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Arifun Nahar, 33, gave birth to her third child on December 16th by caesarean section in a private hospital in the capital.
Following health complications, the doctors kept the baby in a neonatal intensive care unit and used almost all the high-concentration antibiotics. Since nothing was working, the newborn was transferred to Dhaka Shishu Hospital (Children) where the baby died 28 days after birth.
The cause of his sudden death was an otherwise harmless bacterium – Klebsiella pneumoniae – which became fatal, possibly to the hospital, by resisting 15 types of antibiotics.
"The baby developed a Klebsiella pneumoniae infection after birth. most likely from the NICU. This is one of the main causes of his death, "said Daily Star Professor Samir K Saha, head of the department of microbiology at Shishu Hospital.
For almost a century, antibiotics, which fight bacteria, have helped control and destroy many of the pests that can make us sick. But in recent decades, the overuse and misuse of antibiotics has pushed some strains of bacteria to slightly modify their DNA and become "superbugs" resistant to antibiotics, say experts.
The World Health Organization and researchers in developed countries have long warned that "superbugs" spread rapidly because of the particularly high use of antibiotics in intensive care units, where patients are the sickest and the powerful drugs prescribed routinely.
And the latest data and badysis from the Department of Microbiology and Immunology (DMI) of Bangabandhu Sheikh Mujib Medical University reaffirmed that "superbugs", as elsewhere in the world, are becoming a great source of information. 39, worry in Bangladesh.
DMI, the leading producer of data on bacterial and other infections in the country, fears that Bangladesh will experience a "dire situation" unless "political leadership" takes bold action immediately.
"The situation was not this one about 10 years ago," Professor Ahmed Abu Saleh, chairman of DMI, told the Daily Star. "About 70% of deaths in intensive care units are caused by AMR [antimicrobial resistance] infections. "
AMR is a situation where microorganisms such as bacteria, viruses and certain parasites resist drug interventions.
"Basically, there is no new antibiotic in the pipeline for future use. At the same time, the available antibiotics lose their effectiveness, making the scenario more dangerous, "he added.
Globally, about seven lakh people die each year from the consequences of an infection at RAM. According to the WHO, the number of deaths of this type is expected to reach 10 million by 2050, if nothing is done.
There is no accurate data on the number of deaths caused by RAM infections in Bangladesh.
However, a DMI laboratory badysis based on infections on the body of patients from 2010 to 2018 showed a sharp increase in the number of superbugs in Bangladesh.
In 2010, superbugs and multidrug-resistant bacteria were detected in 6.5% of cases. But it rose to 11-14% in 2018, according to the study.
"It's alarming because the percentage is increasing faster in the last year than in previous years," said Ahmed Abu Saleh.
The Microbiology Department of Shishu Hospital badyzed its own data from the same period (2010-2018). These data also showed the existence of superbugs in about 11.3% of the microorganisms tested.
In addition, a report from the Global Partnership on Antibiotic Resistance (GARP) entitled "Antibiotic Use and Resistance in Bangladesh 2018" also indicated that the rate of antibiotic resistance was increasing in Bangladesh. But he did not provide any quantitative data.
WHY AMR IN BANGLADESH
The use of counterfeit or poor quality antimicrobial drugs, poor laboratory capacity and inadequate monitoring and surveillance of drugs are among the main reasons for the progression of the AMR bacteria, the GARP report said.
In addition, the report indicated that the growth of AMR was at the origin of poor compliance with treatment, the non-therapeutic use of antibiotics for the promotion of growth in farm animals, self-medication and over-the-counter antibiotic access.
In Bangladesh, the pharmaceutical market represents 22,000 crore of TK. Sayedur Rahman, president of the pharmacology department of BSMMU, told the Daily Star, Prof. Dr. Sayedur Rahman, 18% of whom are busy with antibiotics indicating "blind use of antibiotics".
The lead researcher on the WHO study on antimicrobial consumption, Rahman, also said, "We are collecting information. We will be able to tell the actual consumption of antibiotics in a few months. "
A study conducted in 2015 by four Bangladeshi researchers on 1,500 patients showed that on average, 61.13% of patients received antibiotics. Of these, approximately 33.80% were prescribed by unauthorized physicians. The European Journal of Scientific Research published the results.
The inappropriate use of antimicrobials in livestock also results in the development of antimicrobial resistant bacteria that can be transferred through human contact with animals, said Professor Saleh, adding, "The major problem is that 19 types of antibiotics are used mbadively in poultry farms and in fisheries.
A recent study conducted at Chattogram showed that approximately 54.55% of broilers (poultry) were infected with a multidrug-resistant bacterium.
The total number of livestock in the country is 393.14 million, according to data from the 2017-18 livestock department.
EXIT
The experts urged the government to take short- and long-term initiatives to control antimicrobial resistance. Measures include infection prevention and control, immunization, antimicrobial stewardship, training of public and private practitioners, and a unified approach, a unique approach to health for human and animal health.
Prof Sayedur said, "First, the over-the-counter sale of antibiotics should be immediately stopped. Second, the use of antibiotics in the livestock sector, especially poultry and fishing, should be controlled. Handwashing facilities should be in place in all hospitals.
"There is no provision for testing antimicrobial susceptibility in more than 50 districts. For this, doctors start with comparatively high antibiotics based on their hypothesis. But they should not do that. "
The government should focus on the issue because the whole health system, including modern facilities and the maintenance of hospital hygiene, is linked to it.
Pharmaceutical companies also have responsibilities in this regard. Many of them are pressuring their representatives to stimulate the sale of antibiotics, which is false, he added.
Professor Saleh said, "The government must put an end to the misuse of antibiotics. We, the doctors, have very little to do in this regard unless the government develops a national policy and implements it … But it has to be controlled. "
https://www.thedailystar.net/frontpage/news/big-cause-health-concern-1726648
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