Minor non-fermenting Gram-negative bacilli in Europe, 2020–2024 (MINOFEu)

Bianco G., Bastos P., Gartzonika K., Christaki E., Mavromanolaki V. E., Maraki S., ...More

International Journal of Antimicrobial Agents, vol.67, no.6, 2026 (SCI-Expanded, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 67 Issue: 6
  • Publication Date: 2026
  • Doi Number: 10.1016/j.ijantimicag.2026.107772
  • Journal Name: International Journal of Antimicrobial Agents
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Chemical Abstracts Core, EMBASE, Environment Index, MEDLINE
  • Keywords: Achromobacter, Antimicrobial resistance, Burkholderia, Non-fermenting Gram-negative bacilli, Sphingomonas, Stenotrophomonas
  • Gazi University Affiliated: Yes

Abstract

Introduction Non-fermenting Gram-negative bacilli (NFGNB) other than Pseudomonas and Acinetobacter species remain largely underrepresented in systematic surveillance programs across Europe. Methods We conducted a multicentre retrospective observational study analysing all minor NFGNB isolates recovered from blood cultures in 56 European Hospital Centres over a 5-year period (2020–2024). Diagnostic approach, epidemiology and antimicrobial susceptibility according to European Committee on Antimicrobial Susceptibility Testing v. 15.0 were investigated. Results A total of 4420 minor NFGNB isolates were included. In 43.6% of cases, the isolates were recovered from polymicrobial blood cultures, and 40.6% were detected during microbiologically defined catheter-related bloodstream infections. Matrix-Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-ToF) mass spectrometry was the most widely used tool for species identification (98%). Antimicrobial susceptibility testing was conducted in all centres, using mostly broth microdilution commercial systems (57%), disk diffusion (57%) and gradient diffusion MIC strip (54%) methods, mainly according to European Committee on Antimicrobial Susceptibility Testing guidelines (67.9%). The most prevalent species were Stenotrophomonas maltophilia (52.4%), Achromobacter xylosoxidans (7.8%), Sphingomonas paucimobilis (5.3%) and the Burkholderia cepacia complex (4.8%). S. maltophilia displayed a high rate of resistance to sulfamethoxazole/trimethoprim (11%), and 2% of the isolates were found to be likely resistant to cefiderocol. A. xylosoxidans showed high resistance to meropenem (10%), piperacillin/tazobactam (24%) and sulfamethoxazole/trimethoprim (53%) when tested by MIC methods, while showing over 90% susceptibility to meropenem when tested by disk diffusion. S. paucimobilis displayed over 90% susceptibility to amoxicillin/clavulanate, ampicillin/sulbactam, imipenem, meropenem and tetracycline. Conclusions This study provides an updated overview of the diagnostic approaches and epidemiology of minor NFGNB across Europe, supporting future comparative analyses and improved diagnostic and antimicrobial strategies.