High Burden of Antimicrobial Resistance and Mortality Among Adults and Children With Community-Onset Bacterial Infections in India.

Abstract

Background:

In India, antimicrobial consumption is high, yet systematically collected data on the epidemiology, risk factors, and outcomes of antimicrobial-resistant infections are limited.

Methods:

A prospective study of adults and children hospitalized for acute febrile illness was conducted between August 2013 and December 2015. In-hospital outcomes were recorded, and logistic regression was performed to identify independent predictors of community-onset antimicrobial-resistant infections.

Results:

Among 1524 patients hospitalized with acute febrile illness, 133 isolates were found among 115 patients with community-onset infections; 66 isolates (50.0%) were multidrug resistant and, of 33 isolates tested for carbapenem susceptibility, 12 (36%) were resistant. Multidrug-resistant infections were associated with recent antecedent antibiotic use (adjusted odds ratio [aOR], 4.17; 95% confidence interval [CI], 1.19-19.7) and were independently associated with mortality (aOR, 6.06; 95% CI, 1.2-55.7).

Conclusion:

We found a high burden of community-onset antimicrobial-resistant infection among patients with acute febrile illness in India. Multidrug-resistant infection was associated with prior antibiotic use and an increased risk of mortality.

• Authors: Vidya Mave, Ajay Chandanwale, Anju Kagal, Sandhya Khadse, Dileep Kadam, Renu Bharadwaj, Vaishali Dohe, Matthew L Robinson, Aarti Kinikar, Samir Joshi, Priyanka Raichur, Katie McIntire, Savita Kanade, Jonathan Sachs, Chhaya Valvi, Usha Balasubramanian, Vandana Kulkarni, Aaron M Milstone, Ivan Marbaniang, Jonathan Zenilman, Amita Gupta
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 215 Issue 8 Pg. 1312-1320 (04 15 2017) ISSN: 1537-6613 [Electronic] United States
• PMID: 28329303 (Publication Type: Journal Article)
• Copyright: © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

Chemical References

• Anti-Bacterial Agents

Topics

• Acute Disease
• Adolescent
• Adult
• Anti-Bacterial Agents (metabolism, therapeutic use)
• Bacteria (drug effects, isolation & purification)
• Bacterial Infections (drug therapy, mortality)
• Child
• Child, Preschool
• Cross Infection (drug therapy, mortality)
• Drug Resistance, Multiple, Bacterial
• Female
• Hospital Mortality
• Humans
• India
• Length of Stay
• Logistic Models
• Male
• Middle Aged
• Prospective Studies
• Risk Factors
• Tertiary Care Centers
• Young Adult