Antimicrobial resistance in children rises globally — 100K+ samples reveal

Spanning 82 countries, there was an increase in every region between 2004 and 2022, with the researchers also offering region- and pathogen-specific forecasts to 2035.

Led by Murdoch Children’s Research Institute (MCRI) in collaboration with the University of Sydney, Clinton Health Access Initiative (CHAI) and The Chinese University of Hong Kong, a monitoring platform has analysed more than 106,000 infection samples from children aged up to 18 years across 82 countries. Between 2004 and 2022, antibiotic resistance was found to have increased in every region — with babies, children in intensive care and countries with fewer healthcare resources the most affected.

Occurring when bacteria evolve to withstand antibiotic treatment, infections become harder to treat as resistant bacteria emerge and spread through communities. As they experience high rates of bacterial infections and have fewer antibiotic options, children are especially vulnerable. Dr Yanhong Jessika Hu of MCRI and the University of Sydney said that by combining almost two decades of global data with forecasting, the platform could identify where resistance was likely to emerge before it becomes an even greater clinical challenge.

Created and recently launched by the study’s team, AMR in Kids (www.amrinkids.com) is a website that allows clinicians, researchers and policymakers to explore antibiotic resistance by country, bacteria and antibiotic class. Region and pathogen-specific forecasts to 2035 are also provided, a measure designed to help researchers to identify emerging threats, inform treatment decisions and help guide public health planning.

“Antimicrobial resistance is one of the biggest threats to children’s health globally, but until now we haven’t had a clear picture of how it’s changing specifically in children,” Hu said. “The AMR in Kids platform addresses a major gap by developing region- and pathogen-specific forecasts for the next decade.” By 2035, some of the most dangerous pathogens could become highly resistant to last-line treatments, forecast modelling by the platform suggests.

“In high-income countries, antibiotic overuse must be tackled across farming, veterinary, primary care and hospital settings, while infection control remains critical,” MCRI’s Associate Professor Penelope Bryant said. “We also need child-friendly antibiotic formulations, clearer dosing guidance and funding for trials on safely reducing antibiotic use. Consumers can help by talking with their GP about the risks of overprescribing antibiotics.”

Two types of Gram-negative bacteria — Acinetobacter baumannii and Klebsiella species — were found to be driving antimicrobial resistance globally. Commonly causing hospital-acquired bloodstream infections and pneumonia, Acinetobacter baumannii showed the highest overall resistance while Klebsiella species — causing urinary tract infections and liver abscesses — recorded the fastest increase, particularly in Southeast Asia, Eastern Europe and the Western Pacific. Resistance to last-line carbapenem antibiotics is projected to rise substantially by 2035, reaching 82% and 35%, for each superbug, respectively.

The study was published in JAMA Pediatrics (doi.org/10.1001/jamapediatrics.2026.2808).

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