India is currently facing a significant and rapid escalation in antimicrobial resistance, with many common infections turning increasingly difficult to treat. The report from the ICMR’s Antimicrobial Resistance Research & Surveillance Network for 2024 highlights a concerning failure of routinely prescribed antibiotics against major hospital-acquired pathogens.
Analysis of nearly one lakh confirmed infection samples indicates that Gram-negative bacteria dominate the resistance patterns. Notably, E. coli, a frequent cause of urinary, abdominal, and bloodstream infections, has shown a troubling decline in susceptibility to multiple frontline antibiotics. Additionally, Klebsiella pneumoniae has been found resistant to piperacillin-tazobactam in most cases and exhibits high levels of carbapenem resistance, severely limiting treatment options.
The levels of resistance in intensive care units (ICUs) are particularly alarming. Acinetobacter baumannii shows 91% resistance to meropenem, forcing clinicians to rely on complex or toxic drug regimens. Pseudomonas aeruginosa is also noted for its rising resistance levels. Overall, drug-resistant Gram-negative organisms account for 72% of bloodstream infections, with many cases of ventilator-associated pneumonia involving pathogens unresponsive to high-end antibiotics.
Diarrhoeal pathogens are displaying high resistance to fluoroquinolones and cephalosporins. Over 95% of Salmonella typhi samples show resistance to fluoroquinolone therapy. Among fungal infections, Candida auris exhibits resistance in nearly one-tenth of isolates, while a significant portion of Aspergillus samples resist amphotericin B. Despite modest improvements in the sensitivity of E. coli to select agents, broader resistance patterns continue to worsen.
Experts are sounding alarms that India's most commonly used antibiotics are rapidly losing their effectiveness, placing critically ill patients at greater risk. Clinicians emphasize the necessity of rational antibiotic use, enhanced stewardship programs, and stringent infection prevention measures. These are crucial to conserve the remaining therapeutic options and avert an impending public health crisis.
Q1. What is antimicrobial resistance (AMR)?
Answer: Antimicrobial resistance refers to the ability of microbes to resist the effects of medications that once effectively treated them, making common infections harder to manage.
Q2. What are the primary bacteria responsible for resistance in India?
Answer: Gram-negative bacteria such as E. coli and Klebsiella pneumoniae are primarily responsible for rising resistance levels in India, particularly in hospital settings.
Q3. Why is antibiotic stewardship important?
Answer: Antibiotic stewardship is crucial to ensure the effective use of antibiotics, minimize resistance development, and protect the efficacy of existing treatments.
Q4. How is resistance being monitored in India?
Answer: The ICMR’s Antimicrobial Resistance Research & Surveillance Network conducts regular analyses of infection samples to monitor resistance patterns across various pathogens.
Q5. What can be done to combat antimicrobial resistance?
Answer: Combating antimicrobial resistance requires rational antibiotic use, enhanced infection control practices, and public awareness to preserve the effectiveness of existing antibiotics.
Question 1: What percentage of bloodstream infections are caused by drug-resistant Gram-negative organisms in India?
A) 50%
B) 62%
C) 72%
D) 80%
Correct Answer: C
Question 2: Which bacterium shows 91% resistance to meropenem in ICUs?
A) E. coli
B) Klebsiella pneumoniae
C) Acinetobacter baumannii
D) Pseudomonas aeruginosa
Correct Answer: C
Question 3: What is the resistance rate of Salmonella typhi to fluoroquinolones?
A) 50%
B) 85%
C) 95%
D) 100%
Correct Answer: C
Question 4: What is a critical measure to combat antimicrobial resistance?
A) Increasing antibiotic prescriptions
B) Rational antibiotic use
C) Ignoring infection control
D) Reducing public awareness
Correct Answer: B
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