Airborne Antibiotic-Resistant Bacteria—Challenge for Healthcare Environments

Antimicrobial resistance (AMR) is a growing global public health challenge. Its development is strongly associated with the inappropriate and excessive use of antimicrobial agents, leading to reduced treatment effectiveness, limited availability of therapeutic options, constraints on medical procedures, and an increasing economic burden. This narrative review synthesizes current knowledge on antibiotic-resistant bacteria detected in airborne samples from healthcare environments and examines their reported resistance profiles. The review focused on the bacterial species identified, methods used for antimicrobial susceptibility assessment, types of healthcare facilities investigated, and environmental and behavioral factors influencing the occurrence and dissemination of airborne antibiotic-resistant bacteria. The clinical relevance of the reported pathogens was discussed in the context of the WHO Bacterial Priority Pathogens List (BPPL), while the WHO AWaRe classification and TrACSS framework were used as complementary interpretative tools to contextualize resistance patterns and their implications for antimicrobial stewardship and AMR surveillance. The reviewed studies showed that airborne bacterial communities in healthcare settings were dominated by Gram-positive bacteria, particularly Staphylococcus spp. and Bacillus spp., while clinically relevant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and Acinetobacter baumannii were also frequently detected. Resistance to β-lactam antibiotics was the most frequently reported resistance pattern. Considerable heterogeneity in sampling strategies, antimicrobial susceptibility testing methods, and interpretive criteria limited direct comparison among studies. The findings highlight the need for standardized monitoring methods, long-term surveillance, and integrated environmental and clinical research to support infection prevention strategies and mitigate antimicrobial resistance.