In a year, threefold rise in superbugs in Gujarat

Ahmedabad

: Human ammunition against microbes is getting weaker. In Gujarat, average 18 cases of microbes were recorded daily in 2023 which were antimicrobial resistant (AMR) - totalling 6,451 till December 14. It meant that there were very few antibiotics which could be used to treat such infections.

The number is worrisome as 2022 had recorded 2,261 such microorganisms, indicating a threefold rise in a year. More importantly, out of total AMRs found in 2023, 11 per cent were pan-drug resistant (PDR) or were immune to all available antibiotics today. The number was 5 per cent in 2022.

The data by the Gujarat Biotechnology Research Centre (GBRC) and Gujarat State Biotechnology Mission (GSBTM) also indicated that 66 per cent or twothirds of microorganisms were extreme drug resistant (XDR), and 10 per cent were multi-drug resistant (MDR).

Researchers said the surge in numbers should also be seen as a result of improved reporting from various state-based facilities as more number of samples were flagged as potential AMR and were sent for further analysis.

Researchers said that analysis of the origin for 2023 indicated that 60 per cent of such AMR microorganisms was reported from healthcare, whereas 22 per cent of them were from veterinary and fisheries sectors, and 18 per cent from the environment. "The share of healthcare as the origin of AMR has increased from 44 per cent in 2022. Three of the most common organisms reporting AMR included E. Coli, Klebsiella and Acinetobacter," said a researcher.

Dr Urvesh Shah, professor and head of microbiology department at GCS Medical College, said that two key factors responsible for development of AMR worldwide include overuse or injudicious use of antibiotics, and cross-infection.

"Over-the-counter (OTC) medication is a major reason - medicines such as azithromycin are popped even for colds. It should be discouraged. Another issue is cross-infection or sharing of bugs. It can be achieved by proper hand hygiene and other hygienic practices especially in places where there are high chances of infection," said Dr Shah, adding that some of the states in India have already put in place a policy to reduce AMR prevalence with SOPs.

City-based infectious diseases specialists said that out of the total patients in ICUs, about onethird are told by the treating doctors that the infection they are battling can be healed by a handful of medicines and they should be judicious in their medicinal intake.

Antibiotic resistance levels high in E coli, Klebsiella
Gujarat-based data on antimicrobial resistance (AMR) indicated that the top organisms included E coli, Klebsiella, Psuedomonas and Acinetobacter. The data by Gujarat Biotechnology Research Centre (GBRC) and Gujarat State Biotechnology Mission (GSBTM) indicated that AMR presence was found in samples of blood, urine and wastewater among others.

In 2023 till December 14, 23.5 per cent of the AMR samples was E coli and 13.5 per cent was Klebsiella, together accounting for 37 per cent or more than one-third of the total AMR samples in the state. Researchers said institutions in the state have identified higher numbers of AMR this year compared to 2022.

November 18 to 24 was observed as AMR Awareness Week. One of the talks organised by Ahmedabad Medical Association (AMA) focused on the scope of AMR and ways to prevent it. At the seminar, Dr Atul Patel, a specialist on infectious diseases, mentioned that 42 per cent of antibiotic-related adverse events are related to gastrointestinal issues, followed by 24 per cent renal and 15 per cent haematologic (blood-related).

The experts attributed several of the long-term infections in patients to AMR organisms.

Dr Parth Patel, a critical care specialist with Civil Hospital in Ahmedabad, who is also a trained AMR steward, said, "The stewardship is primarily about when to write antibiotics, in what dose, for what kind of infections, identifying the necessary dosage and the pattern of use. Such approach can reduce the resistance rate among the microbes," he said.

Dr Urvesh Shah, professor and head of the microbiology department at GCS Hospital, said, "We must understand that AMR organisms are making the treatment longer and difficult for patients."