Multidrug-Resistant Salmonella and Shigella: Epidemiology, Resistance Mechanisms, and Emerging Therapeutic Strategies.

The review article is a critical examination of the growing global problem of multidrug-resistant (MDR) Salmonella and Shigella, focusing on their epidemiology, molecular resistance mechanisms, and clinical effects. It compiles current information on increasing resistance to major antibiotics, such as fluoroquinolones, third-generation cephalosporins, and sulfonamides, that is caused by a variety of factors, including ESBL production and plasmid-mediated gene transfer, especially in Asia, Africa, and the Middle East. The minireview discusses the new therapeutic approaches such as bacteriophage therapy, antimicrobial peptides, antimicrobials based on nanotechnology, and a combination of antibiotic regimens and their mechanisms, efficacy, and some limitations that exist in these approaches. In addition, it discusses the issues of diagnostic challenges, infection control practices, and antibiotic stewardship as part and parcel of resistance management. It will be a focused, evidence-based review to inform research, clinical practices, and policy to turn the trend of resistance around and enhance patient outcomes. The presented multidisciplinary review shows that MDR Salmonella and Shigella infections have become a threatening problem in the world, which requires urgent measures, including multilateral cooperation, improved molecular tracking, fast diagnostics, and new therapeutic options.