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This is a Cross-Sectional Study study.

January 14, 2026Open Forum Infectious Diseases0 citationsOpen Access

P-1304. Prevalence and Resistance Patterns of Carbapenem-Resistant Enterobacteriaceae in Bangladesh: A Nationwide Laboratory-Based Study

ARAninda Nurbaeti Rahman MSMohammad Julhas SujanInternational Vaccine Institute SRS M Shahriar RizviDirectorate General of Health Services

Key Points

This research assesses the prevalence and resistance patterns of carbapenem-resistant Enterobacteriaceae in Bangladesh.
Conducted a retrospective, cross-sectional analysis of antimicrobial susceptibility testing data from 34 microbiology laboratories from 2017 to 2020.
Evaluated data using WHONET and analyzed with STATA 17.
Defined CRE according to Clinical & Laboratory Standards Institute guidelines.
12.47% of Enterobacteriaceae isolates were identified as CRE, with higher rates in males and older adults.
Increased prevalence of CRE from 12.12% in 2017 to 12.61% in 2020.
CRE showed high resistance to cefotaxime (94.62%–99.31%), ceftazidime (91.56%–97.59%), and aztreonam (91.99%–97.52%).

Abstract

Abstract Background Carbapenem-resistant Enterobacteriaceae (CRE) pose a significant public health threat, particularly in low- and middle-income countries like Bangladesh, where antimicrobial resistance surveillance remains fragmented. CRE infections are major contributors to healthcare-associated infections (HAI) and are associated with high mortality, limited treatment options, and increased healthcare costs. This study evaluates the prevalence, resistance patterns, and temporal trends of CRE in Bangladesh using data from standard public and private microbiology laboratories. Methods We conducted a retrospective, cross-sectional analysis of antimicrobial susceptibility testing (AST) data (from 2017 to 2020) from 34 microbiology laboratories across Bangladesh. Before data collection, each laboratory underwent a quality evaluation using a predesigned questionnaire and a physical assessment. CRE was defined based on Clinical 1 year (18.23%). The prevalence of CRE increased from 12.12% in 2017 to 12.61% in 2020. CRE was more frequently detected in tracheal aspirates (57.77%) and wound swabs (21.20%) compared to urine (7.56%). Indoor samples showed a higher prevalence (18.63%) compared to outdoor samples (8.98%), suggesting a role of HAI. Klebsiella spp. (24.93%) had the higher proportion of CRE than E. coli (7.89%). All CRE isolates showed a high level of resistance against most antibiotics. Resistance was highest to cefotaxime (94.62%–99.31%), ceftazidime (91.56%–97.59%), and aztreonam (91.99%–97.52%). Resistance to amikacin and gentamicin remained lower at 61.51%–86.38% and 68.08%–86.82%, respectively. Conclusion CRE prevalence in Bangladesh remains high, with increasing resistance to carbapenems and third-generation cephalosporins. These findings highlight the urgent need for enhanced infection prevention, antimicrobial stewardship, and routine CRE surveillance to mitigate further spread. Disclosures All Authors: No reported disclosures

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