Emergence of drug-resistant bacteria in Pakistan worries doctors

Pakistani doctors are extremely worried over the emergence of new strains of existing bacteria which are resistant to almost all available antibiotics in the country and fear that there could be widespread deaths if the phenomenon was not dealt with immediately.

The pandrug-resistant (PDR) microorganisms identified by microbiologists in Pakistan include Pseudomonas, Enterobacter, Enterococcus, Acinetobacter, and E.coli. A new strain of a gram-positive bacterium called ‘Vancomycin-Resistant Straphylococcus aureus has also been tested as PDR. These bacteria are causing immense problems for doctors in treating infected wounds and surgical incisions.

Dr Salman Faridi, general surgeon and managing director of the Liaquat National Hospital, told The News on Saturday that extensive and unnecessary use of antibiotics have caused the emergence of PDR bacteria and also totally-drug resistant (TDR) ones.

“Bacteria quickly evolve to deal with antibiotics and develop resistance against the antibiotics used to kill them,” he added.

“We are now facing the threat of a super-bug, a strain of bacteria that does not respond to any of the existing antibiotics.”

Dr Faridi said there were several strains of both gram negative and gram positive bacteria that had been declared PDR.

The last group of antibiotics was developed some 20 years back and since then, the pharmaceutical industry has not been developing a new group that could deal with drug-resistant microorganisms.

Infection control society

Fearing widespread deaths because of PDR and TDR bacteria, leading Pakistani surgeons have formed the Surgical Infection Control Society of Pakistan and prepared a set of guidelines for surgeons all over the country to deal with the phenomenon.

“Antibiotics are given to a patient prior to surgery and after the completion of the operation to heal the wounds, “Dr Faridi explained. “But if the wounds are infected with drug-resistant bacteria, it creates immense problems in healing and may lead to deaths. We need to create awareness among surgeons about the use of antibiotics so that situation doesn’t go out of control.”

He said the society, initially comprising of 40 members, has prepared guidelines for surgeons on the use of antibiotics. These guidelines will be formally launched in December this year for surgeons in small hospitals and clinics across the country.

“All major hospitals have their own anti-biograms, which help doctors and surgeons in using antibiotics keeping in view the nature of the infections and bacteria which cause these them. But most surgeons and doctors have no access to such information,” Dr Faridi noted.

“The society will educate physicians and surgeons about rational usage of antibiotics.”

He said the Surgical Infection Control Society of Pakistan would approach regulatory bodies including Pakistan Medical and Dental Council to ensure that antibiotics were used rationally and would recommend antibiotics for infections keeping in view their requirement, suggest hospitals to hire microbiologists, and seek their advice before prescribing antibiotics and share their antibiograms with physicians and surgeons.

Boosting immune system

Dr Faridi urged physicians to not unnecessarily prescribe antibiotics. Instead, he added, patients should be given medicines and advices that would help boost their immune system so that the body could fight bacteria on its own.

He said there were natural products like organic honey and some plant-based medicine which had antibiotic properties and they had excellent therapeutic capabilities to heal some mild to moderate infections. The use of certain fruit, vegetables, spices and herbs also boosts the immune system and prevent diseases caused by microorganisms.

“I advise people to not use over-the-counter antibiotics, avoid self-medication and also abstain from using strong antibiotics in case of mild infections.

Viral infections and diseases can’t be controlled with the use of antibiotics and mild stomach infections can be cured by drinking clean water and taking supplements that slower down bowel moment.”