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

Surveillance is one of the effective tools to address antimicrobial resistance. In Bangladesh a countrywide antimicrobial resistance surveillance has been ongoing since 2016. The main objective of this surveillance is to formulate the guideline for clinicians and to assist 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, and ten types of bacteria were identified from six types of preselected specimens. All the laboratory works were performed following the standard operating procedure supplied by the AMR surveillance Reference laboratory at IEDCR. Total 19,263 samples were processed during the period of March 2017 to 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 most of the organisms. Third generation cephalosporin was found to be less sensitive to Escherichia coli (37%) and Klebsiella pneumoniae (28%); nevertheless, Salmonella species showed higher sensitivity (97%) to it. Acinetobacter calcoaceticus-baumannii complex isolated from ICU patients showed alarming resistance to all of the antibiotics including 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 the whole country is surely alarming as many of the bacteria are resistant to the commonly used as well as reserve groups of antibiotics. Concerted effort should be taken from all concerned authorities to curb the problem immediately.