Bacterial and Fungal Infections in the Era of Antimicrobial Resistance: Precision Diagnostics, Host Response, and Clinical Prognosis
Bogdan Iulia-Georgiana *
University of Medicine and Pharmacy “Victor Babeș”, Timișoara, Romania, Victor Babeș Clinical Hospital for Infectious Diseases and Pneumophthisiology, Timișoara, Romania and Methodological and Research Center for Infectious Diseases, Timișoara, Romania.
Roșca Ovidiu
University of Medicine and Pharmacy “Victor Babeș”, Timișoara, Romania, Victor Babeș Clinical Hospital for Infectious Diseases and Pneumophthisiology, Timișoara, Romania and Methodological and Research Center for Infectious Diseases, Timișoara, Romania.
Cialma Monica
Victor Babeș Clinical Hospital for Infectious Diseases and Pneumophthisiology, Timișoara, Romania.
Bratosin Felix
University of Medicine and Pharmacy “Victor Babeș”, Timișoara, Romania, Victor Babeș Clinical Hospital for Infectious Diseases and Pneumophthisiology, Timișoara, Romania and Methodological and Research Center for Infectious Diseases, Timișoara, Romania.
*Author to whom correspondence should be addressed.
Abstract
This monograph examines severe bacterial and fungal infections through an integrative precision-infection framework that links pathogen characteristics, host factors, systemic response, antimicrobial resistance, and time. It reviews the biological determinants of severe infection, the evolution from conventional microbiology to rapid molecular and emerging diagnostic technologies, and the clinical implications of antimicrobial resistance. Particular attention is given to biomarkers, severity assessment, older adults, antimicrobial stewardship, and the interpretation of bacterial and fungal coinfection and superinfection. The volume also integrates findings generated within the original research programme underpinning the monograph, including studies of multiplex polymerase chain reaction, bacterial superinfection, multidrug-resistant pathogens, fungal infection, and age-related prognostic patterns. These findings are synthesised into the Precision-Infection Model, proposed as a conceptual framework for structuring clinical reasoning rather than as a validated prediction score. The central argument is that microbiological information has greatest clinical value when interpreted together with host vulnerability, inflammatory response, resistance mechanisms, and the timing of diagnosis and treatment. This approach supports a transition from pathogen identification alone towards clinically contextualised diagnosis and targeted antimicrobial decision-making.
Keywords: Antimicrobial resistance, bacterial infections, fungal infections, molecular diagnostics, host response, antimicrobial stewardship, precision medicine