5 Monivong Boulevard, P.O Box. 983, Phnom Penh, Cambodia accueil@pasteur-kh.org

Following WHO definition “Antimicrobial resistance (AMR) is the ability of a microorganism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics, antivirals and antimalarials) from working against it. As a result, standard treatments become ineffective, infections persist and may spread to others. New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases, resulting in prolonged illness, disability, and death.”

Institut Pasteur du Cambodge focuses its research and routine activities on resistance to antibiotics of bacteria responsible for human infection. Among several explanations such resistance often occur from over/misuse of antibiotics, in human or in animals.

IPC data are coming from 3 difference sources: prospective Birdy research survey (in pregnant women, neonates and young children, in rural and urban settings), sampling of meat and fish from markets, and patients from the medical laboratory.

Results show a very high level of resistance in several group on bacteria.

In pregnant women and babies, there is an alarming prevalence of ESBL (Extended spectrum beta-lactamase ) producing enterobacteria ( E. coli, K. pneumoniae) reaching 80 % in pregnant women and 42 % in infants ( In Europe it is <5%).

Other bacteria are also highly resistant: Staphyococcus aureus with 36 % methicilin resistant, whereas Pneumococci w 78% shows a diminished sensitivity to penicillin.

ESBL enterobacteria and salmonella contamination rates are also very high in samples collected in the markets: 75% and 17% respectively in retailed meat and fish (in 2016).

The frequency of Extended spectrum beta-lactamase producing enterobacteriaceae isolated between 2012 and 2015 in routine samples in IPC medical laboratory varied between 18.9 % and 48.2 % for E. coli, between 28.5 % and 42.0 % for K. pneumoniae, and between 5.3 % and 17.1 % for other enterobacteria, depending on the years.

Recommandations:

1) Antibiotics are not necessary systematically

An antibiotic is an active product on bacteria. According to its mode of action, which varies according to the families of antibiotics, it will be active only on a certain number of species of bacteria (which determines its spectrum of action). Their usefulness is undeniable, and without them, many bacterial infections would be fatal. However, some common pathologies which are encountered in the city, such as colds, pharyngitis, laryngitis or certain angina, are often originated from virus, and antibiotics will not be useful for treatment.

An antibiotic does not lower the temperature, it is not helpful in case of isolated fever.

2) Antibiotics should be used appropriately

Your doctor will prescribe an antibiotic when necessary, it is important to respect the duration for treatment and dosage.

Do not buy antibiotics on your own.

Do not share prescribed antibiotics with other people even if they have the same symptoms or use remaining antibiotics at home.

Always buy antibiotics from reliable pharmacies, avoiding the local pharmacies open along the street selling drugs in small amount of tablets without traceability or adequate preservation. Western pharmacy chains, supplied by recognized suppliers, are today the best guarantee for avoiding falling into false medicines, and thus to take care of their health.