Antimicrobial Resistance and the Blood–Brain Barrier: Complex Interactions and Implications for Neurological Health

This review explores the interplay between antimicrobial resistance (AMR) and the blood–brain barrier (BBB) and its potential implications for neurological health. It encompasses diverse facets, from the mechanisms used by pathogens to cross the BBB to the clinical outcomes and long-term consequences of compromised BBB integrity. The analysis underscores the complexity of this relationship, revealing how AMR challenges treatment efficacy while the BBB acts as a crucial guardian of central nervous system (CNS) homeostasis. Both direct and indirect mechanisms exist through which pathogens impact the BBB, including structural compromise and the elicitation of neuroinflammatory responses. These interactions have profound implications for the incidence, severity, and prognosis of CNS infections. A novel contribution of this review is its discussion of emerging evidence linking AMR to neurodegenerative processes, as well as its consideration of advanced diagnostic and therapeutic strategies.