Common infections such as urinary tract infections, pneumonia, sepsis and diarrhoeal illnesses are becoming increasingly difficult to manage in India as frontline antibiotics lose their effectiveness against hospital pathogens, according to the Indian Council of Medical Research’s (ICMR) 2024 Antimicrobial Resistance Research & Surveillance Network (AMRSN) report. The analysis of nearly one lakh lab-confirmed samples from leading hospitals shows that routinely used drugs including fluoroquinolones, third-generation cephalosporins, carbapenems and piperacillin-tazobactam are failing at alarming rates against Gram-negative “superbugs”.
The report highlights that drug-resistant Gram-negative bacteria now dominate serious hospital infections, with Escherichia coli – a leading cause of urinary tract, abdominal and bloodstream infections – showing declining susceptibility even to stronger antibiotics. Klebsiella pneumoniae, a major driver of pneumonia and sepsis, is resistant to piperacillin-tazobactam in nearly three-fourths of cases and to carbapenems in most samples, severely limiting therapeutic choices for clinicians.
In intensive care units, the situation is more dire, with Acinetobacter baumannii demonstrating 91% resistance to meropenem, often pushing doctors towards more toxic or complex drug combinations. Pseudomonas aeruginosa also shows rising resistance, and the report notes that around 72% of bloodstream infections are now caused by drug-resistant Gram-negative organisms, while ventilator-associated pneumonia is largely driven by Acinetobacter, Klebsiella and Pseudomonas species that no longer respond to many high-end antibiotics.
While there are a few bright spots – including improved sensitivity of E coli to amikacin and some cephalosporins – overall resistance trends continue to worsen across key pathogens. Diarrhoeal pathogens are highly resistant to fluoroquinolones and cephalosporins, with more than 95% of Salmonella Typhi samples resistant to fluoroquinolones, and among fungi, nearly 10% of Candida auris isolates and about one-third of Aspergillus samples are resistant to major antifungals such as amphotericin B.
ICMR has clarified that the data reflect hospital-based infections rather than community-acquired cases, but experts warn the warning signs are unmistakable. Internal medicine specialists such as Dr Rommel Tickoo of Max Hospital, Saket, and Dr Rakesh Gupta of Indraprastha Apollo Hospitals have called the findings a serious public-health alarm, urging stricter antibiotic stewardship, rational prescribing and stronger infection-prevention measures to prevent once-treatable infections from becoming effectively untreatable.
