Multidrug-resistant bacterial infections in a tertiary hospitals: culture positivity, pathogen spectrum, and antibiotic susceptibility

BACKGROUND: Antimicrobial resistance (AMR) is a significant health problem, especially in low- and middle-income countries. This study aimed to investigate the prevalence and trends of antimicrobial resistance (AMR) and multidrug resistance (MDR) in bacterial infections at a tertiary-care hospital in Dhaka, Bangladesh, and the prevalent pathogens and their resistance profiles. METHODS: A cross-sectional study was conducted on clinical specimens from patients admitted to tertiary-care hospitals, processed at Ibn Sina Diagnostic and Imaging Center in Dhaka, Bangladesh. A total of 3,996 clinical specimens were sampled by patients, with inclusion and exclusion criteria. The samples were blood, urine and wound swabs. Data regarding culture positivity, pathogen distribution and antimicrobial susceptibility were summarized using descriptive statistics. RESULT: Out of the 3,996 specimens, 72.5% were positive in terms of significant bacterial growth. The gram-negative bacteria were the dominant ones, with Escherichia coli (25.4%) and Klebsiella spp. (20.4%). The most common pathogens are Pseudomonas aeruginosa (15.8%), Acinetobacter spp. (11.9%), Staphylococcus aureus (10%), and Coagulase-negative Staphylococci (8.1%) were the most common gram-positive. In E. coli, the resistance was significantly high with a 42.5% ciprofloxacin resistance and a 47.0% ceftriaxone resistance. MDR was identified in 53.0% of E. coli isolates, and similar MDR patterns were observed in Klebsiella spp. and Pseudomonas aeruginosa. CONCLUSION: The study shows that there is high-AMR, especially amongst gram-negative pathogens, at a tertiary-care hospital. There is an urgent need to enhance antibiotic stewardship and infection control to deal with the increasing rate of MDR bacterial infections.