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Antimicrobial ResistanceHealth
  • Overview
  • Synthesis
  • Assessments
  • Evidence

Public note

For situational awareness and research transparency. Not medical advice.

Healthactive

Antimicrobial Resistance

Surveillance of emerging AMR phenotypes, carbapenem-resistant Enterobacterales spread, and novel resistance gene dissemination across healthcare settings.

Open assessments

17

Tracked assessments currently open in this scope.

Evidence items

431

Source-attributed evidence available to this scope.

Source feeds

0

Configured sources contributing data to this investigation.

Last activity

Apr 18, 2026

Most recent scope activity captured in the system.

01

Synthesis

The current analyst view of this scope, at increasing levels of depth.

AMR evidence cycle is dry; PubMed stale and multiple connectors at staleness >1.0; two hypotheses approach Apr 27 resolution with no incoming data.

No AMR-specific evidence ingested this cycle. ECDC EARS-Net last ran Apr 21 (stale); PubMed at 14% ok ratio and timing out; Africa CDC failing. Two short-horizon hypotheses — XDR Shigella proportion (resolves Apr 27) and ceftriaxone-resistant gonorrhea US cluster (resolves Apr 27) — are approaching resolution with no evidence to inform them. C. auris expansion (conf 7) and hospital-onset AMR persistence above baseline (conf 7) remain the primary high-conviction bets pending CDC annual reporting.

02

Assessments

Open assessments being tracked inside this scope, ordered for fast review.

ECDC will formally classify Candidozyma auris (formerly Candida auris) as endemic in ≥3 EU/EEA countries via a technical report, surveillance update, or risk assessment by 2026-10-17, formalizing the trajectory described in Medscape 2026-04-13 ("C auris Is Now Endemic in Europe. Can It Be Contained?") and CIDRAP 2025-09-11 ("Multidrug-resistant yeast cases rising rapidly in Europe, survey shows").

Novel Pathogen Detection·active·60%·Through 180D·69 linked items·
Apr 22, 2026

tetM-carrying N. gonorrhoeae prevalence in US surveillance reaches ≥30% by EOY 2026 OR ≥3 independent confirmed extensively drug-resistant (ceftriaxone+azithromycin+ciprofloxacin simultaneously resistant) N. gonorrhoeae transmission clusters documented in US/EU/AU during 2026, threatening the doxyPEP era and last-line cephalosporin therapy.

Novel Pathogen Detection·active·60%·Through Dec 31, 2026·69 linked items·Apr 22, 2026

CDC will publish a Morbidity and Mortality Weekly Report (MMWR) early release or health advisory specifically characterizing XDR Shigella (azithromycin + fluoroquinolone + 3GC resistant) geographic spread and treatment guidance within 60 days of the April 13 2026 emergence report (by June 12 2026), consistent with CDC's precedent of issuing MMWR early releases for novel drug-resistant Shigella phenotypes (2022-2023 ceftriaxone-resistant Shigella MMWR).

Novel Pathogen Detection·active·60%·Through 60D·69 linked items·Apr 22, 2026

At least one XDR Shigella case with genomic linkage to the US April 2026 emergence cluster will be confirmed in Australia, Canada, or Japan within 120 days (by August 13 2026), based on high-frequency MSM travel networks connecting these countries to the US, and the historical 2022-2023 pattern where drug-resistant Shigella reached high-income Pacific Rim countries within 8 months of initial US detection.

Novel Pathogen Detection·expired·40%·Through 120D·69 linked items·Apr 22, 2026

XDR Shigella (extensively drug-resistant, resistant to azithromycin + fluoroquinolones + 3GC) will establish sustained community transmission in at least 3 US states within 12 months of CDC's April 2026 emergence report, requiring updated CDC treatment guidance and triggering enhanced surveillance protocols.

Novel Pathogen Detection·expired·40%·Through Apr 13, 2027·69 linked items·Apr 22, 2026

At least one prospective cohort study will document ARG vertical transfer from mother to neonate as a measurable predictor of neonatal treatment outcomes, demonstrating that community AMR carriage surveillance systematically underestimates baseline population ARG burden

Novel Pathogen Detection·active·40%·Through Dec 31, 2027·23 linked items·Apr 20, 2026

CDC 2026 AR Threats Report (electronic release) will document that ≥3 of the 6 hospital-onset AMR pathogen groups tracked in the 2024 special report (CRAB, CRE, ESBL-Ent, MRSA, MDR-Pa, VRE) remain ≥10% above pre-pandemic 2019 baseline through 2024 surveillance data, confirming sustained post-COVID AMR backslide rather than recovery.

