New Delhi – An alarming new international study published in The Lancet’s eClinicalMedicine has sounded a loud warning over soaring antimicrobial resistance (AMR) in India, placing the country at the center of what experts describe as a rapidly escalating superbug crisis. The research found that an overwhelming majority of Indian patients carried multidrug-resistant organisms (MDROs) or superbugs a prevalence rate that is the highest globally.
The study titled ‘Preprocedural screening for multidrug-resistant organisms in endoscopic retrograde cholangiopancreatography…’, screened over 1,200 patients across four countries India, Italy, the Netherlands, and the United States to assess MDRO carriage before a common endoscopic procedure.
Alarmingly High Resistance Levels
The findings revealed an unprecedented level of resistance in the Indian population:
• Overall MDRO Carriage: An astonishing 83.1% of Indian patients carried at least one superbug. This rate dwarfed that of other nations in the study: Italy (31.5%), the United States (20.1%), and the Netherlands (10.8%).
• Resistance to Common Drugs: 70.2% of Indian patients carried ESBL-producing bacteria, which inactivates many common antibiotics, rendering them ineffective.
• Resistance to Last-Resort Drugs: A highly concerning 23.5% carried carbapenem-resistant bacteria, which is resistant even to carbapenems, the antibiotics typically reserved as the last line of defense. By contrast, carbapenem-resistant organisms were nearly absent in the Netherlands and rare in the US.
Researchers concluded that these exceptional levels reflect systemic issues, including widespread antibiotic misuse, over-the-counter sales without prescriptions, and inconsistent infection-control systems that allow superbugs to spread far beyond hospital walls into the community.
Call for Localized and Urgent Action
While certain patient risk factors like chronic lung disease, congestive heart failure, and recent penicillin use were associated with higher MDRO prevalence, researchers stressed these could not account for India’s drastically disproportionate rates, pointing to a deeper, national emergency.
Given the stark regional differences, the study authors are urging countries to adopt localized infection-control strategies. For India, urgent measures recommended include:
• Responsible Antibiotic Stewardship: Implementing policies to ensure antibiotics are prescribed and used more carefully and responsibly.
• Regulation: Tighter control and regulation over the sales of prescription-only drugs.
• Screening: Introducing routine preprocedural screening for MDROs, particularly before invasive procedures.
• Infection Control: Considering the use of single-use devices for high-risk patients to minimize transmission.
Public health experts caution that without robust and immediate intervention, the superbug crisis will undermine decades of medical progress, making routine surgeries, cancer treatments, and infection management a potentially life-threatening gamble.