Global Trends in Antimicrobial Resistance: Insights from Clinical, Community, and Livestock Settings (۲۰۱۳-۲۰۲۲)

This review synthesizes epidemiological and molecular data from studies conducted between ۲۰۱۳ and ۲۰۲۲ across Asia, the Middle East, Europe, and North America to delineate the contemporary landscape of antimicrobial resistance (AMR) in key bacterial pathogens. We analyze patterns in hospital environments (oncology, neonatal ICU, emergency departments), community-acquired infections, and livestock reservoirs, with a focus on Staphylococcus aureus and Gram-negative Enterobacterales. Findings consistently reveal high prevalence of multidrug-resistant organisms (MDROs): MRSA rates ranged from ۳۳% to ۶۸% in clinical settings, while extended-spectrum β-lactamase (ESBL) production in E. coli exceeded ۶۸% in some hospitals. Livestock-associated MRSA (LA-MRSA), particularly CC۳۹۸ and mecC-carrying clones, emerged as significant zoonotic threats. Resistance to fluoroquinolones and β-lactams is widespread, whereas glycopeptides (vancomycin), linezolid, and carbapenems (for susceptible strains) remain last-line defenses. Critical risk factors included indwelling medical devices, immunosuppression (e.g., cancer, diabetes), and empirical antibiotic overuse. The review underscores the convergence of resistance profiles across human and animal sectors, highlighting the urgent need for integrated One Health surveillance, rapid diagnostics, and stringent antimicrobial stewardship programs to curb the silent pandemic of AMR.

کلیدواژه ها:

Antimicrobial resistance ، Livestock-associated MRSA ، Hospital-acquired infections ، Antimicrobial stewardship ، Zoonotic transmission