ScienceOpen'Epidemiology and Clinical Outcome of Common Multi-drug Resistant Gram-negative Bacterial Infections in a Network of Hospitals in India (IMPRES): A Multicenter Intensive Care Unit-based Prospective Clinical Study' - a #JaypeeJournals UN #SDG03 article on #ScienceOpen:
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Epidemiology and Clinical Outcome of Common Multi-drug Resistant Gram-negative Bacterial Infections in a Network of Hospitals in India (IMPRES): A Multicenter Intensive Care Unit-based Prospective Clinical Study
<div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d902396e561"> <!-- named anchor --> </a> <h5 class="section-title" id="d902396e562">Background and aims</h5> <p dir="auto" id="d902396e564">India witnessed the exponential rise of antibiotic resistance due to the high burden of communicable disease. The Indian Council of Medical Research reported <i>Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii</i>, and <i>Klebsiella pneumoniae</i> (PEAK organisms) as the most common gram-negative isolates, constituting 65.5% of total isolates. The present study aimed to observe the demographics and clinical outcomes of patients infected with these four common gram-negative bacteria in ICUs across India. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d902396e572"> <!-- named anchor --> </a> <h5 class="section-title" id="d902396e573">Patients and methods</h5> <p dir="auto" id="d902396e575">This prospective multicentric observational study was conducted in ICUs of 19 hospitals across India. The data collected for each patient included: demography, diagnosis, disease severity score, site of infection, PEAK organism, risk factors for multidrug resistance, antibiotic sensitivity, resistance pattern, total ventilator days, and 28-day mortality. Subgroup analysis of 28-day mortality was done for community-acquired vs hospital-acquired infection, appropriate empirical antibiotic, Carbapenem- and Colistin-resistant infections. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d902396e577"> <!-- named anchor --> </a> <h5 class="section-title" id="d902396e578">Results</h5> <p dir="auto" id="d902396e580">A total of 936 patients were included in the analysis. Resistance to Cephalosporin, Fluroquinolones, Piperacillin Tazobactam, Carbapenem, Aminoglycosides, and Colistin was observed in 84, 68, 55, 47, 37, and 4.2% of patients, respectively. The 28-day crude mortality rate was 23.5%, which was higher in the subgroup with isolates resistant to empiric antibiotics compared to those with sensitive isolates (29.6 vs 21.4%, <i>p</i> > 0.05). Moreover, 32 and 27% mortality rates were observed in patients who were infected with Carbapenem-resistant and Colistin-resistant PEAK organisms, respectively. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d902396e585"> <!-- named anchor --> </a> <h5 class="section-title" id="d902396e586">Conclusion</h5> <p dir="auto" id="d902396e588">The present study observed a high prevalence of antibiotic resistance in Indian ICUs, contributing to a crude mortality rate of 23.5%. Patients with Carbapenem and Colistin resistance may exhibit higher 28-day crude mortality. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d902396e590"> <!-- named anchor --> </a> <h5 class="section-title" id="d902396e591">How to cite this article</h5> <p dir="auto" id="d902396e593">Das SK, Joshi Z, Govil D, Shah MS, Jakaraddi GN, Sinha S, <i>et al</i>. Epidemiology and Clinical Outcome of Common Multi-drug Resistant Gram-negative Bacterial Infections in a Network of Hospitals in India (IMPRES): A Multicenter Intensive Care Unit-based Prospective Clinical Study. Indian J Crit Care Med 2025;29(6):504–509. </p> <p dir="auto" id="d902396e598">CTRI identifier: CTRI/2023/01/049121.</p> </div>
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