In one of the largest studies to measure the burden of antibiotic resistance in a low-income or middle-income country, researchers from the Center for Disease, Economics and Policy reported that hospital mortality was significantly higher in multidrug-resistant (MDR) or pathogenic patients, which are resistant to drugs (XDR), including golden staphylococci, Escherichia coli, Klebsiella pneumoniae in Acinetobacter baumannii.
The researchers analyzed the results of antimicrobial sensitivity testing and mortality results for more than 4,000 patients who visited one of the ten tertiary or quarterly reference hospitals in India in 2015. Pathogens have been classified as MDRs or XDRs based on drug response profiles proposed by the European and US Centers for Disease Control and Prevention. Mortality data were limited to death at the hospital. Additional demographic and clinical data, including age, gender, location of infection and location at the hospital (ie Intensive Care Unit [ICU] or non-intensive care units).
The total mortality rate of all participants in the study was 13.1 percent, and with a mortality rate of 29.0 percent in infected patients A. baumannii. Patients who died were more likely to be older at the time of testing and were admitted to the ICU. Researchers also found that those caused by gram-negative bacteria are associated with a higher mortality rate compared to those caused by gram-positive bacteria, with rates of 17.7 percent and 10.8 percent among MDR infections.
The results of the study show that patients who had acquired bacterial infections with MDR were 1.57 times more likely to die than compared to patients with similar susceptible infections, while patients receiving XDR infections were more likely to have died 2.65 times in age calculation, and number of coinfections.
In both ICU departments and outside the ICU, mortality rates among patients with XDR infection were greater; This link led to Gram-negative infections (eg XDR K. pneumoniae), which emphasize the importance of rapid identification of these infections among all patients.
In India, MDR and XDR Gram-negative bacterial infections are common and the availability of effective antibiotic therapies is decreasing. This study provides a greater insight into the urgent need to increase surveillance, research and antimicrobial efforts worldwide. In addition, researchers point out that these findings on the burden of antibiotic resistance may contribute to the development of policy efforts to determine antibiotic resistance as a global threat to public health and to inform about future efforts to quantify and monitor the burden of resistance to low and middle-level countries .