Antimicrobial resistance (AMR) is a critical public health issue in Bangladesh, where antibiotic use is widespread but often unregulated. This nationwide cross-sectional study (2017–2020) analyzed data from 26 public and private laboratories across all divisions of the country. Standardized data on antimicrobial susceptibility testing (AST) were collected, curated, and analyzed using WHONET, QAAPT, and R software to assess resistance patterns in 232,329 bacterial isolates from various clinical specimens. Escherichia coli was the most common pathogen (32.5%), followed by Klebsiella sp. (15.5%) and Pseudomonas sp. (10.6%). Urine specimens comprised 50.3% of the tested samples, while blood and soft tissue/body fluids accounted for 12.1% and 24.8%, respectively. Patients aged 55 years and older represented the largest group (36.3%), highlighting their vulnerability to drug-resistant infections. Resistance to third-generation cephalosporins was alarmingly high in Escherichia coli (62.9% resistant to ceftriaxone), whereas carbapenem resistance remained relatively low (5.3% and 6.8% to imipenem and meropenem, respectively). Klebsiella sp. showed widespread resistance, though carbapenems remained relatively effective (imipenem resistance 20.3%, meropenem 21.7%). In contrast, Salmonella sp. remained largely sensitive to third-generation cephalosporins. However, 42% of Staphylococcus aureus isolates were methicillin-resistant (MRSA). This study underscores the urgent need for improved antibiotic stewardship, enhanced diagnostic capacity, and strengthened AMR surveillance to preserve treatment options in Bangladesh.

Introduction: Antimicrobial resistance (AMR) is a critical global public health issue, leading to prolonged illness, increased morbidity and mortality, and rising healthcare costs. The effectiveness of antibiotics is diminishing due to the emergence of resistant bacterial strains. This study aimed to determine the bacterial profile and AMR patterns of clinical isolates at Uttara Adhunik Medical College Hospital (UAMCH), Dhaka. Methods: A retrospective study was conducted at UAMCH from January 2017 to December 2019. A total of 32,187 clinical specimens (urine, blood, stool, wound swabs/pus, and sputum) were processed, of which 4232 yielded positive cultures. Bacterial identification followed standard bacteriological methods, and antibiotic susceptibility was assessed using the Kirby–Bauer disc diffusion method per CLSI guidelines. Data analysis was conducted using WHONET and QAAPT. Results: The highest proportion of positive cultures was from urine (47.5%), followed by blood (35.0%) and wound swabs/pus (10.1%). The most common isolates were Escherichia coli (37.2%), Salmonella typhi (25.7%), and Klebsiella sp. (11.5%). Gram-negative bacteria showed high resistance to commonly used antibiotics such as amoxicillin/clavulanic acid, cefixime, and ceftriaxone, while the resistance rates were lower for gentamicin, amikacin, and meropenem. However, Acinetobacter sp. exhibited alarming resistance to all tested antibiotics. Conclusions: This study highlights concerning resistance patterns among bacterial isolates, emphasizing the need for ongoing AMR surveillance to inform treatment strategies and improve patient care in Bangladesh.

Background: Antimicrobial resistance (AMR) is a pressing global health concern, leading to increased treatment costs, prolonged hospital stays, and higher mortality rates. This study analyzes the prevalence and trends of AMR in pathogenic bacteria isolated from various clinical specimens from Chattogram Medical College Hospital (CMCH) in Chittagong, Bangladesh. The objective is to track AMR over an extended period and provide comparative analytics for local and global surveillance efforts. Methods: Retrospective data from June 2017 to November 2019 were collected from a tertiary care hospital, en-compassing both inpatients and outpatients. Bacterial identification and antibiotic susceptibility testing followed standard methods. WHONET and Quick Analysis of AMR Patterns and Trends (QAAPT) software were utilized for data management and analysis. Results: The analysis included 6,896 records, with an average bacterial growth positivity rate of 39%. The most common specimen type was urine, accounting for 48.9% of all specimens. Among the bacterial isolates, variations in AMR prevalence were observed, particularly with E. coli displaying high resistance to commonly used antibiotics. Soft tissue and blood fluid samples exhibited a high positivity rate for bacterial growth. The study underscores the urgent need for AMR surveillance and evidence-based treatment guidelines tailored to local antibiotic susceptibility patterns. Conclusion: This study highlights the significance of monitoring AMR trends in Chittagong, Bangladesh. By understanding and addressing AMR patterns, policymakers, and stakeholders can develop informed national policies and strategies to combat AMR effectively. Sharing these findings with relevant parties is crucial for creating awareness and promoting evidence-based practices. The study emphasizes the importance of ongoing surveillance efforts and the development of targeted interventions to mitigate the impact of AMR and improve patient outcomes in the region.

Antimicrobial resistance (AMR) is a critical public health issue in Bangladesh, where antibiotic use is widespread but often unregulated. A nationwide study (2017–2020) analyzing data from 26 laboratories examined bacterial resistance trends across 232,329 isolates from various clinical specimens. Escherichia coli was the most common pathogen (32.48%), followed by Klebsiella spp. (15.50%) and Pseudomonas spp. (10.60%). Urine specimens comprised 50.3% of tested samples, while blood and soft tissue/body fluids accounted for 12.1% and 24.8%, respectively. Patients aged 55+ years represented the largest proportion (36.3%), highlighting their vulnerability to drug-resistant infections. Resistance to third-generation cephalosporins was alarmingly high in E. coli (62.89% resistant to ceftriaxone), whereas resistance to carbapenems remained relatively low (imipenem 5.31%, meropenem 6.81%). Klebsiella spp. exhibited widespread resistance, though carbapenems remained effective. In contrast, Salmonella spp. remained sensitive to third-generation cephalosporins. However, 42% of Staphylococcus aureus isolates were methicillin-resistant (MRSA). This study highlights the urgent need for improved antibiotic stewardship, enhanced diagnostic capacity, and strengthened AMR surveillance to mitigate resistance trends and preserve treatment options in Bangladesh. Immediate action is necessary to combat the growing threat of multidrug-resistant pathogens.

