• Multidrug-resistant bacteria employ diverse mechanisms including efflux pumps, enzymatic inactivation, and target site modifications.
• Horizontal gene transfer, particularly via plasmids and transposons, accelerates the spread of resistance genes among bacterial populations.
• Biofilm formation contributes to persistent infections and increased resistance to antimicrobial agents.
• Alternative therapeutic approaches, such as phage therapy and antimicrobial peptides, show promise in overcoming resistance.