Imagine going to the hospital with what you think is just a simple stomach ache. It could be something you ate a few days ago or you didn’t wash your hands before or after you ate something or you just returned from a foreign country and must have contracted a bug. After a few visits and treatments in the emergency department your symptoms don’t resolve and become worse. You develop a fever, vomit continuously and become weak. You deteriorate fast and soon end up in a critical state in an intensive care unit. Your medical team have given all they can to manage you and are baffled as to what is causing this sudden deterioration. An infection is suspected and you eventually develop sepsis. Antimicrobial after antimicrobial drug is used with no improvement. After a few days it is then identified with a blood culture that the bacteria causing your illness is resistant to every antimicrobial the hospital has to offer and stronger sensitive antimicrobials are too expensive to buy or difficult to source in the country. There is nothing more that the medical team can do but support your organs and hope that your body fights the infection. You are fighting a losing battle and you deteriorate. Your family and medical team watch on as you develop multiple organ failure and finally succumb to the infection.
This is what antimicrobial resistance (AMR) can do. Most will be lucky and get treated with the right antimicrobial which is often empirical. Some infections with a resistant microorganism will not mount a severe enough immune response to cause sepsis and death but can cause lasting disabilities. Most infections will resolve undetected and inadequately treated. Resulting in potential transmission of these resistant microorganisms into the community.
How common is AMR in PNG?
There is limited published data in the country. Data on mortality and morbidity in the country as a direct or indirect result of AMR is scares. Yet in our practice every day we do see worrying trends of infectious microorganisms isolated from infected tissues and fluids that are becoming increasingly resistant to the antimicrobials that we use on a daily basis.
Should we be worried?
YES WE SHOULD!
Why?
The next series of posts will outline why we need to be serious about AMR in PNG and the world.
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