WIDESPREAD colonisation of drug-resistant bacteria, especially at high levels among newborns in neonatal intensive care units, constitutes an alarming public health crisis. A recent International Centre for Diarrhoeal Disease Research, Bangladesh study conducted with support from the US Centres for Disease Control and Prevention and the Task Force for Global Health, shows widespread colonisation of drug-resistant bacteria across both community and hospital settings. The Antibiotic Resistance in Communities and Hospitals study, initially conducted in 2019, shows that extended-spectrum cephalosporin-resistant Enterobacterales were highly prevalent, affecting 78 per cent of individuals in the community and 82 per cent of hospital patients. Patients in hosptials were particularly at risk, with 37 per cent carrying carbapenem-resistant Enterobacterales compared with 9 per cent in the wider community while colistin-resistant bacteria were detected in up to 11 per cent of community members. Disturbingly, one in five participants harboured methicillin-resistant Staphylococcus aureus. The second-phase study offers even deeper insights into critical care settings, with 81 per cent of newborns in neonatal intensive care units being colonised with carbapenem-resistant Klebsiella pneumoniae and more than half acquiring it after 48 hours in hospital. Adult ICU patients were similarly affected, facing prolonged hospital stays and increased infection risk.
The findings of the Antibiotic Resistance in Communities and Hospitals study indicate grave implications of antimicrobial resistance for both individual patients and the broader healthcare system. High colonisation rates with carbapenem-resistant and extended-spectrum cephalosporin-resistant bacteria, particularly in neonatal and adult intensive care units, indicate that hospitals have become critical reservoirs for the propagation of the pathogens. For newborns, early colonisation significantly elevates the risk of severe, potentially life-threatening infections while in adult patients, colonisation is associated with longer hospital stays, increased treatment costs and higher morbidity. Beyond hospitals, the pervasive presence of resistant bacteria in community settings threatens to undermine the effectiveness of standard antibiotics, limiting therapeutic options and potentially precipitating outbreaks that are increasingly difficult to control. ICDDR,B experts at a seminar say that addressing this challenge requires a multi-pronged approach: stringent infection prevention and control measures, rigorous hand hygiene protocols, improved hospital sanitation and tighter regulation of antibiotic sales to prevent over-the-counter misuse. Additionally, robust surveillance systems are essential to monitor resistance patterns and guide evidence-based interventions. Without coordinated policy action and public health measures, Bangladesh risks a future where routine infections could escalate into untreatable conditions, eroding decades of medical progress and threatening the efficacy of life-saving antibiotics for future generations.
Urgent and coordinated action is imperative to safeguard the effectiveness of antibiotics and protect vulnerable populations. Strengthening infection control in hospitals, enforcing rational antibiotic use and enhancing nationwide surveillance are crucial steps. Public awareness campaigns, combined with policy measures regulating antibiotic distribution, can mitigate the spread of resistant pathogens.
