Multidrug-Resistant Bacterial Infections: A Mini-Review

Abstract

Multidrug-resistant (MDR) bacterial infections are a major global public-health and sustainable-development challenge. MDR bacteria are generally defined as organisms that are non-susceptible to at least one antimicrobial agent in three or more antimicrobial categories, although definitions may vary by organism and clinical context [1]. Resistance compromises the treatment of common infections, increases mortality and hospitalisation, raises healthcare costs, and threatens procedures such as transplantation, cancer chemotherapy, intensive care, and major surgery. The Global Burden of Disease study estimated that bacterial antimicrobial resistance (AMR) was associated with 4.71 million deaths in 2021, including 1.14 million deaths directly attributable to resistance, and projected a substantial future burden if effective action is not sustained [2]. The World Health Organization’s 2024 Bacterial Priority Pathogens List identifies 24 priority pathogens across 15 families, with carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Enterobacterales, third-generationcephalosporin-resistant Enterobacterales, and rifampicin-resistant Mycobacterium tuberculosis classified as critical priorities [3]. This mini-review discusses the epidemiology, major MDR pathogens, molecular mechanisms, drivers, clinical and environmental consequences, diagnostic approaches, and prevention strategies. It emphasises that MDR infections require coordinated One Health action involving antimicrobial stewardship, infection prevention, vaccination, improved laboratory capacity, responsible agricultural antibiotic use, wastewater management, surveillance, and development of new therapeutic and preventive technologies.