Multidrug Resistance Across Pathogens: Fungi, Bacteria, Parasites, and Viruses

Topic Information

Dear Colleagues,

The global emergence of multidrug resistance (MDR) across diverse pathogen types represents one of the most pressing challenges in modern medicine and public health. The challenge of multidrug resistance transcends traditional pathogen boundaries, requiring coordinated responses that recognize both the unique and shared mechanisms across fungi, bacteria, parasites, and viruses. AMR affects many of the gains of modern medicine, making infections harder to treat and making other medical procedures and treatments much riskier. Success in combating this global threat demands unprecedented collaboration between clinicians, researchers, public health officials, and policymakers.

This Topic examines the multifaceted nature of antimicrobial resistance (AMR), which affects countries in all regions and at all income levels, with its drivers and consequences being exacerbated by poverty and inequality. The scope encompasses bacterial superbugs, emerging fungal threats, parasitic drug resistance, and viral escape mechanisms, highlighting both shared resistance mechanisms and pathogen-specific challenges. The articles in this topics will provide critical insights into current resistance patterns, emerging mechanisms, and innovative solutions that collectively chart a path forward in our ongoing battle against multidrug-resistant pathogens.

Dr. Célia F. Rodrigues
Dr. Andreia S. Azevedo
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Antibiotics antibiotics	5.5	10.2	2012	16.4 Days	CHF 2900	Submit
Bacteria bacteria	-	5.0	2022	27.4 Days	CHF 1200	Submit
Microbiology Research microbiolres	2.5	3.5	2010	20.2 Days	CHF 1800	Submit
Microorganisms microorganisms	4.7	8.2	2013	20 Days	CHF 2700	Submit
Parasitologia parasitologia	1.5	2.0	2021	20.6 Days	CHF 1200	Submit
Pathogens pathogens	3.8	6.7	2012	14.1 Days	CHF 2200	Submit

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Published Papers (10 papers)

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All Antibiotics Bacteria Microbiology Research Microorganisms Pathogens Parasitologia

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13 pages, 518 KB  

Open AccessArticle

Molecular Epidemiology of Drug-Resistant Mycobacterium tuberculosis: Mutation Profiles and Resistance Associations

by Mandlenkosi Manika, Lindiwe Modest Faye, Ntandazo Dlatu and Mojisola Clara Hosu

Microbiol. Res. 2026, 17(5), 93; https://doi.org/10.3390/microbiolres17050093 - 8 May 2026

Viewed by 424

Abstract

Background: The global burden of drug-resistant Mycobacterium tuberculosis continues to threaten tuberculosis control efforts, largely due to the emergence and transmission of resistance-associated genetic mutations. Molecular epidemiology provides critical insights into mutation profiles and resistance associations, yet the interplay among key mutations and [...] Read more.

Background: The global burden of drug-resistant Mycobacterium tuberculosis continues to threaten tuberculosis control efforts, largely due to the emergence and transmission of resistance-associated genetic mutations. Molecular epidemiology provides critical insights into mutation profiles and resistance associations, yet the interplay among key mutations and their contributions to complex resistance patterns remains poorly understood, particularly in high-burden settings. Methods: A retrospective, cross-sectional, laboratory-based design was used to analyze 111 phenotypically confirmed drug-resistant isolates. Molecular drug susceptibility testing (DST) for first- and second-line anti-tuberculosis drugs was performed at the National Health Laboratory Service (NHLS) TB reference laboratory. Drug-resistance profiles were classified according to World Health Organization (WHO) definitions. Descriptive and inferential statistical analyses were conducted to determine mutation frequencies, co-occurrence patterns, and associations with resistance profiles. Results: rpoB (D435V 38.7%; S450L 36.0%) and katG (S315T 80.2%) mutations predominated, forming the core molecular basis of MDR-TB, while 15% harbored inhA promoter mutations associated with low-level isoniazid resistance. The most frequent combinations included rpoB S450L with katG S315T and rpoB D435V with katG S315T, consistent with multidrug-resistant tuberculosis (MDR-TB) profiles. Nearly 48% showed dual resistance to fluoroquinolones and second-line injectables. Conclusion: This study highlights the predominance of resistance-associated mutations and their co-occurrence patterns in shaping MDR-TB profiles in the study setting. The observed burden of second-line drug resistance underscores the importance of comprehensive resistance testing. These findings support the use of mutation profiling for rapid diagnosis and informed treatment decisions, while emphasizing the need for ongoing local surveillance to guide TB control efforts. Full article

