Drug-resistant organisms causing spike in infectious diseases

New Delhi: Multi-Drug Resistant organisms that cause deadly infections are spreading resulting in community-acquired infections, reveals a new study by city’s Sir Ganga Ram Hospital (SRGH).
The new findings are worrying because the organisms are resistant to latest generations of antibiotics, leading to high mortality.
The hospital analysed 201 patients with community-acquired infections for the study. It found their infections carry “classically hospital strains” which were drug resistant with high mortality.
Researchers said that these patients did not come in contact with any health facility in the last three months or more.
The study ‘Association of high mortality with extended-spectrum-lactamase (ESBL) positive cultures in community acquired infections’, was conducted by Department of Critical Care of SRGH.
ESBLs are organisms resistant to various newer generation antibiotics and can be easily transferred in the community, the study said.
These resistant infections pose therapeutic challenges to doctors during treatment and may therefore be associated with high morbidity and mortality.
“The distinction between community-acquired and hospital-acquired infections is becoming increasingly blurred,” said Sumit Ray, author of the study and vice-chairman of critical care at SRGH.
“The main reasons for this are the spread of classically ‘hospital’ strains, particularly resistant Klebseilla and E. Coli, into the community and vice versa, and repeated admissions of individuals to hospitals with long standing underlying diseases.”
He said in addition, the contribution of antibiotic resistance due to easy availability of antibiotics, often used without medical supervision, has resulted in the increasing reservoir of potential infections.
“The resistance to high-end antibiotics by organisms contracted by patients in the community resulting in high mortality, seen in our study, is a cause for worry and needs further research and proper action plan,” Ray said.
According to the researchers, the striking point noted in the results is the emergence of E.coli as most common bacteria in the community causing bacteraemia, respiratory and urinary tract infection.
They are also causing higher mortality in ESBL positive producers as compared to ESBL negative producers.
“A high percentage (63.44 per cent) of these E.coli was ESBL producers. This reflects the increased resistance pattern to high end antibiotics in hospital acquired infections due to inadvertent early use of third generation cephalosporins in the last decade, which is further trickling over into the community, because of plasmid-mediated transfer of its genetic materials during conjugation,” the study added.