Clinical Microbial Infection and Antimicrobial Resistance

Dear Colleagues,

Clinicians are overwhelmed by the ever-changing landscape of antimicrobial resistance that is problematic in the treatment of bacterial, viral, fungal, and even protozoal infections. This ever-changing landscape has posed serious challenges for clinical microbiologists as well as infectious disease clinicians. As new organisms emerge such as Candida auris, the problem of resistance at times seems overwhelming. Even older organisms such as Staphylococcus aureus have challenged us with not only methicillin-resistant S. aureus but also vancomycin-resistant S. aureus. HIV has had the greatest clinical impact among viral pathogens that can emerge to be drug resistant while under the pressures of therapy, and then, they are transmitted to uninfected individuals, resulting in therapeutic challenges for the practicing clinician who must utilize genotypic analysis for decision making. The World Health Organization has indicated that antimicrobial resistance is a top global health threat, contributing to 4.95 million deaths (1). At the center of this controversy is how can we avoid unnecessary antimicrobial usage through strong antimicrobial stewardship programs as advocated by the Infectious Disease Society of America. The pipeline for antimicrobial therapy is limited and poses the greatest threat to dealing with this landscape of ever-changing resistance. In addition, a challenge to clinical microbiology laboratories is providing relevant clinical information and also poses to be a rate-limiting step in addressing this problem. The economic impact of these challenges cannot be underestimated as the World Bank has estimated that antimicrobial resistance could result in USD 1 trillion of additional healthcare cost by 2050 (2). All papers examining the problem of and response to antimicrobial resistance are welcome.

Dr. Louis Saravolatz
Guest Editor

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• antimicrobial resistance
• antimicrobial stewardship
• multidrug resistance
• antibiotic development
• resistance control