Increased Antimicrobial Resistance against metronidazole and carbapenem in clinical anaerobic isolates from Pakistan.

Increased Antimicrobial Resistance against metronidazole and carbapenem in clinical anaerobic isolates from Pakistan was recently reported by reported by Shafquat and colleagues  from , Aga Khan University Hospital,in Karachi, Pakistan.

 Of the 223 clinically significant isolates collected between 2014 and 2017, 39 (17.5%) were metronidazole resistant. Imipenem resistance was determined in 29 metronidazole resistant isolates and of these 7 (24.1%) were found to be resistant. Proportion of metronidazole resistant strains was highest amongst Bacteroides species. A significant increase in metronidazole resistance from 12.3% in 2010-2011 to 17.5% in the current study was found. Carbapenem resistance also emerged in the period 2014-2017.

Isolates from malignancy and transplant patients showed lower odds of developing metronidazole resistance. Prolonged hospital stay was not associated with metronidazole resistance.

The worldwide rising trend of metronidazole resistance and emergence of carbapenem resistance in anaerobic bacteria is alarming. Continued surveillance with strengthening of laboratory capacity regarding anaerobic susceptibility testing is urgently needed.