Drug-resistant urinary tract and bloodstream infections, typhoid and pneumonia show resistance to commonly used antibiotics: ICMR report

A view of the Indian Council of Medical Research (ICMR) in New Delhi. File | Image credit: The Hindu

Drug-resistant and difficult-to-treat urinary tract infections, bloodstream infections, pneumonia and typhoid are among the diseases that are developing resistance to commonly used antibiotics, according to a recent report by the Antimicrobial Resistance Surveillance Network (AMRSN) of the Indian Council of Medical Research (ICMR).

The data collected by the network provides trends and patterns of antimicrobial resistance (AMR) in six major pathogen groups in the country, along with insights into the key resistance mechanisms prevalent in different pathogen groups using genomics and whole genome sequencing. This is the seventh in-depth report of the ICMR-AMRSN and presents data from January 1 to December 31, 2023.

Gram-negative bacilli, which can cause infections anywhere in the body, remain the most commonly isolated pathogens from the most clinically relevant specimens, including blood, urine and respiratory tract samples.

In the outpatient department Escherichia coli Bacillus was most frequently isolated (30.74%), followed by Klebsiella pneumoniae (13.63%), Staphylococcus aureus (12.15%), Pseudomonas aeruginosa (12.06%) and Enterococcus faecalis (4.41%).

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Among the inpatients or on the ward Escherichia coli Bacillus was most frequently isolated (22.75%), followed by Klebsiella pneumoniae (16.21%) and A. baumannii (11.87%).

In the intensive care unit A. baumannii Bacillus was most frequently isolated (23.74%), followed by Klebsiella pneumoniae (20.88%) and Escherichia coli (13.11%).

Twenty-one regional centres from different parts of the country, both in the public and private sectors, participated in the surveillance. The results from all centres for the designated organisms and antibiotics were used to determine the overall susceptibility, but only those drug-pathogen combinations where the number tested was 30 or more were used for the regional centres' analyses.

The report highlights that overuse and inappropriate use of antibiotics are the main causes of antimicrobial resistance. “Continuous monitoring of antimicrobial susceptibility is critical to adapt empiric antibiotic therapy, optimize patient outcomes, and control the spread of resistance,” the report states. The dynamic nature of resistance patterns requires continuous monitoring and adaptation strategies to maintain the effectiveness of current antibiotics.

“Because the network collects data from tertiary care hospitals, the data presented in this report do not reflect the extent of AMR in the country's population and should not be extrapolated to the community context,” the report said.

This report also includes the interpretation of antibiograms from outpatient clinics, hospital wards and intensive care units, which are critical for assessing the impact of AMR and understanding its implications for clinical practice and empirical use of antibiotics. This also helps to identify potential areas for intervention in antibiotic stewardship.