Antibiotic resistance in Bangladesh: A systematic review

Abstract

Background: Antibiotic resistance (ABR) is a worldwide problem and Bangladesh is a major contributor to this owing to its poor healthcare standards, along with the misuse and overuse of antibiotics. This systematic review was conducted to summarize the present scenario of ABR in Bangladesh, to identify gaps in surveillance, and to provide recommendations based on the findings. Methods: Google Scholar, PubMed, and Bangladesh Journals Online were searched using relevant keywords to identify articles related to ABR in Bangladesh published between 2004 and 2018. Inclusion or exclusion was based on a predefined set of criteria. The resistance of a bacterium to a given drug was presented as the median resistance (MR) and interquartile range (IQR). Results: Forty-six articles were included in this systematic review. Antimicrobial susceptibility testing was performed by disk diffusion method in 82.6% of studies, while the Clinical and Laboratory Standards Institute (CLSI) guidelines were followed in 78.3%. Data regarding the susceptibility testing method, guidelines for interpretation, and source of infection (hospital/community) were absent in 10.9%, 19.6%, and 73.9% of the studies, respectively. A high prevalence of resistance was detected in most tested pathogens, and many of the common first-line drugs were mostly ineffective. Resistance to carbapenems was low in most cases. The presence of extended-spectrum beta-lactamase (ESBL)-producing organisms was indicated by the high resistance to beta-lactams. Methicillin-resistant Staphylococcus aureus (MRSA) was identified in four studies. Three studies reported vancomycin susceptibility of enterococci, and the median susceptibility was 100%. Streptococcus pneumoniae exhibited high susceptibility to penicillin (MR 4%). Resistance data were available from only six out of the 64 districts of Bangladesh. Conclusions: A high prevalence of resistance to most antibiotics was detected, along with major gaps in surveillance and information gaps in the methodological data of the studies (susceptibility testing method, guidelines for susceptibility interpretation, source of infection). Based on the findings, we recommend appropriate initiatives to monitor and control the use of antibiotics, as well as nationwide surveillance following standardized methodologies.

Situation of antibiotic resistance in Bangladesh and its association with resistance genes for horizontal transfer

“…Studies show that low-income countries like Bangladesh are more affected by AMR because of the widespread misuse of antibiotics, non-human antibiotic use, poor quality of drugs, inadequate surveillance and factors associated with individual and national poverty indicators like poor healthcare standards, malnutrition, chronic and repeated infections, unaffordability of more effective and costly drugs [9, 10]. Research regarding antibiotic resistance epidemiology may ultimately guide to interventions for AMR.…”

Antimicrobial Resistance Profile andmcr-1Gene Detection inSalmonellaIsolates from Poultry in Bangladesh: Molecular and Bioinformatics Characterization

“…Among them, food from animal sources, especially poultry is in main list. Due to its potential to cause enteric disease, the detection of Salmonella isolates in poultry is of great concern which are globally recognized as food borne zoonoses (52, 55, 56). The severity and length of such diseases could reduce by antimicrobial therapeutics in human (53) and poultry as well (57, 58).…”

Community Acquired Multi-drug Resistant Clinical Strains from Tracheal Aspirates of Patients in Hospital Settings in Dhaka, Bangladesh

“…Epidemiological surveillance of resistance to antibiotics is essential in developing countries like Bangladesh where infections caused by multi-drug resistant bacteria which have resulted in increased morbidity and mortality [19][20]. Antibiotic resistance is an increasingly serious threat in Bangladesh which is most likely a result of unrestricted use of antimicrobial drugs [21][22].…”