Antimicrobial Resistance in Septicemia: Uncovering a Silent Catastrophe in Sylhet, Bangladesh

Septicemia is a major global health concern, particularly in low- and middle-income countries where antimicrobial resistance (AMR) threatens effective treatment. This retrospective observational study analyzed 269 culture-positive bloodstream infection cases from Mount Adora Hospital, Sylhet, Bangladesh, between July 2023 and June 2024. Staphylococcus aureus (69.9%) was the predominant pathogen, followed by E. coli (14.5%) and Pseudomonas spp. (11.9%). Alarmingly high resistance rates were observed for cefixime (82.5%), ceftazidime (77.8%), azithromycin (75.9%), and fosfomycin (71.4%), indicating the limited efficacy of these commonly used antibiotics. Conversely, imipenem (10.4%), amikacin (11.3%), and doxycycline (9.0%) exhibited relatively lower resistance. These findings emphasize the urgent need for revised empirical treatment guidelines and robust antimicrobial stewardship to combat AMR in Bangladesh and similar settings.