Background: It is essential to monitor causative agents of infections and antimicrobial resistance patterns to inform treatment and policy at the local level. In this study, we investigated the microbiological profile and antibiotic susceptibility pattern records in a tertiary care hospital. Materials and Method: This cross-sectional study was performed in a tertiary care hospital in Dhaka city, Bangladesh. The study utilized a retrospective descriptive research approach conducted between January 2018 and February 2021 in which culture results of blood, stool, urine, body fluid, genital, respiratory and soft tissue specimens were retrieved and analyzed. Results: A total of 26,825 samples were ana-lyzed; of which 3,779 records for microbial growth from clinical specimens were identi-fied, yielding a 14.09% isolation rate. Escherichia coli (E. coli), Klebsiella sp., Staphylo-coccus aureus, Pseudomonas sp., coagulase negative Staphylococcus, Salmonella Typhi and Enterococcus sp. were the most frequently isolated organisms among all specimens. E. coli, the most common causative organism of urinary tract infection (UTI) and genital infection, showed high resistance to co-trimoxazole (48%), ciprofloxacin (79%), and cephalosporins (63-65%) while the resistance rate to nitrofurantoin (7%), mecillinam (16%), aminoglycosides (7-18%), meropenem (8%) and colistin (0%) was low. In bloodstream infection, the most common microorganism found was S. Typhi. High sensitivity towards amoxicillin (100%), chloramphenicol (78%), co-trimoxazole (76%), cefixime (100%) and ceftriaxone (100%) were seen in S. typhi whereas almost all isolates were resistant to nalidixic acid (97%) and ciprofloxacin (96%). S. aureus, the predominant cause of soft tissue infection, was highly sensitive to co-trimoxazole (70%), doxycycline (86%), and linezolid (97%). Methicillin-resistant Staphylococcus aureus (MRSA) was 54%. The most common cause of respiratory infection was Klebsiella sp. The rate of resistance of Klebsiella sp. to third and fourth generation cephalosporins was approximately 65% and to ciprofloxacin and meropenem was 74% and 42% respectively. Pseudomonas sp., found commonly in urine, soft tissue, body fluids, and respiratory infections, were susceptible to ceftazidime, piperacillin/tazobactam and ciprofloxacin with resistance rate of 27%, 18% and 34% re-spectively. High resistance to meropenem was recorded for Pseudomonas sp. (30%) and Acinetobacter sp. (64%). Acinetobacter sp. showed low sensitivity (< 45%) to all of the tested antibiotics except colistin and tigecycline. Conclusion: This study highlights the high potential for infections associated with resistant microorganisms in the tertiary care hospital where samples for this study were collected. It is therefore recommended that judicious treatment following drug-susceptibility testing of isolates, regular surveillance programs, and strict infection control measures be put into place to address this increasing drug resistance problem.

Introduction: Antimicrobial resistance (AMR) is an urgent global public health problem. It threatens effective treatment of infections and leads to prolonged duration of illness, higher morbidity and mortality rates, and an increased cost of health care. The effectiveness of currently available antibiotics is decreasing as a result of increasing resistant strains among clinical isolates. Objective: The aim of this study was to determine the bacterial profile and AMR patterns of bacterial isolates from different clinical specimens at Uttara Adhunik Medical College Hospital (UAMCH), Dhaka. Material and methods: This retrospective study was carried out at UAMCH in Bangladesh from January 2017 to December 2019. In total 32,187 clinical specimens such as urine, blood, stool, wound swab/pus, and sputum were collected and processed at the Microbiology laboratory. Among these, 4232 were positive culture samples. Standard bacteriological methods were employed to identify the bacteria, and Kirby-Bauer disc diffusion methods were used in accordance with CLSI guidelines to assess the bacteria's susceptibility to various antibiotics. Data were entered, cleaned, and analyzed using the WHONET software developed by the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance and the Quick Analysis of Antimicrobial Patterns and Trends (QAAPT) web application. Result: Urine had the highest percentage of positive cultures (47.5%, n=2009), followed by blood (35%, n=1500), wound swab/pus (10.1%, n=426) and sputum (5.3%, n=225). Among positive samples, E. coli was the most frequent isolate accounting for 37.19% (1574) of specimens, followed by Salmonella typhi (25.73%, n=1089), Klebsiella sp. (11.51%, n=487), Salmonella paratyphi A (6.38%, n=270), Staphylococcus aureus (4.21%, n=178), and Enterobacter sp. (3.59%, n=152). Overall, the Gram-negative isolates exhibited a high level of resistance to commonly used antibiotics such as amoxicillin/clavulanic acid, cefixime, and ceftriaxone. The resistance rate was lower in case of gentamicin, amikacin, and meropenem; however, Acinetobacter sp. showed a higher and alarming resistance rate against all antibiotics. Conclusion: This study exposes the antibiotic resistance patterns of bacterial isolates to routinely used antibiotics. The outcomes of this study will assist healthcare professionals in Bangladesh and the area in making informed decisions and providing better care to their patients. Therefore, resistance surveillance studies should be conducted to develop local antibiogram data, which will help to choose the best antibiotic for empirical therapy.