HYDERABAD: India is witnessing a “superbug explosion,” with 83% of patients arriving at hospitals already carrying antibiotic-resistant bacteria, according to a global study led by AIG Hospitals, Hyderabad, and published in The Lancet during Antimicrobial Awareness Week. Researchers warn the country has reached a “critical tipping point” in its battle against antimicrobial resistance (AMR).
Experts say unregulated access to antibiotics, rampant over-the-counter sales, and widespread antibiotic use in dairy, poultry, and agriculture have accelerated the crisis.
AMR occurs when microbes evolve to survive medicines designed to kill them, making even common infections extremely difficult—or impossible—to treat. Indian patients were found to be particularly vulnerable, especially those with chronic lung disease, heart failure, or frequent antibiotic exposure.
India records highest resistance among four countries
The study analysed 1,200 patients across India, Italy, the U.S., and the Netherlands. Results showed:
- India: 83% carriers
- Italy: 31.5%
- U.S.: 20%
- Netherlands: 10.8%
Doctors said many of the bacterial strains identified are resistant even to last-resort antibiotics.
The bacteria were detected during ERCP endoscopy procedures, in which a flexible duodenoscope is used to examine the pancreas, liver, and gallbladder. Although duodenoscopes are sterilised after each use, highly resistant bacteria can still cling to the device.
‘Common infections now hard to cure’
Senior gastroenterologist and study co-author Dr D. Nageshwar Reddy warned that routine infections are becoming increasingly dangerous.
“Pneumonia that once took four days to cure may now take 8–10 days—or may never get cured,” he said. “These bacteria can enter the bloodstream and cause sepsis. That’s why deaths from sepsis in India are so high.”
Doctors highlighted two ERCP patients with the same condition who had drastically different outcomes:
- One patient, without resistant bacteria, recovered in three days, spending ₹70,000.
- Another, carrying resistant organisms, required ICU care, 15+ days of treatment, and spent ₹4–5 lakh.
Healthy carriers, higher danger
Doctors warned that even young, otherwise healthy Indians now unknowingly carry multidrug-resistant bacteria in their gut or nose.
Two major risks arise:
- During hospitalisation or surgery, the bacteria can enter the bloodstream and cause sepsis.
- Transmission, where one patient can infect another—for example, a heart-bypass patient contracting a resistant infection from someone nearby.
Unlike Western nations where carriers tend to be elderly, many Indians in their 30s and 40s carry resistant organisms. Some have never been hospitalised.
Evidence from the Netherlands shows resistance can decline with lifestyle and hygiene improvements. Indian doctors are now considering routine screening before procedures.
‘Act now or 98% will be carriers by 2035’
The study calls for urgent policy intervention.
Doctors say India can reverse resistance levels within five years through strict antibiotic-control measures and reduced misuse.
“Otherwise, by 2035, 98% of people may carry dangerous bacteria,” Dr Reddy warned. “If we act now, we can bring 83% down to 40%.”
They urged tighter pharmacy regulations, curbs on antibiotic use in agriculture, stronger pharmacovigilance, and a nationwide antibiotic-stewardship campaign.
The study also emphasised adopting a One Health approach linking human, animal, and environmental health—critical for both public safety and India’s growing medical-tourism industry.
