Trends in antibiotic resistance among major bacterial pathogens isolated from blood cultures tested at a large private laboratory network in India, 2008–2014

Sumanth Gandra, Nestor Mojica, Eili Klein, Ashvin Ashok, Vidya Nerurkar, Mamta Kumari, Uma Ramesh, Sunanda Dey, Viral Vadwai, Bibhu R. Das, Ramanan Laxminarayan

Research output: Contribution to journalArticle

Abstract

Objective There have been no long-term studies on trends in antibiotic resistance (ABR) on a national scale in India. Using a private laboratory network, the ABR patterns of organisms most commonly associated with bacteremia, obtained from patients across India between 2008 and 2014, were examined. Methods A retrospective study of patient blood cultures collected over a 7-year period (January 1, 2008–December 31, 2014) was conducted. Data on the microorganism(s) identified and their antimicrobial susceptibility were obtained from SRL Diagnostics (Mumbai, India). Results Of 135 268 blood cultures, 18 695 (14%) had at least one identified pathogen. In addition to continual high rates of methicillin-resistant Staphylococcus aureus (MRSA; approximately 44.2%), high resistance to nalidixic acid among Salmonella Typhi (98%) was observed, and carbapenem resistance increased in both Escherichia coli (7.8% to 11.5%; p = 0.332) and Klebsiella pneumoniae (41.5% to 56.6%; p < 0.001). Carbapenem resistance was also stable and high for both Acinetobacter species (approximately 69.6%) and Pseudomonas aeruginosa (approximately 49%). Resistance was also detected to colistin in the Gram-negatives and to vancomycin and linezolid in S. aureus. Conclusion Increasing resistance to antibiotics of last-resort, particularly among Gram-negatives, suggests an urgent need for new antibiotics and improved antimicrobial stewardship programs in India.

Original languageEnglish (US)
Pages (from-to)75-82
Number of pages8
JournalInternational Journal of Infectious Diseases
Volume50
DOIs
StatePublished - Sep 1 2016

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Microbial Drug Resistance
India
Linezolid
Carbapenems
Methicillin-Resistant Staphylococcus aureus
Colistin
Nalidixic Acid
Salmonella typhi
Acinetobacter
Klebsiella pneumoniae
Vancomycin
Bacteremia
Pseudomonas aeruginosa
Staphylococcus aureus
Retrospective Studies
Escherichia coli
Anti-Bacterial Agents
Blood Culture

Keywords

  • Antibacterial agents
  • Antibiotic resistance
  • Blood culture isolates
  • India
  • Trends

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Trends in antibiotic resistance among major bacterial pathogens isolated from blood cultures tested at a large private laboratory network in India, 2008–2014. / Gandra, Sumanth; Mojica, Nestor; Klein, Eili; Ashok, Ashvin; Nerurkar, Vidya; Kumari, Mamta; Ramesh, Uma; Dey, Sunanda; Vadwai, Viral; Das, Bibhu R.; Laxminarayan, Ramanan.

In: International Journal of Infectious Diseases, Vol. 50, 01.09.2016, p. 75-82.

