Sustained rise in antimicrobial resistance in India: ICMR study

 

 

 

TWO topmost pathogens responsible for causing bloodstream infections (BSIs), the most common hospital-acquired infection, have been found to be resistant to the antibiotic imipenem among ICU patients, an ICMR study has found. These two pathogens are Klebsiella pneumoniae and Acinetobacter baumannii. Besides, two other pathogens Staphylococcus aureus and Enterococcus faecium causing BSIs were resistant to the antibiotics oxacillin and vancomycin, respectively, the study stated. Normally these antibiotics work on patients not suffering from BSIs. Bacteria Acinetobacter spp was the most common pathogen responsible for ventilator associated pneumonia, according to the ICMR’s annual report 2023 which provides comprehensive details of bloodstream infections (BSIs), urinary tract infections (UTIs) and ventilator associated pneumonia (VAP) reported from January 2023 to December 2023 from a network of 39 hospitals across India.

 

The network hospitals in this report are part of the ICMR’s AMR network and hospitals that have voluntarily joined the network, said senior ICMR scientist Dr Kamini Walia, who led the antimicrobial resistance (AMR) study. A high rate of resistance was seen among UTI causing E choli and Klebsiella pneumoniae and Acinetobacter baumannii against antibiotics carbapenem, fluoroquinolones and third generation cephalosporins, Dr Walia said. Any infection, which develops after 48 hours of admission of a patient in the hospital, is called healthcare-associated infection, she explained. Hospitals must invest in prevention of infections in hospital settings. Antibiotics like piperacillin-tazobactam and carbapenems which are used for treating blood infections caused by E coli bacteria have been found to be more resistant among OPD, ICU and ward patients over the last seven years.

 

In Acinetobacter baumannii, one of main pathogens of the hospital acquired infections such as Pneumonia, there is no significant change in the susceptibility trends to all the tested antibiotics compared to 2022. Resistance to carbapenems in Acinetobacter baumannii was recorded as 88 per cent in the year 2023, limiting the availability of available treatment options, Dr Walia said. Resistance to carbapenem was observed in all the isolates of the OPD, ward and ICU but highest resistance was reported in ICU patients, she said. It was close to 72 per cent to make it the most effective antibiotic in terms of susceptibility after colistin antibiotic for A. Baumannii. Colistin is the last resort the antibiotic used to treat bacterial infections which have acquired resistance to other antibiotics. As reported in previous years’ reports, fungal pathogens like C. Tropicalis and C. Albicans were found to be leading causes of candidemia, a type of fungal bloodstream infection in hospitalised patients the current year.