Electrochemical Biosensing for Antibiotic-Resistant Bacteria: Advances, Challenges, and Future Directions.

The rapid rise of antibiotic-resistant bacteria (ABR) presents an urgent global health challenge, necessitating the development of efficient and scalable diagnostic technologies. Electrochemical biosensors have emerged as a promising solution, offering high sensitivity, specificity, and adaptability for point-of-care applications. These innovative platforms utilize bio-recognition elements, advanced electrode materials, microbial enzymes, and redox-active metabolites to identify antibiotic resistance profiles at a molecular level. Recent progress in microfluidics and lab-on-a-chip systems has enabled real-time, high-throughput antimicrobial susceptibility testing, significantly improving diagnostic precision and speed. This review aims to critically evaluate recent advances in electrochemical biosensing strategies for detecting ABR, identify key challenges, and propose future directions to enhance clinical applicability. Key developments include bio-receptor-based detection strategies, novel electrode surfaces, and multiplexed platforms integrated with microfluidic systems. Additionally, this review examines essential biomarkers for detecting antibiotic resistance and explores key challenges, including variability in biomarker expression and sensor reproducibility. It also highlights practical barriers to clinical implementation, such as cost constraints and scalability concerns. By presenting innovative approaches, such as cost-effective material alternatives, advanced analytical techniques, and portable biosensing systems, this review outlines a strategic pathway for enhancing the accessibility and effectiveness of electrochemical biosensors in antibiotic resistance management.