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Data shows drug resistance for hospital infections

Dec 03 2012, 10:00 IST
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SummaryAn evaluation of data recorded over a 10-year period by AIIMS shows rising resistance towards antibiotics used to treat infections acquired in hospitals

An evaluation of data recorded over a 10-year period by AIIMS shows rising resistance towards antibiotics used to treat infections acquired in hospitals. In case of high-end antibiotics, the resistance among patients admitted in the ICU and wards of AIIMS rose by over 60 per cent.

Patients in ICUs, particularly those on ventilators who already have compromised immunity, are prone to infections from organisms present in the hospital.

In ventilator associated pneumonia (VAP) cases, carbapenem antibiotics like Meropenem and others like Ciprofloxacin were effective in 80 per cent and 60 per cent of the cases respectively between 2001 and 2003. This dropped to 19 per cent and 0 per cent between 2007 and 2009. While 25 per cent of the patients responded to Amikacin in 2001-03, this had dropped to 9 per cent in 2009.

“These were commonly used antibiotics and regarded as standard treatment options for hospital-acquired infections. Our data clearly shows that these have progressively become ineffective,” Dr Randeep Guleria, professor of medicine who heads the Pulmonary Medicine Department at AIIMS, said.

Calling the pattern of infections acquired in hospitals “worrying”, he added: “Not only are we seeing growing susceptibility to pathogens, but the nature of pathogens in our ICUs is changing. We are seeing more of gram-negative pathogens that are more potent.”

During 2011-2012, common antibiotic responsiveness in the case of gram-negative pathogens like Acinetobacter, Pseudomonas and Klebsiella dropped to below 10 per cent on an average — many patients showed zero sensitivity to the drugs.

In the medicine wards, Meropenem responsiveness to Acinetobacter, a gram-negative bacteria which was the most common bug responsible for pneumonia (54.9 per cent patients), was only 4.72 per cent. In case of Pseudomonas, Ciprofloxacin was effective only in 7.9 per cent of the cases.

Among ICU patients who contracted infections from Acinetobacter, sensitivity to Meropenem was lower at 3.45 per cent. For Imipenem, another carbapenem antibiotic, sensitivity was 3.77 per cent for Acinetobacter.

In the case of Pseudomonas aeruginosa, the common bacteria behind pneumonia among ICU patients, the maximum response was to a combination of high-end antibiotics like Piperacillin-Tazobactam (76 per cent) followed by Cefoperazone-Sulbactam (71 per cent) during 2007-09. For Acinetobacter and Pseudomonas, 100 per cent sensitivity was seen in a combination of Colistin-Tigecycline antibiotics.

“These combinations are now the only treatment option for drug-resistant pneumonia. Consistent use of these antibiotics over a period of time may lead to resistance patterns even for these drugs. This is

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