Superbugs linked to eight out of 10 deaths in Bangladeshi ICUs

A technician transfers samples of bacteria into a tray of test tubes - Bloomberg
A technician transfers samples of bacteria into a tray of test tubes - Bloomberg

Antimicrobial resistant superbugs could be responsible for up to 80 per cent of deaths in Bangladesh's biggest intensive care unit (ICU), a senior doctor has warned.

Prfofessor Sayedur Rahman, chairman of the department of pharmacology at the Bangabandhu Sheikh Mujib Medial University (BSMMU), told the Telegraph that out of approximately 900 patients admitted to the unit in 2018, 400 died.

And out of those deaths around 80 per cent were attributed to a bacterial or fungal infection that was resistant to antibiotics, said Dr Rahman.

Bangladesh, India and Pakistan are seen as drivers of antimicrobial resistance (AMR) because of poor adherence to antibiotic treatment, the non-therapeutic use of antibiotics for growth promotion in farm animals, self-medication and illegal over-the-counter access to antibiotics.

"Most patients [that die] come from public ICUs where there is strictly no AMR surveillance. And this is the generator of antibacterial resistance," said Dr Rahman.

"There should be more security... they [antibiotics] should not be available over the counter and others should only be dispensed from hospitals," he added.

A 2015 study published in the European Journal of Scientific Research found that over one-third of patients in Bangladesh surveyed were given antibiotics by people without authorisation to do so.

“[The] situation wasn’t like this about 10 years back,” Professor Ahmed Abu Saleh, the chairman of the department of microbiology and immunology at the BSMMU told the Bangladesh newspaper, The Daily Star.

He said that about 70 per cent of deaths across all ICUs in Bangladesh could be put down to superbugs.

He added: “Basically, there is no new antibiotic in the pipeline for future use. At the same time, the available antibiotic drugs are losing their effectiveness – which has made the scenario more dangerous.”

The global threat posed by superbugs is expected to skyrocket in the coming decades and unless effective measures are taken, 10 million people could die annually by 2050 from AMR, a report warned in 2016.

That figure is higher than the total number of people who died from cancer, diabetes and diarrhoea in 2018.

Antimicrobial resistance occurs naturally over time as microorganisms undergo genetic changes. As they evolve, antibiotics can become less effective at treating an infection.

In South Asia the prescription of incorrect or poor quality medicine by unqualified doctors looking to make a quick buck is seen as a driver of antimicrobial resistance. In many countries, stringent controls over the prescription of medicine to animals are not upheld.

Antibiotics intended for human use are also given to animals in a bid to make them put on weight more quickly and thus generate more profit.

A study in Chittagong, the second-largest city in Bangladesh, found that over half of poultry chickens were infected with multi-drug resistant bacteria.

However, the emergence of AMR superbugs is not just a problem for South Asia and can be seen across the world.

A 2017 study in the journal Lancet Infectious Diseases confirmed that the malaria parasite in Cambodia, Laos, Myanmar, Thailand and  Vietnam had developed resistance to the artemisinin-based combination therapy prescribed to treat the disease.

Around the world, resistant strains of the HIV virus are thought to account for between 10 and 20 per cent of infections and up to 40 per cent of those re-starting medical treatment.

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