Prevalence and pattern of antibiotic resistance in clinical isolates from Rangpur district of Bangladesh : a cross-sectional study

Abstract

Background: Antimicrobial resistance (AMR) is accelerating in low- and middle-income countries, yet district-level data remain scarce in northern part (Rangpur) of Bangladesh. Methods: We analyzed 200 clinical specimens from two Rangpur facilities (Jan–Jun 2025). Bacterial identification and antimicrobial susceptibility testing followed CLSI (2025). Proportions and 95% CIs were calculated. Results: Culture positivity was 58.5% (117/200; 95% CI 51.6–65.1). Escherichia coli predominated (77.8% of isolates). MDR prevalence was 92.3% in E. coli (84/91; 95% CI 85.0–96.2) and 100% in Klebsiella pneumoniae (n=1). Overall resistance to third-generation cephalosporins was 63.8% (e.g., cefixime 79.1%, ceftriaxone 59.8%), and fluoroquinolone class resistance 28.5% overall; notably, E. coli ciprofloxacin resistance reached 76.9%. Agents retaining activity included amikacin (R ≈13%) and nitrofurantoin (R ≈27% for urinary isolates). Conclusions: AMR in Rangpur is severe, with very high MDR—especially in E. coli—and limited efficacy of commonly used oral agents. Strengthened stewardship, diagnostics, and integrated surveillance are urgently required; organism-specific therapy should be guided by susceptibility testing.