This indicator is measured based on isolate-level antimicrobial resistance (AMR) data collected annually through the enhanced surveillance initiative launched in the Region. Coordinated through national AMR focal points, the initiative has enabled countries to report carbapenem-resistant pathogens isolated from blood cultures. 

For this indicator, there were not enough data to support an assessment. Reliable regional trend data for bloodstream infections caused by carbapenem‑resistant organisms remain scarce. The baseline rate in 2015 was 1.185 infections per 1000 patients, with a 2025 target of 1.067, but no recent regional estimate is available. Expanded surveillance networks have increased participation to 7 countries. In Colombia, the sentinel network expanded from 2 to 444 hospitals; however, heterogeneity in data quality and denominators hinders assessment of regional trends. 

The principal constraints are insufficient investment in microbiology laboratory capacity to produce reliable AMR data, uneven coordination and accountability , and fragmented information systems that hinder data‑to‑action pathways. Most countries have developed or updated national action plans on AMR and have established coordination mechanisms, although fewer than 30% have a dedicated budget. During the biennium, Caribbean countries received laboratory equipment and implemented low‑cost carbapenemase detection methods in 17 laboratories across 9 countries. The Bureau and partners have supported capacity‑building and training activities, as well as civil‑society initiatives such as Empowered Communities to Tackle AMR, aimed at raising awareness and promoting responsible antibiotic use.