In another revelation that further endorses increasing trend of antibiotic resistance in the country, a new study published in the Indian Journal of Medical Research has disclosed that over the last 10 years antibiotic resistance increased from 40 per cent to 61 per cent in 2009.
According to the experts, extensive use of antibiotics has added to the escalation of antibiotic resistance. The study was undertaken to evaluate the association, if any, between antibiotic use and resistance in a hospital setting, and also detect the predominant mechanism of antibiotic resistance in Escherichia coli and Klebsiella pneumoniae over a period of 10 years.
In a retrospective study of 10 years, a total of 77,618 blood culture samples from 2000 to 2009 from indoor patients were screened and those yielding E. coli and K. pneumoniae were included in the study. Antibiotic susceptibility records as well as the percentage of ESBL producers were noted.
Experts found that ESBL producing E. coli increased from 40 per cent in 2002 to 61 per cent in 2009, similarly there was a significant (P<0.05) rise in resistance to most powerful antibiotics like cefotaxime (75 to 97 per cent), piperacillin-tazobactum (55- 84 per cent) and carbapenem (2.4-52 per cent) in K. pneumoniae. A significant (P<0.05) association was observed between resistance and consumption of carbapenem and piperacillin and tazobactum consumption in K. pneumonia.
“Our study demonstrated a rise in consumption and resistance to broad spectrum antimicrobial agents and also established an association between consumption and resistance to these antibiotics. Over a period of 10 years, the emergence of pan-resistance in K. pneumoniae could be due to the production of carbapenemases whereas ESBL production was the common mechanism of resistance in E. coli,” said the study.
While the experts have cited paucity of data on trends of antibiotic consumption from India, according to the available data, experts say that it is higher than other developing nations of the world.
The increase in antibiotic resistance, experts say, is due to several factors but the major cause appears to be excessive use of antibiotics. “Our study showed a significant association between increased use and resistance to carbapenems and piperacillin and tazobactum combination in K. pneumoniae isolates as has been shown earlier,” said the study.
The increasing trend in antibiotic resistance in India, experts say is not new.