Antibiotic resistance is escalating across India, including Hyderabad, according to the 2023 ICMR Antimicrobial Resistance (AMR) Surveillance Network report. The data highlights growing resistance among common pathogens like E. coli and Klebsiella pneumoniae, which cause infections such as UTIs, pneumonia, and diarrhea. Resistance to widely used antibiotics like piperacillin-tazobactam, carbapenems, and fluoroquinolones has increased significantly. The report reveals that 80% of Klebsiella pneumoniae and 91% of Acinetobacter baumannii, both hospital-acquired infection agents, are now resistant to imipenem. This trend raises alarm over the declining efficacy of antibiotics, exacerbating treatment challenges.
Antibiotic resistance is rapidly becoming a significant public health crisis across India, including major cities like Hyderabad. The latest data from the Indian Council of Medical Research’s (ICMR) 2023 Antimicrobial Resistance Research and Surveillance Network report, covering the period between January and December 2023, reveals a troubling rise in the ineffectiveness of the most commonly prescribed antibiotics. This growing resistance is making it increasingly difficult to treat common infections, including urinary tract infections (UTIs), pneumonia, typhoid, and blood and lung infections caused by bacteria like E. coli and Klebsiella pneumoniae.
One of the most concerning aspects of the report is the resistance of E. coli, a pathogen responsible for a wide range of ailments, including foodborne illnesses, urinary tract infections, dysentery, and diarrhea. The report highlights that E. coli is showing increased resistance to several antibiotics that were once effective. This is largely attributed to the overuse and misuse of antibiotics, including both rampant prescription practices and self-medication by the general public. The overuse of antibiotics has allowed bacteria to evolve, rendering them less susceptible to treatments. For instance, susceptibility to the antibiotic piperacillin-tazobactam has dropped significantly, from 56.8% in 2017 to just 42% in 2023, indicating that the bacteria is no longer responding well to this treatment.
Klebsiella pneumoniae, another common bacterial pathogen, is also becoming increasingly resistant. This bacterium is a frequent cause of UTIs and hospital-acquired infections, and the decline in its susceptibility to key antibiotics is alarming. Over the last seven years, resistance rates for Klebsiella pneumoniae have surged, particularly to piperacillin-tazobactam, which saw a drop in effectiveness from 42.6% to 26.5%. Carbapenems, considered a last resort for many bacterial infections, have also become less effective, with imipenem resistance rising from 58.5% to 35.6%, and meropenem from 48% to 37.6%. Fluoroquinolones, such as ciprofloxacin, have seen their effectiveness fall from 32% to just 17.1%, further narrowing the treatment options for this stubborn infection.
The growing resistance problem is not confined to just a few pathogens. Broad-spectrum antibiotics, which were once the cornerstone of infection control, are increasingly becoming ineffective. The report highlighted significant increases in resistance to ciprofloxacin, which jumped from 26% in 2017 to 38.5% in 2023, and levofloxacin, which increased from 31.3% to 34.5%. These antibiotics were once highly effective across a range of bacterial infections but are now facing diminishing returns due to bacterial evolution and adaptation.
Perhaps most concerning is the resistance of hospital-acquired infections, which are notoriously difficult to treat due to the weakened immune systems of hospitalized patients. Pathogens like Acinetobacter baumannii and Klebsiella pneumoniae, which frequently cause blood and lung infections, have developed extensive resistance to antibiotics commonly used in hospitals. According to the ICMR report, 91% of Acinetobacter baumannii and 80% of Klebsiella pneumoniae infections are now resistant to imipenem, one of the most powerful antibiotics used in critical care settings.
Another critical finding from the report is the growing resistance of Staphylococcus aureus and Enterococcus faecium, both of which are major causes of hospital-acquired infections. The data showed that 63% of Staphylococcus aureus infections were resistant to oxacillin, while 42.7% of Enterococcus faecium infections were resistant to vancomycin, which is often the last line of defense against these pathogens.
Doctors and healthcare experts are sounding the alarm on the worsening problem of antimicrobial resistance (AMR). With bacteria continuing to evolve and adapt, they are becoming less susceptible to existing antibiotics, making treatment of common infections more challenging and time-consuming. This could eventually lead to a future where many once-treatable infections become untreatable, leading to a significant rise in morbidity and mortality rates.
The ICMR report underscores the urgent need for concerted action to combat AMR. This includes more prudent prescription practices by healthcare professionals, public education on the dangers of antibiotic misuse, and stronger regulations to curb the over-the-counter sale of antibiotics. Additionally, the development of new antibiotics and alternative treatments must be prioritized to stay ahead of evolving bacterial strains. Without immediate and sustained efforts, the world could face a scenario where even minor infections become deadly due to a lack of effective treatments.
In conclusion, the growing resistance of bacteria to commonly used antibiotics is a grave concern for public health in India and across the globe. The latest data from the ICMR highlights a significant rise in resistance, particularly in bacteria like E. coli, Klebsiella pneumoniae, and Acinetobacter baumannii. This trend is largely fueled by the overuse and misuse of antibiotics, both in clinical settings and through self-medication. If left unchecked, antimicrobial resistance could lead to a future where routine infections become life-threatening, placing an enormous burden on healthcare systems and potentially reversing decades of medical progress.