Research output: Contribution to journalArticle

Gandra, Sumanth ; Mojica, Nestor ; Klein, Eili ; Ashok, Ashvin ; Nerurkar, Vidya ; Kumari, Mamta ; Ramesh, Uma ; Dey, Sunanda ; Vadwai, Viral ; Das, Bibhu R. ; Laxminarayan, Ramanan. / Trends in antibiotic resistance among major bacterial pathogens isolated from blood cultures tested at a large private laboratory network in India, 2008–2014. In: International Journal of Infectious Diseases. 2016 ; Vol. 50. pp. 75-82.
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abstract = "Objective There have been no long-term studies on trends in antibiotic resistance (ABR) on a national scale in India. Using a private laboratory network, the ABR patterns of organisms most commonly associated with bacteremia, obtained from patients across India between 2008 and 2014, were examined. Methods A retrospective study of patient blood cultures collected over a 7-year period (January 1, 2008–December 31, 2014) was conducted. Data on the microorganism(s) identified and their antimicrobial susceptibility were obtained from SRL Diagnostics (Mumbai, India). Results Of 135 268 blood cultures, 18 695 (14{\%}) had at least one identified pathogen. In addition to continual high rates of methicillin-resistant Staphylococcus aureus (MRSA; approximately 44.2{\%}), high resistance to nalidixic acid among Salmonella Typhi (98{\%}) was observed, and carbapenem resistance increased in both Escherichia coli (7.8{\%} to 11.5{\%}; p = 0.332) and Klebsiella pneumoniae (41.5{\%} to 56.6{\%}; p < 0.001). Carbapenem resistance was also stable and high for both Acinetobacter species (approximately 69.6{\%}) and Pseudomonas aeruginosa (approximately 49{\%}). Resistance was also detected to colistin in the Gram-negatives and to vancomycin and linezolid in S. aureus. Conclusion Increasing resistance to antibiotics of last-resort, particularly among Gram-negatives, suggests an urgent need for new antibiotics and improved antimicrobial stewardship programs in India.",
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AU - Mojica, Nestor

AU - Klein, Eili

AU - Ashok, Ashvin

AU - Nerurkar, Vidya

AU - Kumari, Mamta

AU - Ramesh, Uma

AU - Dey, Sunanda

AU - Vadwai, Viral

AU - Das, Bibhu R.

AU - Laxminarayan, Ramanan

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N2 - Objective There have been no long-term studies on trends in antibiotic resistance (ABR) on a national scale in India. Using a private laboratory network, the ABR patterns of organisms most commonly associated with bacteremia, obtained from patients across India between 2008 and 2014, were examined. Methods A retrospective study of patient blood cultures collected over a 7-year period (January 1, 2008–December 31, 2014) was conducted. Data on the microorganism(s) identified and their antimicrobial susceptibility were obtained from SRL Diagnostics (Mumbai, India). Results Of 135 268 blood cultures, 18 695 (14%) had at least one identified pathogen. In addition to continual high rates of methicillin-resistant Staphylococcus aureus (MRSA; approximately 44.2%), high resistance to nalidixic acid among Salmonella Typhi (98%) was observed, and carbapenem resistance increased in both Escherichia coli (7.8% to 11.5%; p = 0.332) and Klebsiella pneumoniae (41.5% to 56.6%; p < 0.001). Carbapenem resistance was also stable and high for both Acinetobacter species (approximately 69.6%) and Pseudomonas aeruginosa (approximately 49%). Resistance was also detected to colistin in the Gram-negatives and to vancomycin and linezolid in S. aureus. Conclusion Increasing resistance to antibiotics of last-resort, particularly among Gram-negatives, suggests an urgent need for new antibiotics and improved antimicrobial stewardship programs in India.

AB - Objective There have been no long-term studies on trends in antibiotic resistance (ABR) on a national scale in India. Using a private laboratory network, the ABR patterns of organisms most commonly associated with bacteremia, obtained from patients across India between 2008 and 2014, were examined. Methods A retrospective study of patient blood cultures collected over a 7-year period (January 1, 2008–December 31, 2014) was conducted. Data on the microorganism(s) identified and their antimicrobial susceptibility were obtained from SRL Diagnostics (Mumbai, India). Results Of 135 268 blood cultures, 18 695 (14%) had at least one identified pathogen. In addition to continual high rates of methicillin-resistant Staphylococcus aureus (MRSA; approximately 44.2%), high resistance to nalidixic acid among Salmonella Typhi (98%) was observed, and carbapenem resistance increased in both Escherichia coli (7.8% to 11.5%; p = 0.332) and Klebsiella pneumoniae (41.5% to 56.6%; p < 0.001). Carbapenem resistance was also stable and high for both Acinetobacter species (approximately 69.6%) and Pseudomonas aeruginosa (approximately 49%). Resistance was also detected to colistin in the Gram-negatives and to vancomycin and linezolid in S. aureus. Conclusion Increasing resistance to antibiotics of last-resort, particularly among Gram-negatives, suggests an urgent need for new antibiotics and improved antimicrobial stewardship programs in India.

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