en ميکروب شناسي Microbiology مروري Review Article <div style="text-align: justify;"><span style="font-size:12px;"><span style="font-family:Times New Roman;"><b>Background:</b> Antimicrobial resistance (AMR) represents one of the most significant global health threats of the 21st century and undermines advances in modern medicine. As a geographically and demographically strategic nation, Iran 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 an effective national response.<br> <b>Methods:</b> A structured review was conducted of studies published between January 2015 and November 2024 in PubMed, Scopus, and Web of Science, supplemented by searches of 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.<br> <b>Results:</b> Iran faces an alarming burden of multidrug-resistant and extensively drug-resistant Gram-negative pathogens, notably <i>Acinetobacter baumannii</i>, <i>Pseudomonas aeruginosa</i>, and <i>carbapenem-resistant Enterobacteriaceae</i>, with carbapenem resistance rates exceeding 80-90%. Widespread dissemination of key carbapenemase genes (<i>blaNDM</i>, <i>blaOXA-48</i>, <i>blaVIM</i>) has been documented. Gram-positive pathogens, including methicillin-resistant <i>Staphylococcus aureus</i> and vancomycin-resistant enterococci, also remain highly prevalent. The crisis is driven by unregulated and excessive antibiotic use, weak infection prevention and control measures, fragmented surveillance, and limited diagnostic capacity.<br> <b>Conclusion</b>: AMR in Iran has reached critical levels and constitutes a national public health emergency. Urgent, coordinated reforms involving 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 entering a post-antibiotic era in which routine infections and medical procedures become life-threatening.</span></span></div> Antimicrobial Resistance, Iran, Multidrug Resistance, Carbapenemase, One Health 0 0 http://mlj.goums.ac.ir/browse.php?a_code=A-10-946-3&slc_lang=en&sid=1 Behin Omidi b.omidi@iauctb.ac.ir 100319475328460033507 100319475328460033507 No Department of Biology, CT.C., Islamic Azad University, Tehran, Iran Sana Zarrin sana.zarrin.edu@gmail.com 100319475328460033508 0009-0000-5321-5564 No Department of Biology, CT.C., Islamic Azad University, Tehran, Iran Yasaman Ghazzagh yasaman.ghazagh.edu@gmail.com 100319475328460033509 0009-0009-6036-4766 No Department of Biology, CT.C., Islamic Azad University, Tehran, Iran Yasin SarveAhrabi yasin.ahrabi2016@gmail.com 100319475328460033510 100319475328460033510 Yes Department of Biology, CT.C., Islamic Azad University, Tehran, Iran