en ميکروب شناسي Microbiology مروري Review Article <span style="font-size:11pt"><span style="line-height:150%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:14.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">Background:</span></span></span></b><span style="font-size:14.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""> 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.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:150%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:14.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">Methods:</span></span></span></b><span style="font-size:14.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""> A structured review was conducted of studies published between January 2015 and <u><span style="background:yellow">November 2025</span></u> 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.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:150%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:14.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times="">Results:</span></span></span></b><span style="font-size:14.0pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""> <u><span style="background:yellow">Iran faces an alarming burden of MDR and drug resistant (XDR) Gram negative pathogens, notably <i>Acinetobacter baumannii</i>, <i>Pseudomonas</i> <i>aeruginosa</i> 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 <i>Staphylococcus aureus</i> 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.</span></u></span></span></span></span></span></span><br> <b><span style="font-size:14.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">Conclusion:</span></span></span></b><span style="font-size:14.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times=""> <u><span style="background:yellow">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.</span></u></span></span></span> 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 100319475328460033289 100319475328460033289 No Department of Biology, CT.C., Islamic Azad University, Tehran, Iran. Sana Zarrin sana.zarrin.edu@gmail.com 100319475328460033290 100319475328460033290 No Department of Biology, CT.C., Islamic Azad University, Tehran, Iran. Yasaman Ghazzagh yasaman.ghazagh.edu@gmail.com 100319475328460033291 100319475328460033291 No Department of Biology, CT.C., Islamic Azad University, Tehran, Iran. Yasin SarveAhrabi yasin.ahrabi2016@gmail.com 100319475328460033292 100319475328460033292 Yes Department of Biology, CT.C., Islamic Azad University, Tehran, Iran.