HYDERABAD: How serious has the issue of drug resistance become? An answer can be found in a research paper authored by microbiology experts from Nizam’s Institute of Medical Sciences (NIMS). The authors suggest that patients suffering from intra-abdominal infections be administered ‘the most potent antibiotics immediately’, instead of common antibiotics. The authors observe that a large percentage of bacteria, causing intra-abdominal infections, produce ESBL. These particular bacterial strains are known to produce an enzyme called beta-lactamase, which can breakdown antibiotics belonging to the penicillin and cephalosporin groups, thereby rendering them useless against infections. A considerable number of samples collected from patients were thus identified as multi-drug resistant. In fact, not just penicillin or cephalosporin, the bacteria found in these samples were resistant to the latest class of antibiotics as well - carbepenems.
The microbiologists suggest that intra-abdominal infections like pancreatitis, peritonitis or pancreatic necrosis must be treated with the most potent antibiotics since common ones would most probably be useless. In the study, 12 per cent mortality was observed among patients infected by intra-abdominal infections.
Cause for worry
For the study, the NIMS microbiologists studied 119 cases of intra-abdominal infections undergoing surgery or interventional drainage that were received at the institute over a span of two years.
Escherichia coli (E. coli), which was isolated in nearly 58 of the 119 cases, was found to be the predominant bacteria. And of these 58 cases, 41 of them were found to be ESBL producing. In 16 cases, it was multi-drug resistant. Almost half of the E. coli samples were found to be resistant to antibiotics like Amikacin, Gentamicin, around 90 percent were resistant to Ciprofloxacin, Livofloxacin and about 30 percent were resistant to Carbapenems like Imipenem and Meropenem.
Another predominant bacteria was Klebsiella Pneumoniae, that was isolated from 11 cases, of which three were found to be multi-drug resistant. Its resistance to various antibiotics was similar to that of E coli.