Prevalence and Antibiotic Resistance Patterns of Multidrug-Resistant Bacteria Isolated from Clinical Specimens

https://doi.org/10.5281/zenodo.19229069

Abstract

The escalating global crisis of antimicrobial resistance (AMR) poses a severe threat to public health, with multidrug-resistant (MDR) bacteria responsible for an estimated 4.71 million deaths in 2021 and projected to cause 10 million annual deaths by 2050. This review synthesizes current epidemiological data on the prevalence and resistance patterns of MDR bacteria isolated from clinical specimens across diverse geographic regions, with particular emphasis on low- and middle-income countries (LMICs) in Africa and South Asia. High MDR rates were consistently observed across specimen types, with urine (up to 72%), blood (52.3%), and wound/pus samples showing the highest burden. ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) dominate, exhibiting resistance to multiple antibiotic classes through mechanisms including β-lactamase production (ESBLs, carbapenemases), target modification, efflux pumps, and biofilm formation. Regional hotspots include West Africa (59% overall MDR), Pakistan (high XDR Salmonella typhi and MRSA), and Nepal (52.3% MDR in tertiary care). The analysis underscores the critical role of inappropriate antibiotic use, environmental reservoirs, and healthcare-associated transmission in driving resistance. Strengthening antimicrobial stewardship, rapid diagnostics, enhanced surveillance (e.g., WHO GLASS), and a One Health approach are urgently required to curb the spread of MDR pathogens and preserve the efficacy of existing antimicrobials.