The prevalence of antimicrobial resistance (AMR) associated with medical implants is a global concern in modern healthcare systems. The global population is at risk of infectious diseases due to medical implants, and there is compelling evidence that the type of material used in their manufacture increases this risk. Furthermore, approximately 26% of healthcare-associated illnesses are caused by infections associated with these devices [1]. These infections are frequently the source of persistent or recurring illnesses and are also responsible for implant replacement owing to device failure [1,2]. Complex interactions among microorganisms, biomaterials, and host immune systems can result in implant-associated diseases. Implant-associated infections also include fibrous encapsulation, granulation tissue formation, reactions to foreign particles, and stimulation of local tissues, which causes inflammation [3].

Almost 500,000 medical devices have been introduced in the world market, and invasive indwelling and implanted devices account for a small proportion of these devices [4]. Common examples of invasive devices include contact lenses, urinary catheters, and tracheal tubes; however, the most recent classification system distinguishes these devices from those that are physically placed in the human body or come into direct contact with the mucous membranes [5]. Bacterial infections during surgery are typically caused by infections associated with implants. After orthopaedic implant surgery, early postoperative infections appear up to three months later, while late infections occur up to 24 months (approximately two years) or later [6]. Among gram-positive cocci, Staphylococcus aureus, Staphylococcus epidermidis, and enterococci are the most prevalent implant-associated pathogens. Escherichia coli, Pseudomonas aeruginosa, and Proteus mirabilis are the most prevalent gram-negative bacteria that cause infections in prosthetic devices [7]. Various virulence factors, including toxins, enzymes, and biofilms, are associated with these infections. According to the National Institutes of Health (NIH), bacterial biofilms are responsible for up to 80% of chronic infections and 65% of infectious diseases [8]. Catheters and prostheses are medical devices that can be colonized by sessile cells [9]. Implant-associated pathogens have shown an increasing trend in antimicrobial resistance (AMR). During infections, mortality rates from multidrug-resistant (MDR) P. aeruginosa and (MDR) A. baumannii are frequently significant contributing factors [10]. Recent investigations have evaluated the increasing resistance of A. baumannii to tobramycin, ceftazidime, ciprofloxacin, and imipenem [11]. P. aeruginosa isolated from hospitals have demonstrated a considerable increase in MDR features [12].

Antimicrobial resistance (AMR) in medical implants is a major concern because bacteria form biofilms on their surfaces. These biofilms can lead to persistent infections, necessitating their removal and antibiotic therapy. Staphylococcus aureus and Staphylococcus epidermidis are prevalent pathogens, and their virulence and resistance to treatment are significant issues. Material compositions, such as titanium, can also contribute to biofilm formation. Understanding biofilm formation and the factors influencing adhesion is crucial for developing effective prevention strategies. This study assessed the burden of infectious medical implants (IMI). The most recent patterns of bacterial species dominance and biofilm potential in implant-related infections were investigated, and bacteria were classified as MDR, XDR, or pan-drug resistant (PDR) isolates based on their antimicrobial resistance patterns to antibiotics. Importantly, no comprehensive investigation has been undertaken in Pakistan to examine the severity of infectious medical implants, resistance profiles of isolated bacteria, biofilm development on a wide range of implant materials, or the connection between infection and the type of implant created.