13-year-long study finds resistance for last-resort antibiotics

A study has found a high level of antimicrobial resistance (AMR) against both primary and reserved antibiotics. The 13-year-old, and ongoing study conducted at BJ Medical College (BJMC) and Sassoon General Hospital (SGH) has found incidents of drug-resistant to colistin (polymyxin) and carbapenems (beta-lactams), the two last-resort antibiotics used against multi-drug and extensively-drug resistant pathogens apart from other reserved antibiotics, said officials.
BJMC is part of the National Centre for Disease Control’s (NCDC)-Ministry of Health and Family Welfare (MoHFW) National AMR surveillance programme. The programme was started at BJMC in 2013, making it the second centre in the country after Safdarjung Hospital, Delhi. Under the project, now as many as 40 premier healthcare institutes in India are part of the NCDC’s National AMR Surveillance Network. BJMC is also part of the Maharashtra surveillance of antimicrobial resistance programme “MAHASAR”, said officials.
Antimicrobial resistance is a threat to global health and development and contributes to millions of deaths worldwide each year and is considered a silent pandemic. AMR occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines. The misuse and overuse of antimicrobials in humans, animals and plants are the main drivers in developing drug-resistant pathogens, according to officials involved in the study.
Dr Rajesh Karyakarte, head, BJMC Microbiology Department, said, “The study has covered over one lakh antimicrobial susceptibility tests to find which primary or reserved antibiotic drugs are helpful for the treatment of patients. Such studies are significant in instituting rapid empirical antimicrobial treatment in patients with septicemia and other life-threatening infections.”
According to the study, pathogens like E. coli, Klebsiella, Pseudomonas, Acinetobacter, Salmonella, Staph aureus and Enterococcus amongst others were studied and their anti-microbial susceptibility test was done. Antimicrobial susceptibility testing (AST) is a test that determines which antibiotics or other antimicrobial drugs are effective against a specific bacteria or fungus. The NCDC study helps to prepare an antibiogram of such pathogens so that empirical treatment can be instituted by the treating doctors.
Dr Karyakarte said that during the study alert pathogens like Colistin Resistant GNB (Gram-negative bacilli), Linezolid Resistant GPC (Gram Positive Cocci), Vancomycin-Intermediate S. aureus (VISA) and Vancomycin-Resistant S. aureus (VRSA) and Ceftriaxone Resistant Salmonella were identified.
“These pathogens are considered alarming and if found in hospital settings need to be notified on priority. Details of the alert pathogens are notified to NCDC. The practice is followed regularly,” he said, adding that the details of the study will be released later.