(This article belongs to the Topic Multidrug Resistance Across Pathogens: Fungi, Bacteria, Parasites, and Viruses)

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20 pages, 1022 KB  

Open AccessArticle

Characterization, Virulent-Determinants, Antimicrobial Resistance, and MALDI-TOF MS Proteomic Profile of Nontyphoidal Salmonella Isolated from Chicken Meat in Fukuoka, Japan

by Khin Zar Linn, Su Zar Chi Lwin, Aye Thida Maung, Marwa Nabil Sayed Abdelaziz, Catherine Damaso Hofilena, Yuzhi Lin, Haomin Ye, Yoshimitsu Masuda, Takahisa Miyamoto and Ken-ichi Honjoh

Microbiol. Res. 2026, 17(3), 63; https://doi.org/10.3390/microbiolres17030063 - 20 Mar 2026

Viewed by 708

Abstract

Nontyphoidal Salmonella (NTS) is a zoonotic pathogen that threatens public health worldwide. This study investigated the prevalence, serotype, virulence, and antimicrobial resistance of NTS isolated from chicken meat in Fukuoka, Japan. Of 50 samples, 64% were positive for Salmonella spp., and 32 NTS [...] Read more.

Nontyphoidal Salmonella (NTS) is a zoonotic pathogen that threatens public health worldwide. This study investigated the prevalence, serotype, virulence, and antimicrobial resistance of NTS isolated from chicken meat in Fukuoka, Japan. Of 50 samples, 64% were positive for Salmonella spp., and 32 NTS strains were isolated from positive samples. Serotyping identified three serotypes: S. enterica ser. Schwarzengrund (78.1%), S. enterica ser. Thompson (15.6%), and S. enterica ser. Oranienburg (6.3%). Multilocus sequence typing revealed three sequence types (STs), and MALDI-TOF MS analysis revealed six distinct clusters, reflecting heterogeneity in protein expression among isolates with the same STs. All isolates harbored the virulence genes hilA, spiC, and ssrB, but not spvC. Microplate assays showed that all S. enterica ser. Schwarzengrund and S. enterica ser. Thompson strains formed biofilms with varying strengths. Antimicrobial susceptibility tests demonstrated that S. enterica ser. Thompson and S. enterica ser. Oranienburg strains were sensitive to all the antimicrobials tested. However, S. enterica ser. Schwarzengrund strains showed resistance to multiple antibiotic classes, and 36% of the isolates were multidrug resistant. These findings suggest a potential public health concern, particularly from S. enterica ser. Schwarzengrund, and underscore the importance of continuous surveillance that integrates both genotypic and phenotypic methods. Full article

(This article belongs to the Topic Multidrug Resistance Across Pathogens: Fungi, Bacteria, Parasites, and Viruses)

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28 pages, 4269 KB  

Open AccessReview

Genetic Elements That Contribute to Antibiotic Resistance in Bacteria of Clinical Importance

by Benjamín Abraham Ayil-Gutiérrez, Erika Acosta-Cruz, Juan Manuel Bello-López, Yesseny Vásquez-Martínez, Marcelo Cortez-San Martin, Lorenzo Felipe Sánchez-Teyer, Luis Carlos Rodríguez-Zapata, Francisco Alberto Tamayo-Ordoñez, Esmeralda Cázares-Sánchez, Víctor Hugo Ramos-García, Eric Sánchez-López, Hernan de Jesús Villanueva-Alonzo, Virgilio Bocanegra-García, Humberto Martínez-Montoya, Grethel Díaz-Palafox, María José García-Castillo, María Concepción Tamayo-Ordoñez and Yahaira de Jesús Tamayo-Ordoñez

Bacteria 2026, 5(1), 14; https://doi.org/10.3390/bacteria5010014 - 5 Mar 2026

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Abstract

Antimicrobial resistance (AMR) poses a severe threat to global health by limiting treatment options and increasing clinical and economic burdens. This review synthesizes evidence showing that resistance evolution is strongly shaped by antibiotic pressure, leading to the accumulation of adaptive mutations, activation of [...] Read more.

