César de la Fuente is on a mission to combat antimicrobial resistance by looking at nature's own solutions. César de la Fuente is an associate professor at the University of Pennsylvania, where he leads the Machine Biology Group. When he was just a teenager trying to decide what to do with his life, César de la Fuente compiled a list of the world's biggest problems. He ranked them inversely by how much money governments were spending to solve them. Antimicrobial resistance topped the list. Twenty years on, the problem has not gone away.

The UK is to use artificial intelligence (AI) to tackle the rising numbers of infections that have become resistant to treatment. The project - a collaboration between the Fleming Initiative and the pharmaceutical company GSK - is a battle between superbugs and supercomputers. It aims to speed up the discovery of fresh antibiotics and deliver new ways of killing other threats, including deadly fungal infections. Overusing antibiotics drives bacteria to evolve resistance to infections, which means new drugs are a priority. Drug-resistant infections are a growing problem - one known as the silent pandemic.

One in six laboratory-confirmed bacteria tested in 2023 proved resistant to antibiotic treatment, according to the World Health Organization. All were related to various common diseases. The proliferation of difficult-to-treat bacterial diseases represents a growing threat, according to the World Health Organization's (WHO) Global Antibiotic Resistance Surveillance Report. The report reveals that, between 2018 and 2023, antibiotic resistance increased by more than 40 percent in monitored pathogen-drug combinations, with an average annual increase of 5-15 percent. According to data reported by more than 100 countries to WHO's Global Antimicrobial Resistance and Use Surveillance System (GLASS), one in six laboratory-confirmed bacteria in 2023 proved resistant to antibiotic treatment, all related to various common diseases globally.

For patients with inflammatory bowel disease, antibiotics can be a double-edged sword. The broad-spectrum drugs often prescribed for gut flare-ups can kill helpful microbes alongside harmful ones, sometimes worsening symptoms over time. When fighting gut inflammation, you don't always want to bring a sledgehammer to a knife fight. Researchers at MIT's Computer Science and Artificial Intelligence Laboratory (CSAIL) and McMaster University have identified a new compound that takes a more targeted approach. The molecule, called enterololin, suppresses a group of bacteria linked to Crohn's disease flare-ups while leaving the rest of the microbiome largely intact.

Antimicrobial Resistance (AMR) is a rapidly escalating global health crisis. While genomic sequencing enables rapid prediction of resistance phenotypes, current computational methods have limitations. Standard machine learning models treat the genome as an unordered collection of features, ignoring the sequential context of Single Nucleotide Polymorphisms (SNPs). State-of-the-art sequence models like Transformers are often too data-hungry and computationally expensive for the moderately-sized datasets that are typical in this domain. To address these challenges, we propose AMR-EnsembleNet, an ensemble framework that synergistically combines sequence-based and feature-based learning. We developed a lightweight, custom 1D Convolutional Neural Network (CNN) to efficiently learn predictive sequence motifs from high-dimensional SNP data. This sequence-aware model was ensembled with an XGBoost model, a powerful gradient boosting system adept at capturing complex, non-local feature interactions. We trained and evaluated our framework on a benchmark dataset of 809 E. coli strains, predicting resistance across four antibiotics with varying class imbalance. Our 1D CNN-XGBoost ensemble consistently achieved top-tier performance across all the antibiotics, reaching a Matthews Correlation Coefficient (MCC) of 0.926 for Ciprofloxacin (CIP) and the highest Macro F1-score of 0.691 for the challenging Gentamicin (GEN) AMR prediction. We also show that our model consistently focuses on SNPs within well-known AMR genes like fusA and parC, confirming it learns the correct genetic signals for resistance. Our work demonstrates that fusing a sequence-aware 1D CNN with a feature-based XGBoost model creates a powerful ensemble, overcoming the limitations of using either an order-agnostic or a standalone sequence model.

Electronic health records (EHRs) are long, noisy, and often redundant, posing a major challenge for the clinicians who must navigate them. Large language models (LLMs) offer a promising solution for extracting and reasoning over this unstructured text, but the length of clinical notes often exceeds even state-of-the-art models' extended context windows. Retrieval-augmented generation (RAG) offers an alternative by retrieving task-relevant passages from across the entire EHR, potentially reducing the amount of required input tokens. In this work, we propose three clinical tasks designed to be replicable across health systems with minimal effort: 1) extracting imaging procedures, 2) generating timelines of antibiotic use, and 3) identifying key diagnoses. Using EHRs from actual hospitalized patients, we test three state-of-the-art LLMs with varying amounts of provided context, using either targeted text retrieval or the most recent clinical notes. We find that RAG closely matches or exceeds the performance of using recent notes, and approaches the performance of using the models' full context while requiring drastically fewer input tokens. Our results suggest that RAG remains a competitive and efficient approach even as newer models become capable of handling increasingly longer amounts of text.

Now, the MIT team have gone one step further by using generative AI to design antibiotics in the first place for the sexually transmitted infection gonorrhoea and for potentially-deadly MRSA (methicillin-resistant Staphylococcus aureus). Their study, published in the journal Cell, interrogated 36 million compounds including those that either do not exist or have not yet been discovered. Scientists trained the AI by giving it the chemical structure of known compounds alongside data on whether they slow the growth of different species of bacteria. The AI then learns how bacteria are affected by different molecular structures, built of atoms such as carbon, oxygen, hydrogen and nitrogen. Two approaches were then tried to design new antibiotics with AI.

Antibiotic Resistance (AR) is a critical global health challenge that necessitates the development of cost-effective, efficient, and accurate diagnostic tools. Given the genetic basis of AR, techniques such as Polymerase Chain Reaction (PCR) that target specific resistance genes offer a promising approach for predictive diagnostics using a limited set of key genes. This study introduces GenoARM, a novel framework that integrates reinforcement learning (RL) with transformer-based models to optimize the selection of PCR gene tests and improve AR predictions, leveraging observed metadata for improved accuracy. In our evaluation, we developed several high-performing baselines and compared them using publicly available datasets derived from real-world bacterial samples representing multiple clinically relevant pathogens. The results show that all evaluated methods achieve strong and reliable performance when metadata is not utilized. When metadata is introduced and the number of selected genes increases, GenoARM demonstrates superior performance due to its capacity to approximate rewards for unseen and sparse combinations. Overall, our framework represents a major advancement in optimizing diagnostic tools for AR in clinical settings.

When I first became a doctor, I cared for an older man whom I'll call Ted. He was so sick with pneumonia that he was struggling to breathe. His primary-care physician had prescribed one antibiotic after another, but his symptoms had only worsened; by the time I saw him in the hospital, he had a high fever and was coughing up blood. His lungs seemed to be infected with methicillin-resistant Staphylococcus aureus (MRSA), a bacterium so hardy that few drugs can kill it. I placed an oxygen tube in his nostrils, and one of my colleagues inserted an I.V. into his arm. We decided to give him vancomycin, a last line of defense against otherwise untreatable infections.

Doctors believe Artificial Intelligence is now saving lives, after a major advancement in breast cancer screenings. A.I. is detecting early signs of the disease, in some cases years before doctors would find the cancer on a traditional scan. Scientists have found a drug that could combat drug-resistant infections – and they did it using artificial intelligence. Using a machine-learning algorithm, researchers at the Massachusetts Institute of Technology (MIT) and Canada's McMaster University have identified a new antibiotic that can kill a type of bacteria responsible for many drug-resistant infections. The compound kills Acinetobacter baumannii, which is a species of bacteria often found in hospitals.