Data Challenge:AMRFloodNexus

Empiric antimicrobial therapy guidelines remain structurally static, failing to account for climate-driven environmental selection pressures that accelerate resistance emergence in vulnerable populations. This study investigates whether flooding as a dominant environmental stressor correlates with accelerated carbapenem resistance in Klebsiella pneumoniae, and whether MIC trajectories from 2015 to 2025 suggest current empiric therapy guidelines inadequately protect flood-affected populations in low- and middle-income countries. Using the Pfizer ATLAS_Antibiotics and Venatorx GEARS datasets from the Vivli AMR Register, we will compare carbapenem (Imipenem, Ertapenem, Meropenem) MIC trajectories for K. pneumoniae across two climatically distinct cohorts: a flood-dominant cohort comprising India, Pakistan, and Vietnam, and an arid non-flood-dominant control cohort comprising Tunisia, Morocco, and Egypt. Flood event timelines will be integrated from the EM-DAT International Disaster Database. MIC values will be analyzed as continuous log-transformed variables across pre- and post-flood epochs. Cumulative distribution plots and Kolmogorov-Smirnov testing will identify statistically significant rightward MIC shifts following major flood events. Probability of Target Attainment will be calculated against standard national empiric carbapenem dosing regimens to quantify the direct clinical consequence of resistance acceleration in disaster-affected populations. This research advances AMR science across four impact domains. It identifies whether climate shocks create predictable windows of empiric therapy failure, directly improving patient outcomes in disaster settings. It provides evidence for dynamic, climate-informed stewardship guidelines replacing static protocols. It generates actionable surveillance data for flood-prone LMIC populations underrepresented in resistance literature. Finally, it equips national health ministries with a quantitative framework for preemptive guideline revision following climate disasters.