Tuesday, May 26, 2020

Superbugs: The cause of death

Superbugs: The cause of death in 80 percent of patients in the ICU


Doctors in Bangladesh say antibiotic-resistant bacteria, also known as 'superbugs', are responsible for the deaths of a large number of patients in hospital intensive care units (ICUs).

Professor Sayedur Rahman, chairman of the pharmacology department at Bangabandhu Sheikh Mujib Medical University in Dhaka, told BBC Bangla that most of the patients in the ICU had superbugs on their bodies.



"Patients who are dying in the ICU are already complex patients with weakened immune systems and may have many more problems," he said. But we also found that 70 to 80 percent of them had antimicrobial resistance superbugs. ”

There may be many more causes of their deaths, but it has been found that 60 to 70 percent of the bacteria that attack dead patients are resistant to antibiotics. These invading bacteria are in some cases resistant to common antibiotics, and sometimes resistant to all types of antibiotics. ”

In 2016, a total of 900 patients were admitted to the ICU of Sheikh Mujib Medical University, out of which 400 died. About 80 percent of these patients were found to have antibiotic-resistant bacteria in their bodies.



He said the patients who come to Bangabandhu Sheikh Mujib Medical University have already come here with treatment from various hospitals. As a result, they may be infected with such drug-resistant bacteria from there or may be infected here as well.

Professor Rahman said most of these patients came from other hospitals, indicating that there was not enough care in those ICUs.

What is meant by Antimicrobial Resistance (AMR)?
Professor Sayedur Rahman said that the bacteria that usually attack the human body, they have some ability to survive from those drugs due to prolonged exposure to the drugs.

This is called antibiotic resistance in the language of medical science.

Why is it so risky?
Bacteria that are resistant to such drugs can spread the disease to other bacteria. As a result, this ability is created in many bacteria at a very fast speed.

As a result, these germs cannot be controlled with any other antibiotics, meaning that the antibiotics do not work. As a result, it becomes difficult to cure the patient.



Superbugs or antimicrobial resistance is not the only problem in Bangladesh, there is growing concern all over the world. However, experts believe that this problem is growing rapidly in Bangladesh due to its dense population and low surveillance.

How is this resistance created in the environment?
If antibiotics are used in the body of animals or in the production of vegetables that we eat meat or vegetables, they create resistance, which affects humans.

Professor Rahman said, “People need fish, poultry, cows for protein and they need antibiotics to save them cheaply. That means people are risking their futures for their protein. ”



He also mentioned that it can be spread from hospital to resistant person's sneezing-cough, stool-urine.

But why such a bacterial infection in the ICU?
Professor Sayedur Rahman has mentioned several reasons for this.

"The patient's immune system is weakened by the illness, so at other times he can no longer handle the bacteria he could handle on his own."

Secondly, the patients who come to our hospital (Bangabandhu Sheikh Mujib Medical University Hospital) usually come here after getting treatment in other hospitals. But those hospitals are relatively weak in preventing the spread of infection. As a result, they become infected with bacteria that have become drug-resistant. ”

Third, infection in the ICU. The recommendations made in this case are not followed in the ICU of our country. As a result, patients can be exposed to bad bacteria after being admitted to the ICU. That is why this rate is slowly increasing. ”



Eight years ago, the rate was 20 to 25 percent, but now it has at least tripled, says the professor at the country's only medical university.

What is the reason behind this type of infection?
Professor Sayedur Rahman said, “There is still some research going on. When the results are published, it can be said for sure. However, the reasons that are now being considered are that the measures that should be taken in the hospital to prevent infection are very weak here. ”

"In Bangladesh, by the way, about 10 lakh people are buying over-the-counter antibiotics every day without a doctor's advice."

A 2015 study in the European Journal of Scientific Research found that one in three patients in Bangladesh took antibiotics without a doctor's advice.

"Billions of chickens are using antibiotics, they are getting into the human body in many ways."

Scientists at the ICDDRB say many children have been found to be resistant to antibiotics, although they may not have taken any medications. It is made in their body through genes.

"This means that even if children do not take antibiotics, these drug-resistant germs in the environment are entering their bodies and the drugs are not working," said Monirul Alam, a senior scientist at ICDDRB.

So what is the status of conventional antibiotics in the market?
Professor Sayedur Rahman says, “In general, our research is hospital-centric, where relatively complex patients come. Those tests showed that in half of their cases, at least half of the antibiotics they used to treat 10/15 years ago had lost their effectiveness. ”

"So we understand that if this continues, the bacteria will become dangerously resistant in the future and it will become increasingly difficult to treat humans."

How can the problem be dealt with?
Sayedur Rahman, a professor at Bangabandhu Sheikh Mujib Medical University, said, "First, it is necessary to stop selling antibiotics without a prescription." The easiest way to do that is to paint such medicine packets red, so that everyone understands that it is risky.

Stopping the use of antibiotics needed by humans in livestock, especially poultry. Because if these antibiotics become resistant to the environment, it will create a lot of risk to human life. ”

"Every hospital must be monitored or teamed by the government to ensure that the necessary measures are taken to prevent infection there."

Professor Rahman said, these steps must be taken together.

Otherwise, Bangladesh will be in a much more precarious position than other countries. "Because it's a small place, there are a lot of people, so it can spread infections or germs quickly," the doctor warned.

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