Antimicrobial resistance (AMR) poses a severe threat to global health by limiting treatment options and increasing clinical and economic burdens. This review synthesizes evidence showing that resistance evolution is strongly shaped by antibiotic pressure, leading to the accumulation of adaptive mutations, activation of efflux systems, and widespread dissemination of resistance determinants across clinical, animal, and environmental settings. We highlight recent genomic, metagenomic, and structural findings that elucidate the molecular basis of AMR, with particular emphasis on horizontal gene transfer mediated by mobile genetic elements such as plasmids, integrons, and transposons. Analyses across One Health interfaces reveal extensive sharing of antimicrobial resistance genes among humans, livestock, and environmental reservoirs, identifying Enterobacteriaceae and ESKAPE pathogens as key hubs of resistance dissemination. Special focus is placed on Acinetobacter baumannii, where phylogenetic and three-dimensional structural analyses of class D β-lactamases OXA-23 and OXA-24/40 demonstrate a conserved catalytic framework coupled with substantial sequence and conformational variability. These structural differences likely influence carbapenem specificity and resistance levels. Collectively, the findings underscore how genetic diversity, mobile elements, and structural adaptation converge to drive AMR, reinforcing the need for integrated genomic and structural approaches to guide surveillance and antimicrobial development. Full article

(This article belongs to the Topic Multidrug Resistance Across Pathogens: Fungi, Bacteria, Parasites, and Viruses)

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33 pages, 1836 KB  

Open AccessSystematic Review

Antimicrobial Effects of Quebrachitol: A Systematic Review

by Doris Evelyn Yah Hui Jong, Siang Yin Lee, Yun Khoon Liew, Phyu Synn Oo, Amar Harris Arifin, Zi Ni Ngai, Beek Yoke Chin, Shamala Salvamani and Rhun Yian Koh

Microbiol. Res. 2026, 17(3), 52; https://doi.org/10.3390/microbiolres17030052 - 27 Feb 2026

Cited by 1 | Viewed by 930 | Correction

Abstract

Quebrachitol, an optically active cyclitol derived from plants, has recently gained attention as a potential natural product with therapeutic properties, though its antimicrobial effects remain unclear. This systematic review aims to determine, appraise, and consolidate evidence of the antimicrobial potential of quebrachitol. PRISMA-guided [...] Read more.

Quebrachitol, an optically active cyclitol derived from plants, has recently gained attention as a potential natural product with therapeutic properties, though its antimicrobial effects remain unclear. This systematic review aims to determine, appraise, and consolidate evidence of the antimicrobial potential of quebrachitol. PRISMA-guided searches of PubMed, Scopus, and Google Scholar (2000–2024) identified English-language experimental in vitro, in vivo, and in ovo studies. Data on antimicrobial activity, dosage or treatment duration, and mechanisms were extracted, with study quality assessed using QUIN and SYRCLE tools. Of 866 studies screened, 11 met inclusion criteria: seven in vitro, one in vivo, one in ovo, and two combining both approaches. Quebrachitol demonstrated inhibitory effects against Salmonella sp., Candida albicans, infectious bursal disease virus (Avibirnavirus gumboroense), Newcastle disease virus, Plasmodium sp., and notably, biofilm formation by Staphylococcus epidermidis and methicillin-resistant Staphylococcus aureus (MRSA). Overall, quebrachitol exhibits promising antimicrobial potential, but rigorous in vivo studies are required to confirm its efficacy and safety in addressing antimicrobial resistance. Full article

(This article belongs to the Topic Multidrug Resistance Across Pathogens: Fungi, Bacteria, Parasites, and Viruses)

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16 pages, 497 KB  

Open AccessArticle

Phenotypic and Molecular Characterization of Carbapenem-Resistant Escherichia coli Isolated from Retail Meats in Hat Yai, Thailand

by Arnon Chukamnerd, Woralop Modleahman, Pattamarat Rattanachuay, Rattanaruji Pomwised and Pharanai Sukhumungoon

Bacteria 2026, 5(1), 10; https://doi.org/10.3390/bacteria5010010 - 9 Feb 2026

Viewed by 837

Abstract

(1) Background: Carbapenem-resistant Escherichia coli (CREC) is widespread and resistant to almost all available antimicrobial agents. In this study, we aimed to assess the phenotypic and molecular characteristics of CREC isolated from retail meats in Hat Yai, Songkhla, Thailand. (2) Methods: A total [...] Read more.

