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Global trends and research profile of antibiotic heteroresistance: a bibliometric and visual analysis

Hou J, Peng C, Chen W, Peng L, Ma Y, Kang M

Frontiers in microbiology, 2026

Abstract

Introduction: Antibiotic heteroresistance challenges clinical treatment, risking adverse outcomes and antimicrobial resistance emergence. This study aims to explore its research status and trends.

Methods: We screened global publications on antibiotic heteroresistance from the Web of Science Core Collection, Scopus and PubMed databases. Bibliometrix and VOSviewer were used to conduct the bibliometric and visual analysis of the publications.

Results: In total, 1516 publications on antibiotic heteroresistance were included. The number of publications and citations increased with time, most notably in the last two decades. Among the 377 sources, the most active and most cited journal was Antimicrobial Agents and Chemotherapy. The most productive and most cited author were Michael J. Rybak and Keiichi Hiramatsu, respectively.Emory University and Monash University were the institutions with the most publications and citations, respectively. The USA had the highest publications and citations. Emory University and Monash University were the institutions with the most publications and citations, respectively. The USA had the highest publications and citations. A total of 1758 author keywords and five main clusters were identified, including heteroresistance terms cluster, Gram-positive bacteria cluster, Gram-negative bacteria cluster, Mycobacterium tuberculosis cluster and antifungal heteroresistance cluster. The top ten antibiotics and microorganisms with keywords co-occurrence…

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