Antimicrobial Susceptibility in Infectious Disease Epidemiology

Antimicrobial susceptibility forms a cornerstone of infectious disease epidemiology by quantifying the sensitivity of pathogens to therapeutic agents and guiding interventions to limit resistance. The process centres on laboratory assays—such as minimum inhibitory concentration determination and disc diffusion—to establish breakpoints that distinguish susceptible from resistant strains. Surveillance systems integrate these data to monitor temporal and geographic trends, detect emergence of multidrug-resistant organisms and inform empirical treatment guidelines. Epidemiological analyses correlate patterns of resistance with antimicrobial consumption, demographic factors and health-care practices, revealing hotspots of resistance and directing stewardship efforts. Global significance is evident in the spread of extended-spectrum β-lactamase and carbapenemase producers, which compromise frontline therapies and elevate morbidity and mortality. In response, antimicrobial stewardship programmes harness susceptibility data to refine prescribing, shorten durations of therapy and promote narrow-spectrum agents when feasible. The interplay between surveillance, stewardship and policy fosters a dynamic framework that balances individual patient outcomes with population-level containment of resistance. Emerging tools—such as rapid genotypic assays and machine-learning models—promise to accelerate susceptibility profiling and tailor interventions. Yet persistent challenges include standardisation of testing in resource-limited settings, integration of data streams across sectors and maintenance of antibiotic pipelines. Addressing these requires coordinated global action, robust data sharing and sustained investment in diagnostic and stewardship infrastructures to preserve antimicrobial efficacy and safeguard public health.

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Antimicrobial Susceptibility in Infectious Disease Epidemiology publication trend

The graph below shows the total number of articles in antimicrobial susceptibility in infectious disease epidemiology across all publications each year (not limited to Nature Index journals).

Technical terms

Antimicrobial susceptibility: The degree to which a microorganism is inhibited or killed by a given antimicrobial agent under standardized laboratory conditions.

Minimum inhibitory concentration (MIC): The lowest concentration of an antimicrobial that prevents visible growth of a microorganism after a defined incubation period.

Extended-spectrum β-lactamase (ESBL): Enzymes produced by certain bacteria that confer resistance to penicillins and cephalosporins by hydrolysing their β-lactam ring.

Carbapenemase: A class of β-lactamase enzymes capable of hydrolysing carbapenems, leading to resistance against last-resort antibiotics.

Antimicrobial stewardship programme: A coordinated set of interventions designed to optimise antimicrobial use, improve patient outcomes and limit the emergence of resistance.

References

1. Establishment of an Antimicrobial Stewardship Program to Spare the Use of Oral Fluoroquinolones for Acute Uncomplicated Cystitis in Outpatients. Antibiotics (2024).
2. Trend of distribution and antimicrobial resistance in uropathogens in China from the CHINET antimicrobial resistance surveillance program, a 7-year retrospective study. One Health Advances (2024).
3. Clinical effectiveness of beta-lactams versus fluoroquinolones as empirical therapy in patients with diabetes mellitus hospitalized for urinary tract infections: A retrospective cohort study. PLOS ONE (2022).