Indian study links multidrug-resistant infections to higher mortality risk

A new study by researchers with the Center for Disease Dynamics, Economics and Policy has found a significant relationship between multidrug-resistant (MDR) bacterial infections and mortality in India.

In the retrospective study, published today in Clinical Infectious Diseases, researchers analyzed patient-level antimicrobial susceptibility tests (ASTs) results and patient mortality outcomes from 10 Indian hospitals. They focused on resistance patterns for drugs commonly used to treat ESKAPE pathogens—Enterococcus spp., Staphylococcus aureusKlebsiella pneumoniaeAcinetobacter baumanniii, Pseudomonas aeruginosa, and Enterobacter spp—and resistance to Escherichia coli. To evaluate patient mortality in relation to MDR bacteria, they conducted multivariate regression analyses, adjusting for age, sex, hospital location, and specimen source.

The researchers analyzed data on 5,103 AST results. The overall mortality rate of patients was 13.1%, with increased odds of mortality among patients with MDR infections (odds ratio [OR], 1.57; 95% confidence interval [CI], 1.14 to 2.16) and XDR infections (OR, 2.65; 95% CI, 1.81 to 3.88). Infections with MDR and XDR E coli, XDR K pneumoniae, and MDR A baumannii were associated with 2-3 times higher mortality. Mortality in patients with methicillin-resistant S aureus (MRSA) infections that were also non-susceptible to aminoglycosides was significantly higher when compared with susceptible strains.

“While data were observational, preventing establishment of causality, our results provide strong quantification of the association between mortality and multidrug resistant patterns in a representative LMIC [low- and middle-income country], and highlight the significant threat MDR and XDR pathogens pose to human health in developing countries,” the authors write.

Source: CIDRAP

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