Trends in antimicrobial resistance amongst pathogens isolated from blood and cerebrospinal fluid cultures in Pakistan (2011-2015): a retrospective cross-sectional study

Background: Only a few studies have presented long-term trends in antimicrobial resistance (AMR) at a nationwide level in Pakistan. This study presents a comprehensive situational analysis of AMR trends among pathogens isolated from blood and cerebrospinal fluid (CSF) cultures, between 2011 and 2015, in Pakistan. Methods: A retrospective analysis of AMR data on pathogens isolated from Blood and CSF over a five year period was carried out. Susceptibility data on these pathogens was obtained from Chughtai Laboratory (CL). Then, proportion of the resistant pathogens were calculated and analyzed. Results: Our results show that highest resistance rates against all tested antimicrobials were observed in Acinetobacter species. We observed a steep rise in carbapenem resistant Acinetobacter species from 50 to 95.5% between 2011 and 2015. Our results also highlight the emergence of third and fourth generation cephalosporins resistance in Salmonella enterica serovar Typhi in Pakistan. While we observed a rise in AMR in other major pathogens, we unexpectedly found decreasing resistance trends in Staphylococcus aureus. Conclusions: Taken together, our results show an overall increase in AMR in pathogens isolated from blood and CSF cultures in Pakistan between 2011 and 2015.