In addition to these technical considerations, it is important to note that all L. infantum isolates displaying significant overexpression in our study were isolated in the Maghreb area. However, as only 6 resistant French isolates were assessed in our study, we are unable to make a robust conclusion regarding the variations observed between the two regions. Moreover, the number of isolates tested does not enable us to conclude a significant association between the pattern of molecular resistance and the geographical origin of L. infantum isolates, although the findings argue in favor of the presence of resistance factors in the Maghreb area. Interestingly, these resistance factors are not limited to visceral leishmaniasis species, as we identified them in the 3 causative agents of cutaneous leishmaniasis in the Maghreb. To our knowledge, this is the first report of molecular patterns associated with drug resistance in L. major and L. killicki field isolates. Overall, as molecular resistance patterns in clinical isolates appear to be heterogeneous and involve numerous genes, it would be challenging to develop suitable molecular methods to replace current time-consuming in vitro tests unless new molecular approaches, such as high-throughput whole-genome sequencing, unveil a clear dichotomy between susceptible and resistant isolates. It may be of interest to define subgroups of resistant strains, based on the genes involved in resistance, specific for each geographic area and clinical outcome.