Mexico, Saudi Arabia, Spain, and the United Kingdom, covering the period from February 2023 to February 2024.
Among 8,060 eligible patient records, 7,434 had complete data and were included in the analysis. Urinary tract infections were the most common infection type across participating countries, accounting for 29.0% of cases, and occurred predominantly in female patients, who represented 59.0% of UTI cases.
Pathogens, Antimicrobial Treatment, and Outcomes
Comorbidity patterns were broadly consistent across countries, with vascular disorders and metabolic and nutritional disorders among the most commonly recorded. Antimicrobial treatment varied by country and infection type. Meropenem was the most commonly used antimicrobial across most infection types in India, while amoxicillin clavulanate was most commonly used in the UK.
Clinical outcomes differed substantially by infection site. Patients with skin and skin structure infections had the highest survival rate, at 94.4%, and the shortest mean hospital stay, at 20.6 days. By contrast, lower survival rates were reported among patients with bloodstream infections, mixed infections, and lower respiratory tract infections, at 81.7%, 82.1%, and 83.3%, respectively.
CODAR Data Point to High-Risk Infection Patterns
The CODAR pilot study also identified pathogen-specific outcome concerns. Low proportions of patients alive, defined as 55.0% or lower, were observed with both monotherapy and combination therapy in selected pathogen and infection combinations. These included Acinetobacter baumannii in lower respiratory tract infections, Klebsiella pneumoniae in lower respiratory tract infections and bloodstream infections, and Escherichia coli in urinary tract infections in India. In the UK, low proportions of patients alive were observed for Staphylococcus aureus in skin and skin structure infections and Enterococcus faecium in urinary tract infections.
The findings highlight the value of ongoing microbiological surveillance, particularly where antimicrobial resistance intersects with severe infection types and poorer survival. For clinicians, the data reinforce the need for infection control strategies, timely pathogen identification, and suitable antimicrobial therapies to support patient management in hospital settings.
Reference
Townsend A et al. Analysis of Infection Types, Pathogens, Antimicrobial Treatment, and Clinical Outcomes Data in Hospitalised Patients: Comprehensive Online Database for Antimicrobial Resistance (CODAR) Retrospective Pilot Study. J Epidemiol Glob Health. 2026; doi:10.1007/s44197-026-00578-z.
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