Prevalence of silver resistance determinants and extended-spectrum β-lactamases in bacterial species causing wound infection: First report from Bangladesh.

Background: The use of silver is rapidly rising in wound care and silver-containing dressings are widely used along with other antibiotics, particularly β-lactams. Consequently, concerns are being raised regarding the emergence of silver-resistance and cross-resistance to β-lactams. Therefore, this study aimed to determine the phenotypic and genotypic profiles of silver-resistance and extended-spectrum β-lactamases in isolates from chronic wounds.

Methods: 317 wound swab specimens were collected from tertiary hospitals of Dhaka city and analysed for the microbial identification. The antibiotic resistance/susceptibility profiles were determined and phenotypes of silver resistant isolates were examined. The presence of silver-resistance () genes () and extended-spectrum β-lactamases (ESBL) () were explored in isolated microorganisms.

Results: A total of 501 strains were isolated with (24%) as the predominant organism. In 29% of the samples, polymicrobial infections were observed. A large proportion of (59%) was resistant to carbapenems and a significantly high multiple antibiotic-resistance indexes (>0.2) were seen for 53% of organisms (P < 0.001). According to molecular analysis, the most prevalent types of ESBL and gene were (47%) and (42%), respectively. Furthermore, phenotypic silver-nitrate susceptibility testing showed significant minimum-inhibitory-concentration patterns between -negative and -positive isolates. We further observed co-occurrence of silver-resistance determinants and ESBLs (65%).

Conclusions: Notably, this is the first-time detection of silver-resistance along with its co-detection with ESBLs in Bangladesh. This research highlights the need for selecting appropriate treatment strategies and developing new alternative therapies to minimize microbial infection in wounds.