Machine learning (ML) algorithms are increasingly applied in medical research and in healthcare, gradually improving clinical practice. Among various applications of these novel methods, their usage in the combat against antimicrobial resistance (AMR) is one of the most crucial areas of interest, as increasing resistance to antibiotics and management of difficult-to-treat multidrug-resistant infections are significant challenges for most countries worldwide, with life-threatening consequences. As antibiotic efficacy and treatment options decrease, the need for implementation of multimodal antibiotic stewardship programs is of utmost importance in order to restrict antibiotic misuse and prevent further aggravation of the AMR problem. Both supervised and unsupervised machine learning tools have been successfully used to predict early antibiotic resistance, and thus support clinicians in selecting appropriate therapy. In this paper, we reviewed the existing literature on machine learning and artificial intelligence (AI) in general in conjunction with antimicrobial resistance prediction. This is a narrative review, where we discuss the applications of ML methods in the field of AMR and their value as a complementary tool in the antibiotic stewardship practice, mainly from the clinician’s point of view.

Generative AI, including large language models (LLMs), has transformed the paradigm of data generation and creative content, but this progress raises critical privacy concerns, especially when models are trained on sensitive data. This review provides a comprehensive overview of privacy-preserving techniques aimed at safeguarding data privacy in generative AI, such as differential privacy (DP), federated learning (FL), homomorphic encryption (HE), and secure multi-party computation (SMPC). These techniques mitigate risks like model inversion, data leakage, and membership inference attacks, which are particularly relevant to LLMs. Additionally, the review explores emerging solutions, including privacy-enhancing technologies and post-quantum cryptography, as future directions for enhancing privacy in generative AI systems. Recognizing that achieving absolute privacy is mathematically impossible, the review emphasizes the necessity of aligning technical safeguards with legal and regulatory frameworks to ensure compliance with data protection laws. By discussing the ethical and legal implications of privacy risks in generative AI, the review underscores the need for a balanced approach that considers performance, scalability, and privacy preservation. The findings highlight the need for ongoing research and innovation to develop privacy-preserving techniques that keep pace with the scaling of generative AI, especially in large language models, while adhering to regulatory and ethical standards.

Hospital-acquired infections, particularly in the critical care setting, have become increasingly common during the last decade, with Gram-negative bacterial infections presenting the highest incidence among them. Multi-drug-resistant (MDR) Gram-negative infections are associated with high morbidity and mortality with significant direct and indirect costs resulting from long hospitalization due to antibiotic failure. Time is critical to identifying bacteria and their resistance to antibiotics due to the critical health status of patients in the intensive care unit (ICU). As common antibiotic resistance tests require more than 24 h after the sample is collected to determine sensitivity in specific antibiotics, we suggest applying machine learning (ML) techniques to assist the clinician in determining whether bacteria are resistant to individual antimicrobials by knowing only a sample’s Gram stain, site of infection, and patient demographics. In our single center study, we compared the performance of eight machine learning algorithms to assess antibiotic susceptibility predictions. The demographic characteristics of the patients are considered for this study, as well as data from cultures and susceptibility testing. Applying machine learning algorithms to patient antimicrobial susceptibility data, readily available, solely from the Microbiology Laboratory without any of the patient’s clinical data, even in resource-limited hospital settings, can provide informative antibiotic susceptibility predictions to aid clinicians in selecting appropriate empirical antibiotic therapy. These strategies, when used as a decision support tool, have the potential to improve empiric therapy selection and reduce the antimicrobial resistance burden.

Antibiotic resistance presents a critical challenge in healthcare, particularly among the elderly, where multidrug-resistant organisms (MDROs) contribute to increased morbidity, mortality, and healthcare costs. This review focuses on the mechanisms underlying resistance in key bacterial pathogens and highlights how aging-related factors like immunosenescence, frailty, and multimorbidity increase the burden of infections from MDROs in this population. Novel strategies to mitigate resistance include the development of next-generation antibiotics like teixobactin and cefiderocol, innovative therapies such as bacteriophage therapy and antivirulence treatments, and the implementation of antimicrobial stewardship programs to optimize antibiotic use. Furthermore, advanced molecular diagnostic techniques, including nucleic acid amplification tests and next-generation sequencing, allow for faster and more precise identification of resistant pathogens. Vaccine development, particularly through innovative approaches like multi-epitope vaccines and nanoparticle-based platforms, holds promise in preventing MDRO infections among the elderly. The role of machine learning (ML) in predicting resistance patterns and aiding in vaccine and antibiotic development is also explored, offering promising solutions for personalized treatment and prevention strategies in the elderly. By integrating cutting-edge diagnostics, therapeutic innovations, and ML-based approaches, this review underscores the importance of multidisciplinary efforts to address the global challenge of antibiotic resistance in aging populations.

Large language models (LLMs) have transformed Natural Language Processing (NLP) by enabling robust text generation and understanding. However, their deployment in sensitive domains like healthcare, finance, and legal services raises critical concerns about privacy and data security. This paper proposes a comprehensive framework for embedding trust mechanisms into LLMs to dynamically control the disclosure of sensitive information. The framework integrates three core components: User Trust Profiling, Information Sensitivity Detection, and Adaptive Output Control. By leveraging techniques such as Role-Based Access Control (RBAC), Attribute-Based Access Control (ABAC), Named Entity Recognition (NER), contextual analysis, and privacy-preserving methods like differential privacy, the system ensures that sensitive information is disclosed appropriately based on the user’s trust level. By focusing on balancing data utility and privacy, the proposed solution offers a novel approach to securely deploying LLMs in high-risk environments. Future work will focus on testing this framework across various domains to evaluate its effectiveness in managing sensitive data while maintaining system efficiency.

Smart cities, leveraging advanced data analytics, predictive models, and digital twin techniques, offer a transformative model for sustainable urban development. Predictive analytics is critical to proactive planning, enabling cities to adapt to evolving challenges. Concurrently, digital twin techniques provide a virtual replica of the urban environment, fostering real-time monitoring, simulation, and analysis of urban systems. This study underscores the significance of real-time monitoring, simulation, and analysis of urban systems to support test scenarios that identify bottlenecks and enhance smart city efficiency. This paper delves into the crucial roles of citizen report analytics, prediction, and digital twin technologies at the neighborhood level. The study integrates extract, transform, load (ETL) processes, artificial intelligence (AI) techniques, and a digital twin methodology to process and interpret urban data streams derived from citizen interactions with the city’s coordinate-based problem mapping platform. Using an interactive GeoDataFrame within the digital twin methodology, dynamic entities facilitate simulations based on various scenarios, allowing users to visualize, analyze, and predict the response of the urban system at the neighborhood level. This approach reveals antecedent and predictive patterns, trends, and correlations at the physical level of each city area, leading to improvements in urban functionality, resilience, and resident quality of life.