O01 Trends in antimicrobial resistance amongst pathogens isolated from blood and cerebrospinal fluid cultures in Pakistan (2011–15): a retrospective cross-sectional study

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.