Unraveling Resistance: How Clinical Realities Shape Epidemiological Trajectories

Dear Colleagues,

Antimicrobial resistance represents a complex clinical and epidemiological challenge that intersects patient care, healthcare systems, and population health dynamics. The emergence and spread of resistance involve not only the direct interaction between antimicrobial use and microbial evolution but also incorporate healthcare environments, patient movements, and community transmission networks that facilitate the dissemination of resistant pathogens. While clinicians struggle with infections that no longer respond to conventional therapies, epidemiologists track their trajectories across populations and geographic regions. Although antimicrobial stewardship programs and infection prevention strategies offer critical layers of defense, many interventions struggle to translate evidence-based guidance into practice due to the realities of clinical workflows, resource constraints, and local contextual barriers.

Within an integrated clinical-epidemiological framework, this Special Issue aims to cover a range of topics, including resistance surveillance systems that capture both clinical outcomes and transmission patterns, integrated data analysis and predictive modelling that inform treatment decisions in real-world practice, cost-effective diagnostic and therapeutic strategies, and the assessment of stewardship and infection prevention effectiveness across diverse healthcare settings. Furthermore, acknowledging that resistance trajectories are shaped by complex interactions between prescribing practices, patient populations, healthcare infrastructure, and diagnostic capabilities, this Special Issue will focus on understanding how clinical realities, including treatment failures, empiric therapy choices, and care pathways, directly influence epidemiological patterns observed at institutional, regional, and global scales.

Through this integrative lens, we invite contributions that not only address these challenges but also emphasize approaches that consider the interconnected nature of clinical decision-making, microbiological dynamics, and population-level transmission. We particularly welcome studies that translate epidemiological insights into clinically actionable strategies, or that reveal how frontline clinical experiences can reshape our understanding of resistance emergence, persistence, and spread.

Dr. Refath Farzana
Guest Editor

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