The findings of Antimicrobial Resistance Surveillance in Bangladesh (2016-2020)

Antimicrobial resistance is a global problem. Surveillance is one of the effective tools to address this multifaceted problem. In Bangladesh a countrywide antimicrobial resistance surveillance is ongoing since 2016-2020. The main objective of this surveillance is to know the sensitivity pattern of some common bacteria which will eventually help to formulate the guideline for the clinician and to assist the policy makers to know the gravity of the AMR problem in Bangladesh. It is a case based surveillance conducted by Institute of Epidemiology, Disease Control & Research (IEDCR) in nine sentinel sites where five types of clinical cases were selected according to case definition, tested in the microbiology department of the sites and ten types of bacteria were identified from six types of preselected specimens and their sensitivity test were done. All the laboratory works were done following the same standard operative procedure supplied by the AMR surveillance Reference laboratory at IEDCR. Total 19,263 samples were processed during the period of March 2017- March 2020 among which wound swab yielded highest growth (57%). E.coli was the highest (1717) isolated organism among the ten priority pathogens which showed highest sensitivity (91%) to Imipenem. Imipenem also showed higher sensitivity to other organisms like K. pneumoniae (77%), Salmonella species (100%), P. aeruginosa (53%) and Acb complex (29%). Third generation cephalosporin like ceftriaxone was found less than 50% sensitive to E.coli (37%) and K.pneumoniae (28%) although Salmonella species showed higher sensitivity (97%) to it. Acb complex, mostly isolated from ICU patients showed alarming resistance to all of the antibiotics and was less than 50% sensitive to even the highest sensitive antibiotic Imipenem (29%). Salmonella species isolated from blood showed higher susceptibility to most of the antibiotics except ciprofloxacin (7%). Alarmingly, only 36% of the Staphylococcus aureus isolates showed susceptibility to cefoxitin indicates high prevalence of MRSA infection. The result of the surveillance representing whole country is surely alarming as many of the bacteria are resistant to the commonly used as well some of the reserve groups of antibiotics. Concerted effort should be taken from all concerned authorities to curb the problem immediately.