Understanding Gram-Negative Bacterial Infections in Thailand: An Analysis of Trends and Challenges

Gram-negative bacteria pose a significant threat in hospitals and community settings across Thailand. Limited antimicrobial stewardship, access to and use of prevention measures, and gaps in national surveillance contribute to this ongoing global challenge. In the present review, the literature on Gram-negative hospital- and community-acquired infections in Thai adults published between 2010 and 2024 is summarized, focusing on data collection and reporting gaps. Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Burkholderia pseudomallei were the most frequently reported pathogens. Of these, A. baumannii, K. pneumoniae, and P. aeruginosa were the most common hospital-acquired infections, whereas E. coli and B. pseudomallei were the most common community-acquired infections. Although there is a critical need for studies on antibiotic resistance patterns, treatments, and specific Gram-negative pathogens, the authors of large-scale prevalence studies did not clearly outline the distribution of these types of infections. More inclusive nationwide studies in which both hospital- and community-acquired Gram-negative infections are examined would be beneficial.