The Mortality Burden of Multidrug-resistant Pathogens in India: A Retrospective, Observational Study
Sumanth Gandra1, Katie K Tseng1, Anita Arora2
1Center for Disease Dynamics, Economics & Policy, Washington, DC.
Summary
Multidrug-resistant (MDR) bacterial infections significantly increase patient mortality in low- and middle-income countries (LMICs). This study highlights the urgent need to understand and address the growing threat of antibiotic resistance in these regions.
Area of Science:
- Global Health
- Infectious Diseases
- Microbiology
Background:
- Antibiotic resistance is a growing global health concern, particularly in low- and middle-income countries (LMICs) with increasing antibiotic use.
- There is a significant lack of data on the burden of multidrug-resistant (MDR) pathogens in LMICs.
Purpose of the Study:
- To investigate the association between MDR pathogens and patient mortality in India, a representative LMIC.
- To establish a baseline for antibiotic resistance burden and outcomes in LMICs.
Main Methods:
- A retrospective study analyzing 5103 antimicrobial susceptibility test (AST) results from 10 hospitals in India.
- Examined patient-level data for specific bacterial species including E. coli, K. pneumoniae, A. baumannii, and S. aureus.
Main Results:
- The overall patient mortality rate was 13.1% (581 deaths).
- MDR and extensively drug-resistant (XDR) infections with E. coli, K. pneumoniae, and A. baumannii were associated with a 2-3 fold increase in mortality.
- Mortality from methicillin-resistant S. aureus (MRSA) was significantly higher when resistant to aminoglycosides.
Conclusions:
- MDR bacterial infections represent a substantial risk to patients in LMICs.
- Findings underscore the critical need for more research into antibiotic resistance burden and transmission in LMICs.
- Observed resistance patterns and mortality outcomes differ from high-income countries, necessitating tailored strategies.
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