Climate change and surgical site infections in the MENA region: burden, mechanisms, and mitigation

Climate change is increasingly recognized as a driver of healthcare-associated infections, with surgical site infections (SSIs) particularly sensitive to environmental stressors. The Middle East and North Africa (MENA) region faces accelerated warming, water scarcity, and strained health systems, yet the implications for surgical safety remain insufficiently characterized. This narrative review synthesizes current evidence on the relationship between climate change and SSIs across MENA countries, focusing on epidemiological trends, pathogen distribution, antimicrobial resistance, and health system resilience. Eleven MENA-specific SSI studies (2022-2025) were synthesised alongside regional AMR meta-analyses. Available data indicate that SSI rates frequently exceed international benchmarks. Rising temperatures, humidity shifts, extreme weather events, and limited water resources may enhance pathogen survival, biofilm formation, and transmission while simultaneously challenging sterilization and infection prevention practices. These pressures intersect with high antimicrobial resistance and fragmented surveillance systems. No published study has directly tested climate-SSI associations within MENA cohorts; the case rests on regional surveillance and extra-regional climate-SSI evidence. SSIs may therefore serve as indicators of climate-related health system strain, highlighting the need for climate-resilient infrastructure and integrated surveillance to safeguard surgical outcomes.