Antimicrobial resistance of bacterial isolates from the clinical and hospital environment in Gaza Strip, Palestine: A review over 20-year

Antimicrobial resistance is a serious threatening problem associated with high morbidity and mortality. The majority of pathogenic bacteria show multiple drug resistance patterns. Thus, treatment of infections caused by those bacteria become ineffective. This paper evaluates, investigates, and discusses the existing situation of antimicrobial resistance in Gaza Strip, Palestine. The data of this review considered the published articles over the period 2002-2021. Search was conducted using Google scholar, Researchgate, and PubMed search engines. Thirty five articles were included. This review discussed studies done on antibiotic resistant bacteria found in a wide range of environments including clinical samples, foods, poultry, costal water, hospital wastewater, and hospital environments. The reported dissemination and spread of antibiotic resistant bacteria is influenced by several factors like inappropriate and unwise use of antibiotics as well as the un-regulated access of these antibiotics to the environment. Palestine is in urgent need to develop, strengthen, and implement antimicrobial stewardship policy, standard treatment guidelines, a local plan for containment and reduction of antimicrobial resistance, and research related to public health aspects of antimicrobial resistance at the community and hospital level.   Keywords; Antimicrobial resistance, Gaza strip, Palestin