BANGALORE: Microbes are becoming increasingly resistant to different drugs, according to health experts. Although city hospitals claim that they are equipped to protect themselves from superbugs like the Methicillin-Resistant Staphylococcus Aureus (MRSA), cases of resistance are on the rise.
A recent World Health Organisation (WHO) report found that such ‘superbugs’ are taking over hospitals and 50 per cent of affected patients are not responding to usual treatments. The report said one such superbug E Coli bacteria, which causes infection in the urinary tract, originates from various places inside hospitals like burn units and clinical samples of urine and blood from hospitalised patients.
Incessant Use of Antibiotics
While microbe transfer is possible in any setting, chances are higher inside hospitals, said Dr Savitha Nagaraj, associate professor of microbiology at St John’s Medical College.
“Transfer can occur by touching objects like phones, pens, door handles, keyboards, keys on ATM machines and currency notes. But, in a hospital, use of antibiotics is leading to an increase in resistant microbes,” she explained.
So, that is how the superbug MRSA, a bacterium responsible for several difficult-to-treat infections, originated from hospitals. Paediatric blood samples, dental out-patient clinics, hospital orthopaedic surgical units, community-acquired bone and joint infections from healthcare workers and neo-natal samples are additional sources.
Dr Arunkumar Govindakarnavar, virologist and head of Manipal Centre for Virus Research at Manipal University, said irrational use of antibiotics and lack of antibiotic prescription policy has led to the evolution of superbugs.
“Antibiotics are available over the counter. When used in lower doses (subminimal doses) and incomplete courses (less than prescribed period) they aid in antimicrobial resistance,” he said. He said development of drug resistance is a natural process where microbes develop survival tactics against antimicrobials meant to destroy them. People with MRSA are 64 per cent more likely to die than those with non-resistant form of the infection, the WHO report said.
Excessive use of broad spectrum antibiotics and anti-fungal agents is a major cause of resistance, said Dr Savitha. “Antibiotics will not be of any use in viral or fungal infections. But high-end antibiotics are increasingly used before invasive procedures.”
Dr Arunkumar added that there is an ongoing debate about antibiotic use in animal fodder, which is also causing resistance in bacteria, and hence causing diseases in humans.
‘MDR Patients Isolated’
However, doctors at city hospitals maintain that they have isolated patients with multiple drug resistance (MDR). Dr Mallika Reddy, microbiologist at Narayana Health City, said, “Resistance in other bacteria is a serious issue, not only in E Coli or Staphylococcus, but other organisms too.”
Dr Shabnam Roohi, who heads the Laboratory Medicine Department at Sakra World Hospitals, said MDR is difficult to treat. It leads to disability and death, and is expensive to treat. The effects of resistance in various microbes has also increased hospital stay and expenses.”
‘Everyone is Vulnerable’
Dr Arunkumar emphasised that everyone is vulnerable to MDR. “Because of invasive procedures like surgery and prolonged hospitalisation, patients, especially those with compromised immunity levels, easily acquire drug-resistant organisms from hospitals. This may complicate the original condition for which they go to hospitals and may even lead to death.”
Drug resistant strains of microorganisms may ultimately reach the community and pose a public health burden.
Fungi, Viruses Also Resistant
Resistance is not limited to bacteria alone. Patients with compromised immunity levels are at risk from drug-resistant fungi, especially the Candidan species. Dr Arunkumar said, “Fungal diseases need long-term treatment and are costly. Compliance is an issue and incomplete treatment and medication add to the problem.”
Other than the Human Immunodeficiency Virus (HIV), influenza virus can also turn resistant to drugs like Oseltamivir (Tamiflu — drug for flu treatment). In contrast to anti-bacterial agents, there are only a few anti-virals available for viruses and these are expensive. “Resistance is encountered in Herpes simplex and Hepatitis C virus too,” Dr Savitha observed.
Future is Bleak
She expressed fear that there are few new antibiotics in the pipeline and said transmission of resistant bugs should be prevented. “Restrictions should be imposed on prescribing certain groups of antibiotics and anti-fungals, as advocated by national policies,” she said.