Kerala has launched its antibiogram for the third consecutive 12 months, a mirrored image of the State’s dedication to strengthen the surveillance of antimicrobial resistance (AMR), which poses a big menace to public well being.
The State’s antibiogram or the AMR surveillance report – the scientific information summarising the profile of varied bacterial pathogens and its susceptibility to antibiotics – for the 12 months 2023 was launched by Well being Minister Veena George right here on Monday.
The State established Kerala Antimicrobial Resistance Surveillance Community (KARS-Web) in 2019, to foster standardisation and to strengthen and develop AMR surveillance in Kerala in order that rising antibiotic resistance may be detected and monitored. The community of laboratories over time has expanded from 21 labs in 9 districts to 49 labs throughout 12 districts.
The AMR information from 34 surveillance laboratories in 11 districts from January 1 to December 31, 2023, collated and analysed by KARS-Web, varieties the idea of the antibiogram or the antimicrobial resistance profile of precedence pathogens for 2023.
The antibiogram for 2023 has been generated from information submitted by laboratories in tertiary care centres and therefore, this won’t precisely mirror the community-level AMR profile.
Precedence pathogens
The precedence pathogens underneath present surveillance of KARS-NET embody 9 generally remoted pathogens from recognized specimens. These are Staphylococcus aureus; Enterococcus species; Klebsiella species; Escherichia coli; Acinetobacter species; Pseudomonas species; Salmonella enterica serovar Typhi and Paratyphi; Shigella species and Vibrio cholerae.
In 2023, probably the most incessantly reported precedence pathogen from all specimens was E. coli (40.03%), adopted by Klebsiella species (23.53%), S. aureus (11.86%), Pseudomonas species(10.84%), Enterococcus species (8.11%), Acinetobacter species (5.24%), Salmonella enterica serotype Typhi and ParatyphiA & B (0.28%) and Shigella species (0.11%). No Vibrio cholerae instances have been reported throughout this time interval.
Amongst urinary isolates, E. coli was the commonest pathogen remoted (58%) whereas Klebsiella spp. (26%) was the commonest pathogen remoted from blood.
E coli was the commonest precedence pathogen remoted from OPD (46%) and IPD (38%) settings. Within the ICU setting, each E.coli and Klebsiella spp. have been the frequent pathogens reported, every amounting to 29%.
A rise within the proportion of MRSA among the many S.aureus isolates from blood was famous this 12 months (33%), in comparison with the earlier 12 months (27%).
Enterococcus spp. remoted from blood cultures confirmed 3% resistance to Vancomycin, whereas it was 2% through the earlier 12 months. About 12% of E. coli and as much as 43% of Klebsiella spp. remoted from blood have been discovered to be Carbapenem-resistant Enterobacteriaceae (CREs).
Excessive stage of resistance was noticed in Klebsiella spp. remoted from all specimen sorts and for all antibiotics besides Colistin.
Highest resistance to Carbapenem was noticed in isolates of Klebsiella spp. from blood (43%) in comparison with the opposite specimen sorts. Prolonged spectrum beta-lactamase (ESBL) manufacturing was noticed in 74% of blood isolates. Colistin resistance of Klebsiella spp from blood was 2%.
“As within the earlier years, there is a rise in ESBL manufacturing (ESBL are enzymes that confer resistance to most beta-lactam antibiotics, together with penicillins, cephalosporins). Resistance to Carbapenem, one of many final resort antibiotics that may deal with ESBL-producing micro organism, has additionally been rising over the previous 5 years in Kerala and these sign main bother for us,” R. Aravind, Head of Infectious Ailments, Authorities Medical Faculty Hospital, Thiruvananthapuram, and the convener of the working committee of Kerala Antimicrobial Resistance Strategic Motion Plan (KARSAP) stated.
This requires stringent an infection prevention and management measures in all healthcare settings and promotion of rational antibiotic prescription in the neighborhood.
With a view to discover the AMR profile on the community-level and to arrange the antibiogram from hospitals on the main and secondary care ranges, the State has already launched the hub and spoke mannequin AMR surveillance system. From subsequent 12 months, the State intends to convey out district-level antibiograms yearly.
Revealed – December 02, 2024 09:34 pm IST