Novel Pathogen Detection·active·70%·Through Dec 31, 2026·23 linked items·Apr 20, 2026

At least one peer-reviewed case series or national surveillance report documenting mcr-type colistin resistance co-resident on the same plasmid as NDM or KPC carbapenemase in a US or EU clinical isolate will be published by 2027-04-20, marking the domestication of the South Asia/Southeast Asia CRE-colistin co-resistance mechanism in western healthcare. Thailand CRKP/colistin genomic surveillance (Nature Jan 2026) documents ST11/ST258/ST307 co-resistance via single mobile plasmid; same high-risk clones dominate US CRE outbreaks. One confirmed case of co-plasmid mcr/NDM in US or EU = last-res...

Novel Pathogen Detection·resolved·50%·Through 365d·0 linked items·Apr 20, 2026

XDR Shigella will be documented causing nosocomial or healthcare-associated transmission in immunocompromised patient wards (oncology, HIV, transplant) in at least one US academic medical center by end 2026, establishing a new healthcare transmission pathway distinct from the MSM sexual network

Novel Pathogen Detection·active·40%·Through Dec 31, 2026·0 linked items·Apr 20, 2026

XDR Shigella (resistant to azithromycin + fluoroquinolones + 3GC simultaneously) proportion in PulseNet US surveillance will exceed 10% of submitted isolates by end of 2026, up from 8.5% in 2023 (MMWR mm7513a1 data endpoint). CIDRAP Jan 14 2026 reported "novel XDR Shigella strain identified in Los Angeles" — the only confirmed 2026 XDR Shigella signal. MMWR 2011-2023 trend shows acceleration: 0% pre-2016 → 8.5% by 2023, with 84% of XDR cases in 2022-2023.

Novel Pathogen Detection·active·50%·Through Dec 31, 2026·1 linked item·Apr 20, 2026

At least one US cluster (≥5 epidemiologically linked cases) of ceftriaxone-resistant Neisseria gonorrhoeae will be confirmed via CDC GISP/ARLN by mid-2027, prompting updated STI treatment guidelines. WHO Nov 2025 warned of "rising, worrisome levels" globally; Healio/CIDRAP Dec 2025 confirmed global surge; FDA approved first new gonorrhoea treatment (zoliflodacin) Dec 2025 specifically because of resistance trajectory.

Novel Pathogen Detection·active·50%·Through Jun 30, 2027·0 linked items·Apr 20, 2026

Candida auris clinical cases reported to CDC will exceed 12,000 cumulative by end of 2026 (from 7,700+ confirmed Jan 2026), with echinocandin resistance proportion exceeding 5% nationally. CDC Feb 2026 study confirms "substantial antifungal resistance"; C. auris spreading through NY/NJ/MI hospital networks (CBS Jan 2026, MLive Dec 2025).

Novel Pathogen Detection·active·70%·Through Dec 31, 2026·1 linked item·Apr 20, 2026

A phylogenetically linked XDR Shigella case will be documented outside the United States by October 2026, tracing to the Los Angeles novel XDR strain identified December 2024/January 2026 via the MSM sexual transmission network

Novel Pathogen Detection·resolved·50%·Through Oct 31, 2026·1 linked item·Apr 20, 2026

At least one additional case of XDR Shigella sonnei carrying BOTH blaDHA-1 (cephalosporinase) and blaCTX-M-15 (ESBL) — the dual-cephalosporinase phenotype first reported in two epidemiologically unlinked LA patients (Yang et al., Antimicrobial Stewardship & Healthcare Epidemiology, CIDRAP 2026-01-14) — will be reported in any T1 source (CDC, MMWR, peer-reviewed journal, ECDC, GLASS) by 2026-07-21.

Novel Pathogen Detection·active·60%·Through 90D·5 linked items·Apr 20, 2026

WHO will issue a global health advisory or Disease Outbreak News specifically addressing the XDR Shigella phenotype (azithromycin + fluoroquinolone + 3GC resistant) within 90 days of the US April 2026 emergence cluster, recognizing international spread risk.

Novel Pathogen Detection·expired·50%·Through 90D·1 linked item·Apr 20, 2026

FDA will initiate a formal regulatory pathway (emergency use, compassionate use IND, or expedited NDA) for pivmecillinam in the US within 180 days of the April 2026 XDR Shigella emergence, given that XDR phenotype (azithromycin + FQ + 3GC resistant) leaves only carbapenems and pivmecillinam as clinically viable options, and pivmecillinam is currently approved in Europe and Canada but not FDA-approved.

