Study: Bangladeshi children carry antibiotic-resistant infections at an alarming rate

Amid reports of many infections getting harder to treat as antibiotics become less effective against them, a recent study found high levels of antibiotic-resistant bacterial infections in children under five with pneumonia in Bangladesh.

A whopping 18% of all bacterial isolates, the study revealed, from children with pneumonia were resistant to all routinely used antibiotics, reports the Medical News Today (MNT), a UK-based online portal.

This comes amidst the World Health Organisation's warning that without urgent action to tackle antibiotic resistance, the world faces a “post-antibiotic era in which common infections and minor injuries can once again kill”. 

Published in the American medical online journal “Open Forum Infectious Diseases” on July 15, the study noticed that children with a multidrug-resistant bloodborne bacterial infection were 17 times as likely to die as those without a bacterial infection.

The research is a collaboration between scientists in Bangladesh and the US.

Referring to a dramatic increase in antibiotic-resistant infections, researcher Jason Harris said he was particularly concerned that people acquire these resistant infections in the community rather than in the hospital.

“In the US, I see a lot on antibiotic resistance in patients who have been in the hospital for weeks or months with chronic illness, but the fact that these are children coming in from the community with these severe resistant infections is very worrying,” he told MNT.

According to Jason, the widespread availability of OTC antibiotics, lack of access to safe drinking water, and inadequate sanitation are fuelling the spread of antibiotic-resistant “superbugs” across South and East Asia.

Citing a much worse situation in Bangladesh, he claimed to have already been examining some community-acquired cases of resistance in the US.

“If we don’t do anything to address it now, these bacteria will continue to spread, and they will inevitably be the new normal everywhere,” he warned.

Pneumonia accounts for 12% of all deaths in children under five in the South Asian nation.

The study

Researchers analyzed the records of 4,007 children under five admitted to the Dhaka hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh or icddr,b between 2014 and 2017 with radiographically confirmed pneumonia.

Of them, 1,814 had a blood culture to test for the presence of a bacterial infection, of which 108 (6%) were positive.

Gram-negative bacteria accounted for 77% of these positive cultures, including Pseudomonas, Escherichia coli, and Salmonella enterica. The authors report that this is an unusually high proportion for bacterial pneumonia.

Out of the 108 positive cultures, 20 (18%) were resistant to all routinely used antibiotics (ampicillin, gentamicin, ciprofloxacin, and ceftriaxone).

Children with confirmed bacteremia, a bacterial infection of the blood, were five times as likely to die as those with a negative blood culture.

In cases where bacteria were resistant to all routinely used antibiotics, 17 times as many children died as those without a blood infection.

“We need better diagnostic tests and better availability of appropriate medicines for kids who might otherwise die from their infections,” Jason told the MNT.

He criticized the use of antibiotics to treat colds, which are viral infections, and mild diarrheal illness, which fuels the spread of antibiotic resistance in the community.

The study mentioned that antibiotic-resistant Gram-negative bacteremia in young children with pneumonia in Dhaka was associated with a high mortality rate. 

“The pandemic of antibiotic resistance is shortening the lives of young children in Bangladesh, and new approaches to prevent and treat these infections are desperately needed,” it observed.