MUMBAI : The majority of the country’s sickest patients may no longer benefit from carbapenem, an antibiotic that effectively treated pneumonia and septicemia until a decade back, according to the latest Indian Council of Medical Research (ICMR) study on antimicrobial resistance.
The study, released on Friday, found that abuse of antimicrobials — be they antibiotics, antivirals or antifungals — had led to widespread resistance to these drugs in the community. ICMR gathered data from 21 tertiary-level hospitals across the country, including BMC-run LTMG Hospital in Sion and Hinduja Hospital in Mahim, between January 1 and December 31, 2022.
Around 1 lakh culture isolates from ICU patients were studied to analyse hospital-acquired infections, finding 1,747 pathogens, bacterium E Coli being the most common culprit followed by another bacterium Klebsiella pneumoniae.
The report said that if eight out of 10 patients with a drug-resistant E-coli infection responded to carbapenem in 2017, only six responded in 2022. It’s worse with infections caused by drug-resistant avatars of bacterium Klebsiella pneumoniae: as against six out of 10 finding the medicine helpful, only four could be helped by it in 2022.
“Even if the new antibiotics for E-coli developed in the West come to India right now, they may not work against a few drug-resistant Indian E-coli strains,” said senior ICM scientist Dr Kamini Walia, one of the main authors of the study.
She, though, said the 2022 report had some heartening findings amidst widespread antimicrobial resistance in India. “We are happy to say that resistance patterns of major super bugs haven’t changed over the last five to six years, but the unfortunate part is that we are not seeing any declining trends.”
Secondly, the scientists found a molecular mechanism of resistance in all superbugs. “We found that NDM (New Delhi metallo-beta-lactamase) is frequently seen in isolates of multi-drug-resistant pseudomonas. This is a unique phenomenon seen only in India and it can help antibiotic developers tailor new drugs for Indian needs,” added Dr Walia.
Doctors also believe that indiscriminate use and prescription of broad-spectrum antibiotics is the worst culprit. “Even the commonly used drugs for diarrhoea such as norflox or oflox are not as widely effective,” said Dr Walia. “In fact, if we were to introduce a new drug, and use it the same way that used carbapenem, it will soon lose its potency.”
In the West, a resistance level between 10% and 20% is considered to be alarming, but in India doctors would prescribe the medicine even if there are reports of 60% resistance levels. “Antibiotic prescription should be taken more seriously by doctors and should only be given to patients only if needed,” she said.
