The global effort to develop new antibiotics or modify existing ones to fight resistant pathogens globally is now huge. Antibiotic resistance evolves when the bacteria can escape the effect of antibiotics by different mechanisms, like neutralizing the antibiotics, pumping them outside of the cell, or modifying their outer structure resulting in inhibition of the drugs. The mechanisms of antibiotic resistance are categorized into four groups: intrinsic resistance in which bacteria can change their structures or components, another way is acquired resistance, where bacteria can acquire new resistance genes and DNA from other resistant bacteria. Furthermore, genetic changes in the DNA which can alter the production of protein leading to different components and receptors that cannot be recognized by the antibiotic, and finally DNA transfer through a horizontal gene transfer between bacteria via transformation, transduction or conjugation. Evidence suggests that patients who are infected by carbapenem-resistant pathogens have an increased likelihood of morbidity and mortality compared with those infected by susceptible pathogens, which is likely due to administration of antibiotics with suboptimal or no activity against these organisms. Thus, recognizing the risk of carbapenem resistance, particularly in the most vulnerable patient populations, and/or early detection of specific carbapenem resistance mechanisms are critical to reduce the risk of mortality, length of hospitalization, and associated costs. The alarming level of carbapenem resistance has presented particular challenges for the management of a variety of infections caused by nonfermenters because of the low permeability of the outer bacterial membrane to several antibiotics, including, but not limited to, the carbapenems