Anti-microbial resistance

Q Why is it in News ?

A Ever since the pandemic struck, concerns have been raised about the improper use of antimicrobials amongst Covid-19 patients.

Q Why is there concern over anti-microbial resistance ?

A 

• The “Global burden of bacterial antimicrobial resistance in 204 countries and territories in 2019 (GRAM)” report, released last month, 4.95 million people died from drug-resistant bacterial infections in 2019, with 3,89,000 deaths in South Asia alone.
• AMR directly caused at least 1.27 million of those deaths.
• Lower respiratory infections accounted for more than 1.5 million deaths associated with resistance in 2019, making it the most burdensome infectious syndrome.
• Amongst pathogens, E coli was responsible for the most deaths in 2019, followed by K pneumoniae, S aureus, A baumannii, S pneumoniae, and M tuberculosis.

Q What is concern for India ?

A 

• As per the yearly trends reported by the Indian Council of Medical Research since 2015, India reports a high level of resistance in all these pathogens, especially E coli and K pneumoniae.
• Only a fraction of the Indian data, available through the WHO-GLASS portal, has been included in the GRAM report.
• India has been reporting high levels of resistance to fluoroquinolones, cephalosporins and carbapenems across the Gram-negative pathogens that cause almost 70 per cent of infections in communities and hospitals.
• Therefore, the Indian data on the AMR burden may not look very different from the estimates published in the report.
• Now that we know that AMR’s burden surpasses that of TB and HIV, a sense of urgency in containing such resistance is called for.
• With no new drugs in the pipeline for drug-resistant infections, time is running out for patients.

Q What can be the way forward ?

A Addressing AMR through a multipronged and multisectoral approach

• Use existing antimicrobials judiciously: The urgency to develop new drugs should not discourage us from instituting measures to use the existing antimicrobials judiciously.
• Improved infection control in communities and hospitals, availability and utilisation of quality diagnostics and laboratories and educating people about antimicrobials have proved effective in reducing antimicrobial pressure — a precursor to resistance.
• The National Action Plan for AMR, approved in 2017, completes its official duration this year. The progress under the plan has been far from satisfactory.
• There is enough evidence that interventions like infection control, improved diagnosis and antimicrobial stewardship are effective in the containment of AMR.
• The GRAM report has underlined that postponing action could prove costly.