UTIs, blood stream infections, typhoid and pneumonia show resistance to commonly used antibiotics: ICMR report

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Drug-resistant and difficult to treat urinary tract infections (UTIs), blood stream infections, pneumonia, and typhoid are among the diseases that are showing resistance to commonly used antibiotics, according to a report published recently by the Indian Council of Medical Research (ICMR)‘s Antimicrobial Resistance Surveillance Network (AMRSN).

The data collected by the network provides trends and patterns of antimicrobial resistance (AMR) in six key pathogenic groups in the country, along with insights on key mechanisms of resistance prevalent in different pathogenic groups using genomics and whole genome sequencing. This is the seventh detailed report from 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 isolated pathogens from the most clinically relevant samples, including blood, urine, and respiratory tract samples.

In outpatient departments, the Escherichia coli bacillus was most 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 in-patients or in wards, again Escherichia coli bacillus was the most isolated (22.75%), followed by Klebsiella pneumoniae (16.21%) and A. baumannii (11.87%).

In intensive care units (ICUs), A. baumannii bacillus was most isolated (23.74%), followed by Klebsiella pneumoniae (20.88%) and E. coli (13.11%).

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

The report highlights that antibiotic overuse and misuse are the biggest drivers of AMR. “Continuous surveillance of antimicrobial susceptibilities is crucial for tailoring empiric antibiotic therapy, optimizing patient outcomes, and controlling the spread of resistance,” the report said, adding that the dynamic nature of resistance patterns requires ongoing monitoring and adaptive strategies to maintain the efficacy of current antibiotics.

“Since the network collects data from tertiary care hospitals, the data presented in this report is not reflective of the community levels of AMR in the country and should not be extrapolated to community settings,’’ the report says.

This report also includes the interpretation of antibiograms from outpatient departments, wards and intensive care units, which is crucial for assessing the impact of AMR and understanding its implications in clinical practice for the empirical use of antibiotics. This further helps identify potential areas for interventions in antimicrobial stewardship practices.