A model-based scorecard could enable hospitals strengthen antimicrobial resistance surveillance. Credit: Sinhyu/ Getty Images Plus

A trend analysis of antimicrobial resistance in bloodstream infections across India reveals a monthly rise in lack of sensitivity to carbapenems in Klebsiella, E. coli and Acinetobacter. This highlights the need to closely monitor unresponsiveness to this class of last-line antibiotics1.

Researchers from the Indraprastha Institute of Information Technology Delhi and Indian Council of Medical Research in Delhi used statistical and machine learning methods to retrospectively analyze 81,265 records from 21 tertiary care centers between January 2017 to December 2022.

The team identified monthly increases in imipenem and meropenem resistance for Klebsiella, E.coli and Acinetobacter infections. Carbapenem resistance in hospital-acquired infections preceded community-borne infections for Klebsiella and Acinetobacter.

In states that were closer to meeting the United Nations' Sustainable Development Goal on good health and well-being there was lower resistance to imipenem in Klebsiella infections.

The researchers also observed decreasing resistance to amikacin in Klebsiella and minocycline in Acinetobacter infections, which may indicate less use of these antibiotics.

At a national level, resistance to cefotaxime — a third-generation intravenous cephalosporin antibiotic — is a potential warning for carbapenem resistance about 9-10 months in advance.

A model-based AMR scorecard, based on this data analysis, could enable hospitals to bolster their surveillance capabilities, the researchers say.