India is facing a growing crisis as common infections become increasingly difficult to treat due to widespread antibiotic resistance. The Indian Council of Medical Research (ICMR) has released its annual report from 2024, titled 'Antimicrobial Resistance Research & Surveillance Network (AMRSN)', which reveals that some of the most common infections, including urinary tract infections, pneumonia, sepsis, and diarrheal illnesses, are becoming increasingly harder to treat as widely used antibiotics continue to fail at alarming rates.
The ICMR's report, which analyzed nearly one lakh lab-confirmed infection samples from leading hospitals, indicates that drug-resistant Gram-negative bacteria continue to dominate. E. coli, a common cause of UTIs, abdominal infections, and bloodstream infections, is showing declining susceptibility to strong antibiotics. Klebsiella pneumoniae, a major cause of pneumonia and sepsis, is resistant to piperacillin-tazobactam in almost three-fourths of cases and to carbapenems in most samples, significantly limiting treatment options. In intensive care units (ICUs), the situation is even more critical, with Acinetobacter baumannii showing 91% resistance to meropenem, compelling doctors to use more toxic or complicated drug combinations. Pseudomonas aeruginosa also continues to show rising resistance. Overall, 72% of bloodstream infections were caused by drug-resistant Gram-negative bacteria, while ventilator-associated pneumonia was largely driven by acinetobacter, klebsiella, and pseudomonas, against which many commonly prescribed high-end antibiotics are ineffective.
Diarrheal pathogens are exhibiting high resistance to fluoroquinolones and cephalosporins, and over 95% of Salmonella typhi samples are resistant to fluoroquinolones. Among fungi, Candida auris showed resistance in nearly 10% of isolates, while one-third of aspergillus samples were resistant to amphotericin B.
These findings highlight a dangerous shift, as noted by Dr. Rommel Tickoo, Director of Internal Medicine at Max Hospital, Saket. Experts caution that without aggressive stewardship and rational prescribing, even common infections may soon become untreatable.
ICMR recommends restricting the sale of newly-launched antibiotics to certain hospital pharmacies to prevent misuse and abuse of antibiotics amidst rising resistance to critical treatments. ICMR's suggestions have been submitted to the Union Health Ministry and the Drug Controller General of India after consultations with researchers. Researchers have linked the introduction of new antimicrobials to rapidly developing resistance, emphasizing the need for cautious and controlled usage.
A study conducted by researchers from ICMR, Cambridge University, and Christian Medical College (CMC), Vellore, highlights hospitals as key breeding grounds for highly antibiotic-resistant strains of bacteria capable of causing severe illness. The study found that bacteria from hospital waste and clinical sources carried more antibiotic-resistance genes compared to those from animals like livestock. These hospital strains were also more likely to be extensively drug-resistant (XDR) and had a greater ability to cause severe infections. The study revealed minimal overlap between bacterial strains from human-related and non-clinical settings, suggesting that dangerous strains of Klebsiella pneumoniae primarily emerge within hospitals. Klebsiella pneumoniae is a particularly difficult-to-treat strain of bacteria, resistant to carbapenems, and classified as a critical priority pathogen by the World Health Organization (WHO).