(1) Background: Carbapenem-resistant Escherichia coli (CREC) is widespread and resistant to almost all available antimicrobial agents. In this study, we aimed to assess the phenotypic and molecular characteristics of CREC isolated from retail meats in Hat Yai, Songkhla, Thailand. (2) Methods: A total of 155 retail meat samples were randomly collected, and 412 presumptive carbapenem-non-susceptible isolates were screened via culturing on imipenem-containing eosin methylene blue (EMB) agar. Susceptibility to imipenem and meropenem was tested using the disk diffusion method, and carbapenemase and virulence genes in CREC isolates were detected using PCR. Phylogenetic groups and genetic relatedness of carbapenemase-positive CREC isolates were analyzed using gene markers and BOX-PCR, respectively. (3) Results: The results revealed a high prevalence of presumptive carbapenem-non-susceptible E. coli (CNSEC) isolates in beef samples. Over 89% of the CNSEC isolates from all meat types were identified as CREC. Of these, only 4.8% of the isolates from beef samples were positive for the bla_NDM gene, and one was also positive for the bla_VIM gene. These isolates carried only the fimH gene as a virulence factor. The bla_NDM-positive CREC isolates were classified in phylogenetic Group D. (4) Conclusions: Identifying antimicrobial-resistant pathogens, particularly CREC, in food-producing animals is critical due to potential risks to public health. Full article

(This article belongs to the Topic Multidrug Resistance Across Pathogens: Fungi, Bacteria, Parasites, and Viruses)

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12 pages, 1897 KB  

Open AccessArticle

Genomic Surveillance Reveals Distinct Clonal Lineages and Antibiotic Resistance Patterns in Staphylococcus aureus from Retail Pork in Beijing Versus Copenhagen

by Yuan Gao, Linli Ji, Taya Tang, Jiadi Zhu, Shuyang Yu, Junjie Niu and Heng Li

Microbiol. Res. 2026, 17(2), 34; https://doi.org/10.3390/microbiolres17020034 - 5 Feb 2026

Viewed by 764

Abstract

The global rise of multidrug resistance (MDR) across bacterial pathogens poses a severe threat to public health, with the food chain serving as a critical reservoir and transmission route for resistant clones. This study investigated the genomic epidemiology of Staphylococcus aureus in retail [...] Read more.

The global rise of multidrug resistance (MDR) across bacterial pathogens poses a severe threat to public health, with the food chain serving as a critical reservoir and transmission route for resistant clones. This study investigated the genomic epidemiology of Staphylococcus aureus in retail pork from Beijing, China, and Copenhagen, Denmark, with a focus on MDR patterns and associated genetic elements. Among 134 isolates, the livestock-associated clonal complex CC398 was the dominant lineage (24.63%) and exhibited a high burden of MDR (48.48%), carrying resistance genes to β-lactams (blaZ and mecA), tetracyclines (tetM and tetK), and aminoglycosides. Notably, MRSA isolates displayed a significantly higher MDR prevalence (73.53%) compared to MSSA isolates (18.00%), underscoring methicillin resistance as a key marker for broader resistance phenotypes. Phylogenetic analysis revealed the segregation of CC398 into distinct sub-lineages, with the livestock-associated branch consistently linked to a characteristic tetracycline–β-lactam MDR profile. Furthermore, high frequencies of mobile genetic elements, such as the rep16 plasmid, were associated with MDR dissemination in CC398. These findings highlight retail meat as an important reservoir for MDR S. aureus and illustrate how livestock-adapted clones contribute to the environmental burden of antimicrobial resistance. This study underscores the need for integrated One Health surveillance that connects veterinary, food safety, and human health sectors to monitor and contain the spread of MDR bacteria across ecological niches. Full article

(This article belongs to the Topic Multidrug Resistance Across Pathogens: Fungi, Bacteria, Parasites, and Viruses)

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16 pages, 1355 KB  

Open AccessArticle

Bacterial Resistance in the ICU: A Comparative Analysis of Pre-Pandemic and Pandemic Periods and the Impact on Clinical Outcomes

by Geane Andriollo Paradynski, Ronaldo dos Santos Machado, Lucas Machado Sulzbacher, Maicon Machado Sulzbacher, Vítor Antunes de Oliveira, Pauline Brendler Goettems Fiorin, Mirna Stela Ludwig, Thiago Gomes Heck and Matias Nunes Frizzo

Microbiol. Res. 2026, 17(1), 8; https://doi.org/10.3390/microbiolres17010008 - 30 Dec 2025

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Abstract

Inappropriate use of antibiotics can stimulate antimicrobial resistance, since bacteria are capable of circumventing pharmacological action through various resistance mechanisms. Recently, during the COVID-19 pandemic, there has been an increase in the use of antimicrobials. This is an analytical, quantitative, and retrospective study [...] Read more.

