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
Authors: Torralba Jocelyn , Moyeda Nicanor , Montoya Hector , Flores Jorge , Kannan Subburaj 
Published: May 2022

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 (CminMIC, CmaxMIC, 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).