Rising resistance to antibiotics rings alarm bells

Sixty five year old Devesh Kumar was admitted to Intensive care Unit of a private-run hospital after he suffered from a massive heart attack. He was but only recovering from one trap when he uncannily fell into another. In the ICU, he was suspected of catching an infection that caused him to develop pneumonia. His bacterial infection would not respond to antibiotics. Kumar died within a few days. Few are aware that the very hospital you may be admitted in can ring a death knell. "Such antibiotic-resistant infections may reside in indwelling catheters inserted in patient's body, where they reside or may enter through surgical wounds," said Dr S Venkatesh, director, National Centre for Disease Control (NCDC), New Delhi.

Since the past year, NCDC has started Antibiotic and Anti-Microbial Resistance (AMR) Surveillance in ten medical colleges across India for four bacterial infections - Klebsiella, Escherichia coli, Staphylococcus aureus, and Enterococcus species.

These bacteria hit multiple organs in the body like genital areas, spinal cord, brain, liver, oral cavity amongst others and commonly cause infections like pneumonia or non-healing of wounds in patients. "Of all samples - blood, urine being assessed at government-labs, upto 30% of samples which have these infections are not responding to antibiotics like fluoroquinolones, third generation cephalosporins and carbapenems,"said Dr Rajesh Bhatia, Former Director, Communicable Diseases, World Health Organization, South-East Asia Region Office.

"Of thirty possible drugs that could be used to cure a patient earlier, barely three to four work these days," said Dr Om Shrivastava, Infectious Disease Consultant in Mumbai.

Patients with such infections simply do not respond to any antibiotics. "Of close to 15-20 patients that I may see in a week, upto two succumb for want of a cure," said another doctor from a private hospital who did not wish to be quoted. Globally, it is estimated that seven lakh persons die annually after developing antibiotic resistance.

"While in 2008, 29% of all patients who had contracted Staphylococcus Aureus, which is a common cause of skin infections causing pus, food poisoning or sinus that affects the respiratory tract, were resistant to Methicillin, in 2015 the number of patients who are antibiotic resistant had risen to 47%," said Dr Sudip Gupta, additional director, NCDC. "One reason is also indiscriminate use of antibiotics in animals. In various studies high levels of antibiotics have been derived from chicken and honey."

Union Health Ministry will submit a National Action Plan to curb AMR on the global forum by May 2017. "The magnitude of problem that we are facing at the moment is immense. We will be much worse affected in India than ever before if we do not rise up to the occasion," said Lav Agarwal, joint secretary, Ministry of Health.

Case Study

In 2013, a 33-year-old Vaishali Sawant from Mumbai who had undergone a C-section at state government-run Cama and Albless Hospital, contracted Methicillin-resistant Staphylococcus Aureus (MRSA), an infection which would not respond to most antibiotics. She was nauseous, vomited, oozed pus from her surgical wound. It was realized later that doctors had forgotten to remove a catheter, inserted in her spinal cord. She underwent five surgeries in all in a bid to salvage her situation. Experts said that the catheter which was accidentally left behind in her spinal cord may have been the reason of it all. Miraculously, the patient recovered from the trauma of MRSA, but not before having suffered from long due to the near-deadly infection.