雖然現今為抗病毒(COVID-19)的年代，細菌對抗生素之抗藥性仍為當今全世界所關注之重要議題。多重抗藥性細菌造成的嚴重感染有持續成長的趨勢，為治療感染上的重大難題，所造成的醫療危機甚至已經到了影響國家安全的層級。本文以腸內菌（含大腸桿菌(Escherichia coli )及克雷伯氏肺炎桿菌(Klebsiella pneumoniae )）對碳青黴烯(Carbapenem)產生抗藥性的流行病學、機轉、治療及防治為例，完整介紹多重抗藥性細菌防治之未來挑戰。為防治多重抗藥性細菌，建議可建立臺灣多重抗藥性細菌之抗藥性機轉及流行病學調查系統，並將其提供予各醫院，以與病歷資訊連結分析。以標準化之實驗室作業執行適當的分子診斷檢驗、微生物判定、抗生素感受性試驗，以及菌株抗藥性相關連之分析，並確實記錄多重抗藥性細菌和抗生素感受性之檢驗數據及臨床衝擊影響之資料，建立資料庫並將數據用於製作臨床上和流行病學上可用之監測報告，逐年即時回饋給醫療院所、臨床醫師及防疫主管機關以更新最合適之感染管制計畫，此為未來對多重抗藥性細菌防治之挑戰。

Despite the current combat against the coronavirus disease (COVID-19), bacterial resistance to antibiotics still remains a crucial topic of international attention. Severe infections caused by multidrug-resistant bacteria are increasing continuously, causing major difficulties in treating infections and even medical crises endangering national security. Focusing on epidemiology, mechanism, treatment, and prevention with regard to carbapenem resistance in enteric bacteria (e.g., Escherichia coli and Klebsiella pneumoniae), this study comprehensively introduced the future challenges facing multidrug-resistant bacteria control. To control multidrug-resistant bacteria, a system for investigating the drug resistance mechanism and epidemiology of multidrug-resistant bacteria in Taiwan can be established for integration with medical records of each hospital and subsequent analysis. Appropriate molecular diagnostic test, microbial identification, antibiotic susceptibility test, and analysis of the correlation of bacterial resistance were conducted with standardized laboratory operations. Data obtained from multidrug-resistant bacteria and antibiotic susceptibility tests and clinical impact data were thoroughly recorded to establish a database, where data are used to produce clinically and epidemiologically applicable surveillance reports. These reports are provided to medical institutions, clinicians, and epidemic prevention authorities on a yearly basis to update the most appropriate infection control plan. These are the crucial tasks in multidrug-resistant bacteria control.