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The Spread of Antibiotic Resistance in Iran: A Review of Multidrug-Resistant Pathogens, Resistance Mechanisms, and National Challenges
Behin Omidi1 , Sana Zarrin1 , Yasaman Ghazzagh1 , Yasin SarveAhrabi2
1- Department of Biology, CT.C., Islamic Azad University, Tehran, Iran.
2- Department of Biology, CT.C., Islamic Azad University, Tehran, Iran. , yasin.ahrabi2016@gmail.com
Abstract:   (1680 Views)
Background: Antimicrobial resistance (AMR) represents one of the most significant global health threats of the 21st century, undermining advances in modern medicine. Iran, as a geographically and demographically strategic nation, faces a severe and escalating AMR crisis. This review synthesizes current evidence on the epidemiology, molecular mechanisms, and systemic drivers of AMR in Iran, while outlining priorities for effective national response.
Methods: A structured review was conducted of studies published between January 2015 and November 2025 in PubMed, Scopus, and Web of Science, supplemented by national and Persian-language databases. Eligible studies investigated the prevalence, molecular characteristics, and clinical outcomes of antibiotic-resistant bacteria in Iran. Data were extracted and narratively synthesized.
Results: Iran faces an alarming burden of MDR and drug resistant (XDR) Gram negative pathogens, notably Acinetobacter baumannii, Pseudomonas aeruginosa and carbapenem resistant Enterobacteriaceae, with carbapenem resistance rates exceeding 80-90%. Widespread dissemination of key carbapenemase genes (blaNDM, blaOXA-48, blaVIM) has been documented. Gram positive pathogens, including methicillin resistant Staphylococcus aureus and vancomycin resistant Enterococci, also remain highly prevalent. The crisis is driven by unregulated over the antibiotic use, weak infection prevention and control measures, fragmented surveillance, and limited diagnostic capacity.
Conclusion: AMR in Iran has reached critical levels, constituting a national public health emergency. Urgent, coordinated reforms across integrated surveillance, mandatory antimicrobial stewardship, strengthened infection prevention and control, One Health integration, expanded research, and public engagement are required. Without decisive national action, Iran risks a post antibiotic era in which routine infections and medical procedures become life threatening.
Keywords: Antimicrobial Resistance, Iran, Multidrug Resistance, Carbapenemase, One Health.
Full-Text [PDF 471 kb]   (368 Downloads)    
Research Article: Review Article | Subject: Microbiology
Received: 2025/10/22 | Accepted: 2025/12/18
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