Drug-resistant bacteria resulting in longer hospital stays, increased treatment costs: NIH officials

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Islamabad: The overuse of third- and fourth-line antibiotics in communities and hospitals has led to the emergence of hard-to-treat bacteria, resulting in longer hospital stays, increased treatment costs, and higher mortality rates.

While definitive data on deaths linked to drug resistance is not available, health experts and scientists at the 3rd National Symposium on Antimicrobial Resistance (AMR), organized by the National Institute of Health (NIH) on Wednesday, estimated that thousands of lives are lost each year to infections caused by resistant pathogens. Speakers also acknowledged the efforts of the health ministry and NIH in combating antimicrobial resistance (AMR).

“AMR presents a considerable challenge, as more and more infections become difficult to treat due to resistance. Extensively drug-resistant (XDR) infections are now common in communities, and hospital-acquired bloodstream infections are becoming increasingly difficult to manage,” said Dr. Muhammad Salman, Executive Director of NIH.

As part of World Antimicrobial Awareness Week (WAAW) 2024, the national symposium was organized by NIH in collaboration with the WHO, Fleming Fund, Health Services Academy (HSA), and Getz Pharma.

Dr. Salman emphasized that the symposium, a recurring NIH initiative, seeks to highlight the magnitude of AMR in Pakistan. Events like awareness campaigns, walks, and seminars aim to promote the rational use of antibiotics.

Dr. Atiya Abro, Deputy Director of Programs at the Ministry of National Health Services, warned that AMR not only jeopardizes human health but also threatens food security by affecting livestock and crop health.

Resistant pathogens, she noted, reduce agricultural productivity and contaminate the environment, thereby facilitating the spread of resistance. She praised the National Action Plan 2.0, noting that the plan’s technical and awareness initiatives reflect a strong commitment to tackling the AMR challenge and are seen as critical steps toward safeguarding public health.

Jaffer Bin Baqar, Getz Pharma’s Public Health Lead, spoke about their collaborative efforts with NIH and other partners to combat AMR. This includes training over 15,000 healthcare providers across the country and raising awareness about the dangers of self-medication and irrational antibiotic use.

He emphasized the importance of limiting antibiotic use to prescription-only practices and adhering strictly to prescribed dosages and durations.

Senior NIH scientist and AMR lead Dr. Omera Naseer shared findings from a study conducted across 11 tertiary care hospitals, revealing that 91% of patients were prescribed antibiotics, many of which were unnecessary.

She highlighted that most hospitals lack proper antibiotic guidelines and fail to conduct laboratory cultures for accurate prescriptions, contributing to the rise of drug-resistant pathogens. “We are working with these hospitals and others to promote antimicrobial stewardship and rational antibiotic use,” Dr. Naseer added.

The economic burden of AMR was discussed by Numrah Safdar, NIH’s senior pharmacist and AMR specialist. She referenced studies at Holy Family Hospital in Rawalpindi and PIMS Islamabad, which showed that AMR drives up treatment costs and extends hospital stays.

NIH Microbiologist Zurva Ashraf presented concerning data on the resistance of pathogens such as E. coli, which causes UTIs and sepsis, as well as Staphylococcus aureus, which leads to MRSA infections. Resistant strains of Klebsiella pneumoniae and Pseudomonas aeruginosa are also causing difficult-to-treat infections in immunocompromised patients. Additionally, multidrug-resistant Salmonella Typhi remains a source of severe complications like intestinal perforation.

The symposium also featured presentations from experts including Dr. Qadeer Ahsan of the Fleming Fund, Dr. Naveed from WHO, and Dr. Shaheer Illahi from HSA. A panel discussion, involving Dr. Munazza, Muhammad Akram, and Dr. Hifza Rasheed, further emphasized the urgent need for stewardship programs and greater collaboration across healthcare, agriculture, and environmental sectors to combat the escalating threat of AMR.

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