BACKGROUND Antimicrobial resistance(AMR)is an escalating global health threat,disproportionately impacting low-income and middle-income countries like India.The rise of multidrug-resistant organisms(MDROs)complicates ...BACKGROUND Antimicrobial resistance(AMR)is an escalating global health threat,disproportionately impacting low-income and middle-income countries like India.The rise of multidrug-resistant organisms(MDROs)complicates treatment,increases healthcare costs,and contributes to higher morbidity and mortality.In India,factors such as antibiotic misuse,over-the-counter availability,and self-medication have exacerbated this crisis.Despite the urgency,regional data on MDRO prevalence remains limited.AIM To assess the burden and distribution of MDRO infections identified at a tertiary healthcare institute in North India.METHODS This cross-sectional study analyzed inpatient data from All India Institute of Medical Sciences(AIIMS)Rishikesh using the E-hospital database from May 2021 to February 2024,except 2022.All inpatients with culture-confirmed MDRO infections were included.Patient charts and discharge summaries were reviewed.Data analysis was performed using Jamovi software,with descriptive statistics summarizing demographics.Theχ²test was used to assess associations between MDROs and various factors.Ethical approval was obtained,and patient confidentiality was maintained.RESULTS This study included 820 participants having 1106 MDROs.The majority of patients were aged 35-64 years,with a male predominance(57.6%).Most cases were from Uttar Pradesh(49.1%)and Uttarakhand(47.6%),with Bijnor and Haridwar districts reporting the highest burden from their respective states.Klebsiella pneumoniae(K.pneumoniae)(30.6%),Acinetobacter baumannii(16.7%),and Escherichia coli(E.coli)(16.7%)were the most common MDROs.Urine was the most frequent sample type(51.0%),with K.pneumoniae as the leading pathogen.Infections varied significantly across departments(P<0.001),with General Medicine and Surgery reporting the highest burden.E.coli and Klebsiella spp.were most prevalent in these departments respectively.MDRO prevalence fluctuated over time,with significant variations by quarter(P<0.001).Following the second coronavirus disease 2019 wave,there was a rapid surge in MDROs,which stabilized after approximately three months.The overall mortality among patients harboring MDROs was 25.9%.CONCLUSION This study highlights the burden of MDROs among patients at AIIMS Rishikesh,with K.pneumoniae as the predominant pathogen.Strengthening antimicrobial stewardship and infection control measures is essential to combat rising AMR,with department-specific,and pathogen-specific stewardships.展开更多
文摘BACKGROUND Antimicrobial resistance(AMR)is an escalating global health threat,disproportionately impacting low-income and middle-income countries like India.The rise of multidrug-resistant organisms(MDROs)complicates treatment,increases healthcare costs,and contributes to higher morbidity and mortality.In India,factors such as antibiotic misuse,over-the-counter availability,and self-medication have exacerbated this crisis.Despite the urgency,regional data on MDRO prevalence remains limited.AIM To assess the burden and distribution of MDRO infections identified at a tertiary healthcare institute in North India.METHODS This cross-sectional study analyzed inpatient data from All India Institute of Medical Sciences(AIIMS)Rishikesh using the E-hospital database from May 2021 to February 2024,except 2022.All inpatients with culture-confirmed MDRO infections were included.Patient charts and discharge summaries were reviewed.Data analysis was performed using Jamovi software,with descriptive statistics summarizing demographics.Theχ²test was used to assess associations between MDROs and various factors.Ethical approval was obtained,and patient confidentiality was maintained.RESULTS This study included 820 participants having 1106 MDROs.The majority of patients were aged 35-64 years,with a male predominance(57.6%).Most cases were from Uttar Pradesh(49.1%)and Uttarakhand(47.6%),with Bijnor and Haridwar districts reporting the highest burden from their respective states.Klebsiella pneumoniae(K.pneumoniae)(30.6%),Acinetobacter baumannii(16.7%),and Escherichia coli(E.coli)(16.7%)were the most common MDROs.Urine was the most frequent sample type(51.0%),with K.pneumoniae as the leading pathogen.Infections varied significantly across departments(P<0.001),with General Medicine and Surgery reporting the highest burden.E.coli and Klebsiella spp.were most prevalent in these departments respectively.MDRO prevalence fluctuated over time,with significant variations by quarter(P<0.001).Following the second coronavirus disease 2019 wave,there was a rapid surge in MDROs,which stabilized after approximately three months.The overall mortality among patients harboring MDROs was 25.9%.CONCLUSION This study highlights the burden of MDROs among patients at AIIMS Rishikesh,with K.pneumoniae as the predominant pathogen.Strengthening antimicrobial stewardship and infection control measures is essential to combat rising AMR,with department-specific,and pathogen-specific stewardships.