Inappropriate use of antibiotics can stimulate antimicrobial resistance, since bacteria are capable of circumventing pharmacological action through various resistance mechanisms. Recently, during the COVID-19 pandemic, there has been an increase in the use of antimicrobials. This is an analytical, quantitative, and retrospective study on bacterial resistance and mortality in Intensive Care Unit (ICU) patients from 2017 to 2022. This study analyzed sociodemographic aspects, clinical, and laboratory parameters in patients admitted to the ICU. A total of 221 medical records of patients with multidrug-resistant bacteria in the ICU were included, with an outcome of 95 discharges (42.98%) and 126 deaths (53.01%). An increase in the prevalence of bacterial resistance in the ICU was identified during the Pandemic period, when compared to the Pre-Pandemic period. It was identified that the increase in bacterial resistance of some pathogens was associated with death. It was also observed that age was a factor for an increased risk of mortality in the ICU, no matter the sex of the patient. Importance of careful analysis in the use of antimicrobials, as well as in the care of ICU patients and in the surveillance of bacterial infections by health professionals. Full article

(This article belongs to the Topic Multidrug Resistance Across Pathogens: Fungi, Bacteria, Parasites, and Viruses)

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17 pages, 1577 KB  

Open AccessArticle

Methanolic Extract of Moringa oleifera Seed Synergizes the Bactericidal Effect of Ampicillin, Cephalexin, and Amoxicillin/Clavulanic Acid Against Multidrug-Resistant Escherichia coli Isolated from Street-Vended Food

by Daniela Mora-Coto, Pedro R. Moreno-Vélez, José Luna-Muñoz, José Jaime Jarero-Basulto, Anahi Pérez-Galicia, Samadhi Moreno-Campuzano and Miguel Angel Ontiveros-Torres

Microbiol. Res. 2025, 16(11), 238; https://doi.org/10.3390/microbiolres16110238 - 12 Nov 2025

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Abstract

Background: Antibiotic drug resistance is a serious global health problem that threatens therapeutics against infectious diseases. As antibiotics become less effective every year, our objective was to evaluate the adjuvant activity of methanolic extracts of Moringa oleifera seed combined with antibiotics of clinical [...] Read more.

Background: Antibiotic drug resistance is a serious global health problem that threatens therapeutics against infectious diseases. As antibiotics become less effective every year, our objective was to evaluate the adjuvant activity of methanolic extracts of Moringa oleifera seed combined with antibiotics of clinical use against multidrug-resistant Escherichia coli isolated from street food samples searching for a new alternative to treat infectious diseases commonly treated with antibiotics. Methods: Secondary metabolites of M. oleifera seeds were obtained through maceration (methanol 80%) and detected following qualitative phytochemical assays. MIC, MBC and tolerance level were determined using microdilution tests. Antimicrobial activity was tested by sensitivity analysis, and the adjuvant activity was explored in combination with twelve antibiotics against the E. coli samples. Results: Alkaloids, phenolic compounds, flavonoids, and polyphenols were detected. MIC and MBC values ranged from 31.3 to 62 mg/mL and 62–125 mg/mL, respectively. The extract showed low antimicrobial activity against the multidrug-resistant E. coli, but the inhibitory capacity of ampicillin, cephalexin, and amoxicillin/clavulanic acid was significantly increased when combined with the plant extract. In contrast, the activity of ciprofloxacin, levofloxacin, tetracycline, polymyxin, and nalidixic acid decreased with the extract. Conclusion: Methanolic extracts of M. oleifera seeds represent a potential adjuvant for beta-lactams in the face of the growing problem of global antimicrobial resistance. This study represents the first steps in exploring the adjuvant capacity of plants against resistant environmental pathogens in Mexico. Full article

(This article belongs to the Topic Multidrug Resistance Across Pathogens: Fungi, Bacteria, Parasites, and Viruses)

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12 pages, 1373 KB  

Open AccessArticle

Genomic Surveillance of Plasmodium falciparum Drug Resistance Markers Between October 2021 and June 2023 in Kigali, Rwanda

by Sandra Noukimi Fankem, Jean-Bosco Mbonimpa, Edgar Mutebwa Kalimba, Mariama Telly Diallo, Mary Efeti Teke and Jacob Souopgui

Pathogens 2025, 14(11), 1092; https://doi.org/10.3390/pathogens14111092 - 27 Oct 2025

Cited by 2 | Viewed by 1664

Abstract

Artemisinin-based combination therapies (ACTs) remain the cornerstone of malaria treatment in Rwanda, but the emergence of drug resistance threatens their efficacy. This study conducted genomic surveillance of Plasmodium falciparum isolates collected in Kigali between October 2021 and June 2023 to assess resistance markers. [...] Read more.

