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One-third of India’s Sepsis Deaths Linked to AMR: Study

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One-third of India’s Sepsis Deaths Linked to AMR: Study

Context:

A recent study published in The Lancet has raised alarms about the overuse and misuse of antibiotics in India, revealing a significant public health crisis

 

More on News:

  • The study highlights that nearly one-third of the 30 lakh sepsis deaths in India in 2019 were linked to antimicrobial resistance (AMR).
  • Sepsis arises when the immune system has a dangerous reaction to a bacterial infection, potentially leading to organ failure if not treated promptly.
  • AMR occurs when bacteria and parasites become resistant to medicines that previously were effective.

 

Case Study

  • A 60-year-old leukaemia patient admitted to the emergency department with a high fever and low blood pressure was promptly started on broad-spectrum antibiotics.
  • Despite the initial treatment, his condition worsened due to a drug-resistant Klebsiella infection. A blood culture revealed this resistance, necessitating a combination of drugs to control the infection.

 

Key Highlights:

  • The study revealed that 60% of the 2.99 million sepsis deaths in 2019 were due to bacterial infections
  • Of these, approximately 1.04 million deaths (33.4%) were linked to antibiotic-resistant bacteria, with 290,000 deaths directly attributable to antimicrobial resistance (AMR).
  • The Lancet report also warns of the global implications of AMR, predicting that more than 39 million people worldwide could die from antibiotic-resistant infections over the next 25 years
  • This forecast is based on a new study by the Global Research on Antimicrobial Resistance (GRAM) Project, which provides a comprehensive global analysis of AMR trends.
  • The study analyses data from 22 pathogens, 84 pathogen-drug combinations, and 11 infectious syndromes (including meningitis and bloodstream infections) across 204 countries and territories, including India.

 

The most common drug-resistant pathogens are:

  • E. coli: Causes gut infections.
  • Klebsiella pneumoniae: Causes pneumonia and urinary tract infections.
  • Acinetobacter baumannii: Associated with hospital-acquired infections.
  • Understanding trends in AMR deaths and predicting future shifts is crucial for developing strategies to mitigate the impact of AMR and save lives.

 

Factors Contributing to AMR:

  • Overuse and Misuse: Indiscriminate antibiotic use, including self-medication and non-compliance with prescribed doses, contributes to resistance.
  • Diagnostic Limitations: Lack of local diagnostic facilities leads to the use of broad-spectrum antibiotics that may not target specific bacteria.
  • Sanitation Issues: Poor sanitation spreads infections, increasing the demand for antibiotics and contributing to resistance.
  • Aquaculture: Antibiotics used in aquaculture can enter the human food chain.

 

Recommendations and Actions:

  • Infection Control Framework: Establish a robust and enforceable framework for infection control and mandatory public reporting of healthcare-associated infections (HAIs).
  • Investments: Invest in new antibiotics and rapid point-of-care diagnostics to combat sepsis and other severe infections.
  • Government Initiatives: The Indian government is working on improving laboratory infrastructure, including mandatory culture facilities in district hospitals.
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