It was organized by the Cambodian Ministry of Health in collaboration with SHCH (Sihanouk Hospital Center of Hope, Cambodia) and the ITM (Institute of Tropical Medicine, Belgium), with support of the World Health Organization, the Fondation Mérieux, URC Cambodia (University Research Co.) and DMDP (Diagnostic Microbiology Development Programme). The observation of bacteria resistant to all commonly available antibiotics (e.g. the New Delhi Metallo-Beta-Lactamase 1 (NDM-1) in India) and its subsequent worldwide spread has brought to light the worldwide presence of the problem of bacterial resistance. Its rapid spread as well as the overuse of antibiotics has contributed to this resistance. Resource limited countries are particularly affected.
In Cambodia, the awareness of antibiotic resistance has grown among health workers. Indeed, recent years have seen the development of microbiology laboratories and the training of technicians and doctors in to the correct usage of these new diagnostic tools. However, in the country, few data about antimicrobial resistance are known.
The meeting had several objectives:
- to compile and present current data on antibiotic resistance in the country’s different laboratories,
- to deliver a training on the techniques for identification of and laboratory biosafety,
- to promote exchange and interaction between different parties (politicians, doctors; biologists; technicians…),
- and to organize longer term actions.
Ten microbiology laboratories from research and diagnostic settings (Takeo, Kampong Cham, Battambang, Phnom Penh…) presented their data, the results showing trends in resistance levels in Cambodia. From the compiled data, one can conclude that 30% to 50% of β-lactamase producing Escherichia coli are extended spectrum (ESBL, known for their propensity to spread in hospitals), 60% of pneumococci show reduced susceptibility to penicillin (PNSP), 20 to 40% of Staphylococcus aureus are methicillin-resistant (MRSA), and that 70% of Salmonella Typhi have a reduced susceptibility to fluoroquinolones and are multidrug-resistant.
In view of these alarming data, the Cambodian Ministry of Health has reaffirmed the principles of correct drug usage in hospitals and has presented the nationwide infection control program and reinforcement programs of diagnostic laboratories. Resistance mechanisms were also clearly explained along with the concept of selective pressure of antibiotics on bacteria.
This workshop allowed for a real sharing of information and knowledge between all of the health workers and also determined several lines for future action, such as the creation of a network of laboratories in Cambodia, the establishment of a national plan to combat resistance and the redaction of standard treatment guidelines. Finally this workshop not only contributed to awareness and action among health authorities and professionals, but also incited to public awareness of the problem of antibiotic resistance and its thriving factors.