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Genesis of Antibiotic Resistance (AR) LXXXIX: Turbulence Modeling(TM) of Hemodynamics in Simplified Severe Sepsis Protocol-2 (SSSP-2)-NCT01663701: Global Alliance for an Integrated Data Base on Antibiotic(AR)/Antimicrobial(AMR)Susceptibility Test Interpretive Criteria (Breakpoints) (STIC), to mitigate AR Pandemic(ARP) in turn Fetter Modalities of Neuro(logy)) Psychiatry


Problem Statement and Rationale: Unpredictable nature of fluid dynamic/mechanical properties of circulation, subsequent to ERP-EGDT, in part attributed to multiple classes of antibiotics (met. Breakdown products, adducts), administered across the globe Tx, sepsis with CC, MCC, DDx, Rx, PX., impeded the TM of ZoO @ LPE vortices, control of VKVS, BLS on ISP surpassing GCS 3-8 to ihm. To obtain a reasonable understanding of the factors governing, antimicrobial stewardship (AS), and STIC, which are intrinsically strewn across the globe, we have completed a review focused on its effective utilization in TM of ERP-EGDT, Tx severe sepsis: Part I: Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data; Approved Guideline-4ed. CLSI document M39-A4. PA; CLSI: 2014; Part II: CLSI-M-100-ED31:2021 CLSI, 31st Edition, Part III: Potential approach to susceptibility testing and management of MDR pathogens by Infectious Diseases Society of America(IDSA) Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections, Part IV: Antimicrobial Use and Resistance (AUR) Options: Resources: protocols, data collection forms & instructions, data validation, supporting materials; Part V: Implementing an Antibiotic Stewardship Program: Guidelines by the IDSA and the Society for Healthcare Epidemiology of America, Part VI: Stewardship Assist, Antimicrobial Stewardship App. Taken together, it would be reasonable to pray that premier global health agencies such as WHO, organize a “World Congress of AR-AMR” on an annual basis where experts on AR/AMR across the globe explore/exchange ideas to mitigate ARP. Also, to reach consensus for a centralized (agency) database for reporting on the complete information from multiple stakeholders across the globe on AF, DRI, RM, STIC, and AS strategies with a renewed focus in the area of: a comprehensive report on the list of routinely tested antibiotics (from county, city, state, country, continental), susceptible, intermediate, the pandemic potential of AR pathogens, list of unused/discontinued antibiotics/antimicrobials, confirmed list of first AR bacterial pathogen isolates,(“Pan Resistant Isolate”: ex: pan resistance enterobacter) of MDR, XDR, & PDR (CRE/CRPA, CRAB), list of novel antibiotics against MDR, XDR, PDR; its pharmacokinetics/pharmacodynamics of (Cmin MIC, Cmax MIC, AUC:MIC), and workflow pathways for conventional and rapid diag. testing. Such an effect will definitely confer a better understanding of the impact of antibiotics (Jarisch Herxheimer Reaction @JHR-neuropsychiatry), toxicity profile on vortices formation, control of VKVS in TM to achieve the dream to identify the point of care intervention for mitigating mortality in ERP-EGDT. (Ack: Source: Subburaj Kannan, M.D., Ph.D., attended MyCE-Harvard Medical School, MA “Antimicrobial Resistant Gram-Negative Infections:”, on 11/03/21).



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