Bhuwaneswor Prasad Kandel
Lecturer (Medical Microbiology),
Prithvi Narayan Campus, Pokhara, Nepal
Bacterial resistance to various antibiotics has been observed since their discovery and the pace of development of new antibiotics in recent years has been paralleled by the appearance of resistance to these antibiotics creating a growing health problem of global magnitude. The relentless threat posed by microbial drug resistance has achieved the dimension of a global pandemic, with a relevant impact in terms of morbidity, mortality and health-care associated costs. The growing threat posed by increasing prevalence of extended spectrum β-lactamases (ESBLs) and carbapenemases among gram-negative bacteria has resulted in infections that can be extremely difficult to treat. Extensive and indiscriminant use of various antimicrobials in clinical and agricultural practices has been creating the major selective force for emergence and global dissemination of resistant strains and resistance genes. Misuse and overuse of antibiotics by clinicians and retailers, their use by patients in suboptimal dose and duration, and use of leftover antibiotics by patients, all have contributed to emergence and spread of multidrug resistant (MDR) bacteria. Residents of long-term care facilities (LTCF) and ambulatory patients are among the main reservoirs of most of antibiotic-resistant bacteria with severe and chronic illness, increased antimicrobial exposure, altered physiological states, use of indwelling devices, surgery, etc. being reported risk factors for infection with MDR organisms leading to treatment failure and prolonged period of hospital stay.


