52% ICU patients at BSMMU multi-antibiotic resistant

Adnan Chowdhury (not his real name) was admitted to the Intensive Care Unit (ICU) at Bangabandhu Sheikh Mujib Medical University (BSMMU) after a massive stroke.  

The doctors formed a medical board for his treatment, and after performing several tests they found that he is resistant to many drugs.  

Antibiotic/Antimicrobial Resistance (AR/AMR) occurs when a drug that was effective against a particular microbe (a bacterium/virus) causing disease is no longer effective against that microbe. 

Antibiotics are essential for fighting bacterial infections, but many bacteria are becoming resistant to antibiotics.

The physicians stopped Chowdhury's treatment for a while because no medicines or antibiotics worked. 

The doctors held several meetings and thought from different angles, but nothing could save Chowdhury's life. 

This is a single example of the death of a multi-antibiotic resistant patient in the country, while in reality, thousands of patients die every year because of this.  

Statistics of the Bangladesh Society of Anaesthesiologists show that 52 percent of patients admitted to the ICU of BSMMU are multi-antibiotic resistant, and the number is increasing very fast.

Professor Dr Debabrata Banik, former Chairman of the Department of Anaesthesia, Analgesia and Intensive Care Medicine at BSMMU, shared his experiences about antibiotic-resistant patients.

"It becomes painful when we find multi-antibiotic resistant patients because very few of them survive," said Professor Banik.   

Remembering an old patient who was admitted to BSMMU, Banik said that he was initially hopeful about the patient's recovery, but after doing some tests, doctors found that he was antibiotic resistant. 

"I and my colleagues tried our best to cure him, but he died," Banik explained. He added that after finding that he was resistant to all antibiotics, they re-examined him and gave him some simple antibiotics, but even those did not work. 

The microbiology report of Md Abdur Rahman, 72, (not his real name), who is now admitted to the medicine unit of Sylhet MAG Osmani Medical College Hospital, revealed that he is resistant to 15 out of 17 antibiotics. 

Talking to The Business Standard Abdur Rahman said, "I took antibiotics for any simple medical problem, even for a normal fever, because I wanted to get well soon. I got them from the pharmacies in my village. They never cautioned me about the misuse of antibiotics."  

"Now I realise the actual impact of the random use or misuse of antibiotics," said Abdur Rahman. He urges everyone not to take antibiotics randomly without a doctors' prescription.

Forty-year-old Kamal Uddin (not his real name), was found resistant to 11 out of 20 antibiotics. After being admitted to the Dhaka Medical College Hospital, he told the same story of taking antibiotics at random and not completing the dose properly.  

Health experts said that misuse and overuse of antibiotics, incomplete dose, drug sellers' greedy intention to sell antibiotics without prescription by registered doctors, a lack of supervision by the authorities, use of antibiotics in animals without veterinary supervision are the major causes of growing antibiotic resistance in Bangladesh. 

The World Health Organisation (WHO) also found that antibiotic resistance is aggravated by the misuse and overuse of antibiotics. 

The WHO says that around seven lakh people die each year as a result of infections with antibiotic resistant bacteria.

It also predicted that the number of deaths may rise to 10 million by 2050 if proper initiatives are not taken immediately.

About 33,000 people die every year in Europe as a result of antibiotic resistance, but the figure is not known for Bangladesh. 

In the 2013 Global Risks Report, a chapter entitled "The Dangers of Hubris on Human Health" cited estimates of 100,000 antimicrobial resistance related deaths in US hospitals and 80,000 in China.   

Dr Chandan Kumar Roy, Associate Professor of Microbiology at BSMMU told this correspondent that the number of antibiotic resistant bacteria in human bodies has doubled over the last 10 years. 

"We found that 6.5 per cent of patients were antibiotic resistant in all medical tests in 2010, but that figure rose to 14 percent in 2018," he said.  

Dr Roy urged drug sellers to stop selling antibiotics without prescription by registered doctors, and to raise awareness about antibiotic resistance.  

Dr Rajib Hossain Sarkar, an antibiotic resistance campaigner, told The Business Standard that antibiotic resistance can also develop in human bodies through animals. 

"Inappropriate use of antimicrobials (an antimicrobial is an agent that kills microorganisms or stops their growth) in livestock also develops antimicrobial resistant bacteria. Sometimes people use it to make the animals healthy and sometimes for no reason at all." 

The most commonly reported antibiotic resistant bacteria includes Escherichia coli (E.coli), Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus pneumoniae.

Sarkar said such kinds of bacteria can get into the human body by consuming chicken, beef and other meats. He added that, "About 19 types of antibiotics are used in poultry farms and fisheries across the country, and this is a matter of grave concern."  

A study by the Chittagong Veterinary and Animal Sciences University (CVASU) said, 54.55 percent of broiler chickens carry multi-drug resistant bacteria.

Health experts and organisations including the WHO say that antibiotics should only be used after being prescribed by a certified health professional. 

Even doctors should not ask patients to use antibiotics before proper diagnosis. Selling antibiotics without prescription to anyone must be prevented, and people's mind-set of taking antibiotics for fast relief will also have to be changed, they said.   

The government must form a national policy to control and supervise the production, marketing and use of antibiotics, they added.  

They also emphasised the need to develop awareness about the dangerous consequences of the misuse of antibiotics.

A new study by the Institute of Infection Control and Infectious Diseases at the University Medical Center Göttingen, and the Hannover Medical School in Germany has found a potential link between antimicrobial resistance and climate change.