Novel Pathogen Detection·expired·50%·Through 180D·1 linked item·Apr 20, 2026

XDR Shigella (azithromycin + fluoroquinolone + 3GC resistant) will be confirmed in at least one US state beyond the index cluster state within 90 days of the April 13 2026 CDC emergence report, based on the very low inoculum transmission threshold (~10-100 organisms) and MSM sexual network connectivity between major US metro areas.

Novel Pathogen Detection·expired·60%·Through 90D·1 linked item·Apr 20, 2026

At least one XDR Shigella case phylogenetically linked to the US April 2026 cluster will be confirmed in a UK, French, or Dutch sexual health clinic or MSM outbreak investigation by September 2026, consistent with the 2022-2023 ceftriaxone-resistant Shigella international spread pattern through MSM travel and sexual networks.

Novel Pathogen Detection·expired·50%·Through 90D·1 linked item·Apr 20, 2026

CDC will issue updated XDR Shigella clinical guidance or treatment advisory by December 31, 2026, specifying carbapenem-class or pivmecillinam as first-line therapy for confirmed XDR Shigella cases, triggered by the April 2026 XDR emergence and the complete failure of standard empirical enteric treatment regimens.

Novel Pathogen Detection·expired·60%·Through Dec 31, 2026·1 linked item·Apr 20, 2026

When CDC releases the 2026 AR Threats Report (electronic format covering ≥19 threats), Candida auris US clinical case count will be reported as ≥2x the 2022 burden (i.e., further multiplication beyond the documented 5x rise from 2019→2022), with ongoing geographic expansion to ≥48 US states.

Novel Pathogen Detection·active·70%·Through Dec 31, 2026·0 linked items·Apr 20, 2026

03

Recent evidence

The most recent source-attributed evidence flowing into this investigation.

Vaccination Coverage by Age 24 Months Among Children Born in 2021 and 2022 — National Immu

Apr 22, 2026
T1·https://www.cdc.gov/mmwr/volumes/75/wr/mm7511a2.htm?s_cid=OS_mm7511a2_w

Vaccination Coverage by Age 24 Months Among Children Born in 2021 and 2022 — National Immu

Apr 22, 2026
T1·https://www.cdc.gov/mmwr/volumes/75/wr/mm7511a2.htm?s_cid=OS_mm7511a2_w

Increases in Kratom-Related Reports to Poison Centers — National Poison Data System, Unite

Apr 22, 2026
T1·https://www.cdc.gov/mmwr/volumes/75/wr/mm7511a1.htm?s_cid=OS_mm7511a1_w

Increase in Poison Center Reports Linked to Kratom-Containing Kava Products — National Poi

Apr 22, 2026
T1·https://www.cdc.gov/mmwr/volumes/75/wr/mm7512a1.htm?s_cid=OS_mm7512a1_w

Increase in Poison Center Reports Linked to Kratom-Containing Kava Products — National Poi

Apr 22, 2026
T1·https://www.cdc.gov/mmwr/volumes/75/wr/mm7512a1.htm?s_cid=OS_mm7512a1_w

Severe Illness Associated with Eating Mushroom-Containing Chocolate Products — United Stat

Apr 22, 2026
T1·https://www.cdc.gov/mmwr/volumes/75/wr/mm7513a2.htm?s_cid=OS_mm7513a2_w

Severe Illness Associated with Eating Mushroom-Containing Chocolate Products — United Stat

Apr 22, 2026
T1·https://www.cdc.gov/mmwr/volumes/75/wr/mm7513a2.htm?s_cid=OS_mm7513a2_w

Emergence of Extensively Drug-Resistant Shigellosis — United States, 2011–2023. case

Apr 22, 2026
T1·https://www.cdc.gov/mmwr/volumes/75/wr/mm7513a1.htm?s_cid=OS_mm7513a1_w·5 linked assessments
Auto-taggedResistance

Notes from the Field : Tetanus in Four Children — Idaho, Minnesota, Missouri, and Wisconsi

Apr 22, 2026
T1·https://www.cdc.gov/mmwr/volumes/75/wr/mm7514a2.htm?s_cid=OS_mm7514a2_w

Notes from the Field : Tetanus in Four Children — Idaho, Minnesota, Missouri, and Wisconsi

Apr 22, 2026
T1·https://www.cdc.gov/mmwr/volumes/75/wr/mm7514a2.htm?s_cid=OS_mm7514a2_w