Alarming antibiotic resistance killing children in Bangladesh: Study

Researchers have found that young children with pneumonia in Bangladesh frequently do not respond to common antibiotics, often resulting in their deaths.

A new study co-authored by researchers from Massachusetts General Hospital (MGH) with colleagues at the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) revealed this.

The study, which appeared in the journal Open Forum Infectious Diseases, offers an early warning that a pandemic of potentially deadly antibiotic resistance is under way and could spread around the globe, said a media statement of icddr,b on Thursday night.

 “At our hospital, dozens of kids died of pneumonia between 2014 and 2017, despite receiving the World Health Organization’s recommended antibiotics and enhanced respiratory support,” Mohammod Jobayer Chisti, MMed, a senior scientist in icddr,b’s Nutrition and Clinical Services Division, who led the study, was quoted as saying in the statement.

Pneumonia is an infection of the lungs that causes fluid and pus to fill air sacs, producing cough, fever, trouble breathing, and other symptoms. In small children, pneumonia can be caused by viruses, but certain types of bacteria are common sources of infection, too.

However, when Dr Chisti and his colleagues examined health records of more than 4,000 children under age five with pneumonia admitted to their hospital between 2014 and 2017, they found that a very different pattern of bacterial infections was occurring.

Some 40 per cent of the gram-negative bacterial infections in this study resisted treatment with first- and second-line antibiotics that are routinely used to treat pneumonia. More alarming, children who had antibiotic-resistant bacterial infections were 17 times more likely than others without bacterial infections to die.

“These kids are already dying early because of antibiotic-resistant bacteria, from what would be a routine infection in other parts of the world,” said Jason Harris, MD, MPH, co-first author of the study and chief of the division of Paediatric Global Health at the Massachusetts General Hospital for Children.

“And this was at one hospital in Bangladesh. Extrapolate these findings across a country of 163 million people, and then to a larger region where antibiotic resistance is emerging, and the overall numbers are probably huge,” said Harris.

There is an urgent need to address factors that are promoting antibiotic resistance in Bangladesh, said Tahmeed Ahmed, executive director of icddr,b and senior author of the study.

For starters, antibiotics can be purchased without a prescription in the country and many people use them to self-treat conditions such as dysentery, cold, cough and fever. Misuse of antibiotics promotes the spread of bacteria that resist the medications.

“If COVID-19 was a tsunami, then emerging antibiotic resistance is like rising flood water. And it’s kids in Bangladesh who are already going under,” Ahmed said.

This research was funded by unrestricted support to icddr,b from the governments of Bangladesh, Canada, Sweden and the United Kingdom. Harris receives funding from the National Institutes of Health.

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