Drug resistant infections associated with higher in-hospital mortality rates in India

November 16, 2018, Center for Disease Dynamics, Economics & Policy

In one of the largest studies to measure the burden of antibiotic resistance in a low- or middle-income country, researchers at the Center for Disease Dynamics, Economics & Policy report that in-hospital mortality is significantly higher among patients infected with multi-drug resistant (MDR) or extensively drug resistant (XDR) pathogens including Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii.

Researchers analyzed antimicrobial susceptibility testing results and mortality outcomes for over 4,000 patients who visited one of ten tertiary or quaternary referral hospitals across India in 2015. Pathogens were classified as MDR or XDR based on drug susceptibility profiles proposed by the European and US Centers for Disease Control and Prevention. Mortality data was restricted to in-hospital deaths. Additional demographic and clinical data including age, sex, place of infection acquisition, and location in the hospital (i.e., intensive care unit [ICU] or non-intensive care unit) were also collected.

The overall mortality rate among all was 13.1 percent, with mortality as high as 29.0 percent among patients infected with A. baumannii. Patients who died were more likely to have been older and admitted to the ICU at the time of testing. Researchers also found that among MDR infections, those caused by Gram-negative bacteria were associated with higher mortality rates compared to those caused by Gram-positive bacteria, with rates of 17.7 percent and 10.8 percent, respectively.

Study results indicate that patients who acquired MDR bacterial infections were 1.57 times more likely to die, compared to patients with similar susceptible infections, while patients who acquired XDR infections were 2.65 times more likely to die when accounting for age, sex, site of , and the number of coinfections.

In both the ICU and non-ICU, odds of mortality were higher among patients with XDR infections; this association was driven by Gram-negative infections (e.g., XDR K. pneumoniae) highlighting the importance of rapidly identifying these infections among all .

In India, MDR and XDR Gram-negative bacterial infections are frequent, and the availability of effective antibiotic therapies are declining. This study provides greater insight into the urgent need to increase surveillance, research, and antimicrobial stewardship efforts worldwide. The further note that these findings on the mortality burden of antibiotic resistance can aid in the development of policy efforts to prioritize antibiotic resistance as a global public health threat and to inform future efforts to quantify and track the burden of resistance across low- and .

Explore further: Antibiotic-resistant bacteria now claiming 33,000 lives annually

More information: Sumanth Gandra et al, The mortality burden of multidrug-resistant pathogens in India: a retrospective observational study, Clinical Infectious Diseases (2018). DOI: 10.1093/cid/ciy955

Related Stories

Antibiotic-resistant bacteria now claiming 33,000 lives annually

November 7, 2018
An ECDC study estimates the burden of five types of infections caused by antibiotic-resistant bacteria of public health concern in the European Union and in the European Economic Area (EU/EEA). The burden of disease is measured ...

New test procedure accelerates the diagnosis of multi-resistant hospital pathogens

September 21, 2018
A team of researchers at the University of Cologne's Faculty of Medicine and the German Center for Infection Research (DZIF) has achieved a scientific breakthrough in the accelerated diagnosis of multi-resistant hospital ...

Gram-negative bacteria increase mortality, vasopressor use and ICU admission

October 4, 2018
Alterations to the respiratory microbiome have been identified as a predisposing factor of interstitial lung diseases (ILD). In a study at CHEST 2018, researchers at Beaumont Health Systems studied the influence of bacterial ...

Infectious diseases docs may be lifesaving for patients with antibiotic-resistant infections

March 21, 2018
For patients with difficult-to-treat, drug-resistant infections, seeing an infectious diseases specialist can be a lifesaver. Such patients experienced significantly lower mortality rates when treated by physicians specializing ...

Avoid piperacillin-tazobactam when treating BSI cause by ceftriaxone-resistant pathogens

April 22, 2018
The antibiotic combination treatment piperacillin-tazobactam was significantly less effective than meropenem when treating potentially fatal bloodstream infections (BSI) caused by ceftriaxone-resistant Escherichia coli and ...

Recommended for you

PET scans to optimize tuberculosis meningitis treatments and personalize care, study finds

December 6, 2018
Although relatively rare in the United States, and accounting for fewer than 5 percent of tuberculosis cases worldwide, TB of the brain—or tuberculosis meningitis (TBM)—is often deadly, always hard to treat, and a particular ...

Silicosis is on the rise, but is there a therapeutic target?

December 6, 2018
Researchers from the CNRS, the University of Orléans, and the company Artimmune, in collaboration with Turkish clinicians from Atatürk University, have identified a key mechanism of lung inflammation induced by silica exposure, ...

Infectivity of different HIV-1 strains may depend on which cell receptors they target

December 6, 2018
Distinct HIV-1 strains may differ in the nature of the CCR5 molecules to which they bind, affecting which cells they can infect and their ability to enter cells, according to a study published December 6 in the open-access ...

Protecting cell powerhouse paves way to better treatment of acute kidney injury

December 6, 2018
For the first time, scientists have described the body's natural mechanism for temporarily protecting the powerhouses of kidney cells when injury or disease means they aren't getting enough blood or oxygen.

New study uncovers why Rift Valley fever is catastrophic to developing fetuses

December 5, 2018
Like Zika, infection with Rift Valley fever virus can go unnoticed during pregnancy, all the while doing irreparable—often lethal—harm to the fetus. The results of a new study, led by researchers at the University of ...

Study highlights potential role of bioaerosol sampling to address airborne biological threats

December 5, 2018
As a leading global city with a high population density, Singapore is vulnerable to the introduction of biological threats. Initiating an early emergency response to such threats calls for the rapid identification of the ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.