Background: Today, hospital infections are among the factors affecting the mortality of hospitalized patients. Despite extensive antibiotic use, the rising prevalence of resistant pathogens poses a global public health threat. The most common causative bacteria include: Pseudomonas aeruginosa, extended-spectrum beta-lactamase-producing Enterobacterales, carbapenemase-producing Enterobacterales, and methicillin-resistant Staphylococcus aureus. Objective: This review examines key antibiotic-resistant pathogens in hospitals, resistance patterns, molecular mechanisms, and diagnostic methods. Context: Global surveillance of antibiotics against Gram-positive and Gram-negative bacteria is crucial for detecting resistance patterns and preventing the spread of resistant strains. Understanding the molecular mechanisms of resistance, such as target site modifications, efflux pump activity, reduced membrane permeability, and the production of antibiotic-inactivating enzymes (e.g., β-lactamases) is essential for developing effective strategies. Rapid and accurate detection using phenotypic and genotypic methods, such as minimum inhibitory concentration testing, PCR, and innovative molecular assays, is crucial for guiding therapy, preventing the spread of resistance, and improving the management of resistant infections. Conclusion: In recent decades, the increasing prevalence of antibiotic resistance in hospital environments has become a serious public health challenge. Urgent measures, including antibiotic stewardship programs and improved diagnostic tools, are required to curb the spread of resistant pathogens. Further research into the molecular mechanisms of resistance and optimization of current treatment options is essential to combat this crisis effectively.
