Context
A year-long study of hospital-acquired infections (HAIs) across the country paints a bleak picture of superbugs (or drug-resistant microorganisms) triumphing over medications. Healthcare Associated Infection Surveillance-India, a newly formed organisation, conducted the survey.
Relevance
GS Paper 2: Health
Mains Question
The superbug crisis in India is a global public health issue. Discuss the factors that are causing the problem. (250 words)
AMR (antimicrobial resistance):
- Antimicrobials are medications used to prevent and treat infections in humans, animals, and plants. They include antibiotics, antivirals, antifungals, and antiparasitics.
- AMR occurs when bacteria, viruses, fungi, and parasites evolve over time and cease to respond to medications (drug resistance), making infections more difficult or impossible to treat and increasing the risk of disease spread, severe illness, and death.
- As a result, the World Health Organization recently designated AMR as a major public health threat.
- AMR organisms have been discovered in humans, animals, food, plants, and the environment (in water, soil and air).
- They can spread from person to person or between people and animals, including through animal-derived food.
The primary causes of AMR are:
- Antimicrobial misuse and overuse;
- Inadequate access to safe drinking water, sanitation, and hygiene (WASH) for both humans and animals;
- Inadequate infection and disease prevention and control in hospitals and farms;
- Limited access to high-quality, low-cost medicines, vaccines, and diagnostics;
- A lack of awareness and understanding; and
- A lack of legislative enforcement.
Why is AMR a worldwide concern?
- The emergence and spread of drug-resistant pathogens with new resistance mechanisms threatens the ability to treat common infections.
- The rapid global spread of multi- and pan-drug resistant bacteria, dubbed “superbugs,” is especially concerning.
- Superbugs cause infections that are resistant to antimicrobial medications such as antibiotics.
Project for Healthcare-Associated Infection Surveillance in India
- The Government of India launched the HAI Surveillance-India project, a cooperative agreement.
- The All-India Institute of Medical Sciences (AIIMS) in New Delhi worked with the US Centers for Disease Control and Prevention (CDC) and the Indian Council of Medical Research (ICMR) on this project.
- Increase national capacity for HAI surveillance in order to meet the demand for reliable AMR data.
- Leverage the ICMR-AMR network’s existing microbiology capacities and robust academic capabilities.
- Promote effective patient care by measuring, tracking, and reporting the magnitude and types of AMR and HAI threats affecting India.
Healthcare-Associated Infection Surveillance-India Results:
- Superbugs were prevalent in Indian hospitals, according to the findings of the first-ever year-long surveillance.
- The presence of superbugs indicates antibiotic resistance and the need for costly last-resort antibiotics (such as carbapenem and colistin).
- Intensive Care Units (ICUs) are breeding grounds for HAIs.
- Most doctors are aware that long-term ICU patients in India become infected with gram-negative microorganisms, which are more difficult to treat than gram-positive organisms found in western ICUs.
- The findings confirm the severity of these gram-negative infections, which were discovered to be common in Indian ICUs.
- Due to antibiotic resistance, Gram-negative bacteria are one of the world’s most serious public health issues.
- Additionally, 38.1% of patients with bloodstream infections and another 27.9% with UTIs died within 14 days, and the HAIs in these cases were possibly only associated complications that did not directly contribute to death.
Significance
- Most importantly, HAI monitoring serves as a standard for hospitals. If a hospital has a HAI rate of 4 per 1,000, it can be compared to other hospitals.
- The findings emphasise the significance of improving hospital infection control practises and instituting practises to reduce irrational antibiotic use.
- To prevent the emergence of newer superbugs, a hospital antibiotic use audit could be performed, revealing how many hospitals follow the rules.
