Drug-resistant bacteria spreading rapidly in ICUs: icddr,b

 
Difficult-to-treat drug-resistant bacteria are spreading rapidly in intensive care units (ICUs) across Bangladesh, with more than half of patients who were initially free of the bacteria acquiring them during hospital treatment, according to two new studies by icddr,b.

The studies also found alarmingly high mortality among patients who developed these infections but showed that stronger infection prevention and control (IPC) measures can significantly reduce severe infections and deaths.

Published in the Microbiology Spectrum and Antimicrobial Resistance & Infection Control journals, the studies analysed data from 373 critically ill adult ICU patients admitted between July 2023 and February 2024 and 363 newborns admitted to a neonatal intensive care unit (NICU) between December 2023 and September 2024 at a government tertiary hospital in Dhaka.

The research, funded by the US Centers for Disease Control and Prevention (CDC), focused on difficult-to-treat resistant Gram-negative bacteria, which are resistant to commonly used antibiotics and can cause severe pneumonia, bloodstream, urinary tract and wound infections, particularly among critically ill patients.

Researchers examined four major hospital-acquired bacteria-Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa.

The study found that 48.5 per cent of ICU patients were already colonised with these bacteria in their gut on admission. More importantly, 105 of the 198 patients (53 per cent) who were initially free of the bacteria acquired colonisation during their ICU stay, indicating substantial in-hospital transmission.

Among patients who developed culture-confirmed infections, more than 90 per cent died in the ICU. Researchers said the exceptionally high mortality likely reflected limited treatment options, hospital-acquired infections and overcrowded critical care settings.

Using whole-genome sequencing, researchers also found that, in some patients, the same bacterial strain present during colonisation later caused life-threatening infections.

Dr Gazi Md Salahuddin Mamun, Assistant Scientist at icddr,b and lead author of the study, said the research tracked ICU patients throughout their stay and used laboratory testing and whole-genome sequencing to understand how resistant bacteria spread within hospitals and progressed from colonisation to infection.