Abstract
BACKGROUND: While antimicrobial resistance (AMR) continues to be a major public health problem in Pakistan, data regarding trends of resistance among pathogenic bacteria remain scarce, with few studies presenting long-term trends in AMR. This study was therefore designed to analyse long-term AMR trends at a national level in Pakistan. METHODS: We report here results of a comprehensive analysis of resistance among pathogens isolated from blood and CSF, between 2011 and 2015. Susceptibility data were obtained from a local laboratory with collection points all across Pakistan (Chughtai Laboratory). Resistance proportions to most commonly used antimicrobials were calculated for each pathogen over a period of 5 years. RESULTS: While Acinetobacter species demonstrated highest resistance rates to all tested antimicrobials, a sharp increase in carbapenem resistance was the most noticeable (50%–95%) between 2011 and 2015. Our results also highlight the presence of third and fourth generation cephalosporins resistance in Salmonella enterica serovar Typhi in Pakistan. Interestingly, where a rise in AMR was being observed in some major invasive pathogens, decreasing resistance trends were observed in Staphylococcus aureus to commonly used antimicrobials. CONCLUSIONS: Overall pathogens isolated from blood and CSF between 2011 and 2015 showed an increase in resistance towards commonly used antimicrobials.