Artemisinin-based combination therapies (ACTs) remain the cornerstone of malaria treatment in Rwanda, but the emergence of drug resistance threatens their efficacy. This study conducted genomic surveillance of Plasmodium falciparum isolates collected in Kigali between October 2021 and June 2023 to assess resistance markers. Using Oxford Nanopore Technology and Sanger sequencing methods, we analyzed 250 clinical isolates focusing on mutations in the pfcrt, pfmdr1, pfdhfr, pfdhps, and Pfkelch13 genes. Resistance-associated mutations were highly prevalent: pfcrt 76T (26%) and pfmdr1 184F (72.8%) were common, indicating continued lumefantrine pressure. All isolates carried mutations in pfdhfr and pfdhps, with the IRNI-SAEAA and IRNI-SAEGA haplotypes found in 45.6% and 24.8% of samples, respectively, suggesting sustained antifolate resistance. Pfkelch13 mutations were present in 50.4% of isolates, including validated R561H (25.6%), A675V and candidate P441L mutations. Novel haplotypes, including K189T + R561H (24.8%), were identified for the first time in Rwanda. The BTB/POZ domain mutation H384R was observed in 6.4% of isolates, raising questions about its potential functional role. These findings highlight complex and evolving resistance patterns and emphasize the urgent need for continued molecular surveillance and functional validation to inform malaria control strategies in Rwanda. Full article

(This article belongs to the Topic Multidrug Resistance Across Pathogens: Fungi, Bacteria, Parasites, and Viruses)

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14 pages, 279 KB  

Open AccessArticle

Molecular Epidemiology of Different Bacterial Pathogens and Their Antimicrobial Resistance Genes Among Patients Suffering from Surgical Site Infections in Lebanon

by Inass Kawtharani, Ghassan Ghssein, Ola Srour, Abdul Amir Chaaban and Pascale Salameh

Microbiol. Res. 2025, 16(10), 216; https://doi.org/10.3390/microbiolres16100216 - 1 Oct 2025

Cited by 4 | Viewed by 1628

Abstract

Background: Antimicrobial resistance (AMR) is a major global health threat, particularly in surgical site infections (SSIs), where multidrug-resistant (MDR) pathogens complicate treatment. Objective: This study aimed to identify antimicrobial resistance genes and assess their prevalence in bacterial species causing SSIs in Lebanon. Materials [...] Read more.

Background: Antimicrobial resistance (AMR) is a major global health threat, particularly in surgical site infections (SSIs), where multidrug-resistant (MDR) pathogens complicate treatment. Objective: This study aimed to identify antimicrobial resistance genes and assess their prevalence in bacterial species causing SSIs in Lebanon. Materials and Methods: The present research is a multicenter and prospective study that included patients who developed SSIs after surgery in seven hospitals, within the period of January 2024–September 2024. Bacterial isolates from wound swabs or tissue samples were identified using standard microbiological methods. Antimicrobial susceptibility was tested by disk diffusion, and resistance genes were detected by PCR. Data were analyzed using Statistical Package for the Social Sciences (SPSS). Results: Among 6933 surgical patients, 63 developed SSIs (0.91%; 95% CI [0.70–1.15]). Gram-negative bacteria predominated (73%), mainly Escherichia coli and Pseudomonas aeruginosa, while Gram-positive isolates accounted for 27%, mostly Staphylococcus aureus. MDR was observed in 71% of Gram-positive and 61% of Gram-negative isolates. The most frequent genes were mecA in S. aureus (100%) and coagulase-negative staphylococci (83.3%); bla_CTX-M in E. coli, Klebsiella pneumoniae, and Enterobacter cloacae (100%); and bla_NDM in E. cloacae (100%) and Acinetobacter baumannii (60%). bla_KPC was less common, and no isolates carried Imipenemase (IMP), Verona integron-encoded metallo-β-lactamase (VIM), and Oxacillinase-48-like β-lactamase (OXA-48). Conclusions: This study highlights the high prevalence of antibiotic resistance in agents causing SSIs in Lebanese hospitals. Resistance genes, particularly mecA, bla_CTX-M, and blaNDM, were highly prevalent in SSI pathogens, underscoring the urgent need for surveillance and judicious antibiotic use in Lebanese hospitals. Full article

(This article belongs to the Topic Multidrug Resistance Across Pathogens: Fungi, Bacteria, Parasites, and Viruses)

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