Data on cefiderocol resistance in West Africa

The gap

Evidence profile

Sourced from the stated research gap and future work of the source papers, classified as general, spanning 3 journals.

Supporting evidence — 3 representative gaps

• NDM‑mediated cefiderocol resistance among a series of carbapenem‑resistant Gram‑negative bacilli isolates in Niger (2026) · F1000Research · doi

  There is a lack of data on cefiderocol resistance in West Africa, particularly among NDM-producing Gram-negative bacilli. The study aims to address this knowledge gap by characterizing cefiderocol-resistant isolates and detecting carbapenemase genes. The research seeks to understand the mechanisms of cefiderocol resistance and its implications for public health.

  generalstated research gap
  Keywords: there lack data cefiderocol resistance west africa particularly
• Fosfomycin Resistance in Escherichia coli: Mechanisms, Trends, and Clinical Challenges (2026) · Cureus · doi

  Fosfomycin-resistant E. coli infections are on the rise, which emphasizes the necessity of ongoing research and the creation of practical solutions to maintain fosfomycin’s clinical usefulness. The molecular epidemiology of resistance genes, particularly plasmid-mediated determinants like fosA3, and their function in the spread of MDR strains should be the main focus of future research. In both hospital and community settings, WGS and advanced genomic surveillance may aid in the early identification and tracking of resistant clones [16]. Accurate diagnosis of fosfomycin resistance and prompt therapeutic decision-making depend on the development of quick molecular diagnostic approaches and uniform susceptibility testing procedures. Affordable molecular assays for rapid detection of fosA3 and other transferable resistance determinants remain limited in many resource-constrained settings and should be prioritized to improve early detection and surveillance of fosfomycin resistance. Additionally, investigating fosfomycin-based combination therapies against carbapenem-resistant and ESBL-producing E. coli may enhance treatment results and lessen the emergence of resistance during therapy [7]. Future goals should include bolstering antimicrobial stewardship initiatives, encouraging sensible antibiotic usage, and carrying out multicentric surveillance investigations, especially in emerging nations like India. To maximize fosfomycin’s therapeutic function against resistant Gram-negative organisms, more clinical trials assessing the drug’s effectiveness and safety in severe systemic infections are required [5].

  generalfuture workevidence 5/5
  Keywords: fosfomycin resistance resistant molecular surveillance coli infections clinical determinants like fosa function future settings early
• Carbapenem-resistant Gram-negative pathogens: molecular epidemiology, diagnostic advances, and emerging therapeutic strategies (2026) · Frontiers in Microbiology · doi

  Despite major advances in diagnostics and therapeutics, CR-GNPs remain a significant global health threat because of the continued emergence of resistance mechanisms and high- risk clones. Future control strategies will rely on genomic surveillance, precision diagnostics, AI-assisted clinical decision support, antimicrobial stewardship, and One Health interventions. 6.1 Expansion of genomic surveillance programs Routine implementation of WGS is expected to transform CR- GNP surveillance by enabling comprehensive characterization of resistance determinants, virulence factors, mobile genetic elements, and transmission pathways. Real-time genomic surveillance will facilitate early detection of emerging carbapenemase variants, track the spread of high-risk clones and assist with infection prevention. Integration of genomic data into national and international surveillance networks will strengthen monitoring of resistance dissemination and the emergence of hybrid resistance– virulence plasmids across healthcare, community, animal, and environmental settings (McArthur and Tsang, 2017). 6.2 Precision diagnostics and rapid resistance prediction Current diagnostic approaches for CR-GNPs remain limited by turnaround time, cost, and incomplete characterization of resistance mechanisms. Future precision diagnostics integrating nanopore sequencing, metagenomics, CRISPR-based assays, and multiplex molecular platforms are expected to enable rapid detection of pathogens and resistance determinants directly from clinical specimens. Expanding access to affordable point- of-care (POC) molecular diagnostics, particularly in low- and middle-income countries, will improve timely diagnosis, optimize antimicrobial therapy, and strengthen antimicrobial stewardship (Elbehiry and Abalkhail, 2025). 6.3 AI and digital microbiology role Artificial intelligence is expected to play an increasingly important integrating in CR-GNP management by microbiological, genomic, epidemiological, and clinical data for resistance prediction, therapeutic guidance, and outbreak surveillance. Successful implementation will require standardized datasets, robust model validation, transparent algorithms, and appropriate regulatory oversight (Peiffer-Smadja et al., 2020). 6.4 Novel therapeutic approaches Novel BL/BLI combinations have expanded treatment options for CR-GNP infections; however, resistance to these agents is increasingly being reported. Continued investment in innovative therapeutics remains essential. Promising future therapeutic strategies include: • Next-generation β-lactamase inhibitors active against MBLs • Improved siderophore antibiotics • Bacteriophage therapy • Antimicrobial peptides • Anti-virulence compounds • Monoclonal antibody-based therapies • Host-directed immunomodulatory approaches

  generalfuture workevidence 5/5
  Keywords: resistance surveillance diagnostics genomic antimicrobial future precision clinical expected virulence approaches therapeutic therapeutics gnps remain

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