Background: Antimicrobial-resistant pathogens pose a severe health threat, and contribute to increasing mortality rates. In Gaza, the healthcare system is overwhelmed by war challenges, including disrupted infection prevention measures, halted vaccination programs, limited treatment accessibility and a shortage of effective antimicrobials. These challenges contribute scientifically to the spread of multidrug-resistant (MDR) infections. Objective: This study is to determine the antimicrobial susceptibility to bacteria isolated from clinical samples in Al-Ahli Arab and Indonesian hospitals.

Setting and Participants: This cross-sectional retrospective study analyzed 2774 microbiological culture records from two secondary care hospitals, both of which are located in the North of Gaza Strip. Culture records from June 1^st to November 30^th, 2024 were retrieved. Data were cross-tabulated and assessed with the Chi-squared test in IBM SPSS statistics version 22.0.

Results: 2774 clinical cultures were analyzed, 1880 (67.8%) were positive. The predominant bacterial isolate recovered was Enterobacterales (32.2%), followed by Staphylococcus aureus (15.5%), Pseudomonas aeruginosa (12.5%), Coagulase Negative Staphylococci (CoNS) (3.6%), and Streptococcus spp. (1.2%), and the other gram-negative (2.2%). An increase in culture-positive results among patients during the war was observed throughout the data collection period. An increase in antibiotic resistance among patients was observed. For example, resistance to amoxicillin/clavulanic acid (85.9%), cefotaxime (84.2%), ceftazidime (80.9%), cefuroxime (75.6%), ceftriaxone (75.1%), nalidixic acid (72.2%), cefoxitin (72.8), levofloxacin (65.9%), sulfamethoxazole/trimethoprim (65.4%), meropenem (54.2%), cefepime (53.3%), gentamycin (38.0%), amikacin (25.5%), vancomycin (22.8 %) and colistin (21.5%).

Conclusion: The findings collectively present a severe and rapidly escalating public health crisis. The high culture positivity rate and unprecedented resistance levels, including 72.6% cefoxitin resistance in Staphylococcus spp. and 46.6%, 66.4 % carbapenem resistance in Enterobacterales, Pseudomonas; respectively demonstrate that the conflict has fostered a "perfect storm" environment. This has accelerated the spread of resistant pathogens due to compromised infection control, staff shortages, and the likely indiscriminate use of available antibiotics, creating an urgent global demand for coordinated intervention and rigorous antibiotic stewardship.

Conference Title

AMR on Gaza 2025 (Online Mini‑Conference): "AMR is no longer a silent crisis”

Conference Country

Palestine

Conference Date

Nov. 22, 2025 - Nov. 22, 2025

Conference Sponsor

Islamic University of Gaza

Additional Info

Conference Website