Antimicrobial Resitance (AMR)

Addressing the Global Health Crisis​

Antimicrobial Resistance (AMR) is one of the most significant health challenges facing the world today, particularly in low- and middle-income countries (LMICs) already grappling with existing inequities in access to and quality of care across various socioeconomic, geographic, and demographic categories. The causes and effects of AMR are interconnected and mutually reinforcing, with AMR being both a cause and a consequence of existing inequities in LMICs. In India, for example, high disease burden, limited resources, and weak health systems result in the inappropriate use of antibiotics, which is the leading driver of AMR, thereby exacerbating the existing inequities. Several policies and frameworks are defined at the global and national levels. For instance, the Global Action Plan (GAP) developed by WHO guided the development of National action plans (NAPs) in partner countries. It discusses the key strategies to address AMR at national and global levels. All NAPs emphasize the importance of using antimicrobials carefully and appropriately. However, they do not consider the contextual challenges and obstacles hindering progress towards this goal, especially in resource-constrained settings already grappling with existing challenges. Efforts to combat AMR are challenged by the poor availability of reliable data, particularly from low and middle-income countries, making it very difficult to estimate the burden of disease. The availability of information is a critical component to identifying the contextual challenges to address AMR.

Projects

Since October 2018, HISP India has been at the forefront of designing and developing an AMR surveillance system, built on the DHIS2 platform. This system is designed to efficiently report, manage, and analyze antimicrobial resistance data, offering various visualization tools such as charts, tables, and standard reports.

The system is tailored to meet the unique needs of:

  • Healthcare Facilities: Enabling patient-centric care with robust sample tracking mechanisms in laboratories.
  • Research Institutions & Policymakers: Supporting advanced analytics for geographical and pathogen-specific resistance trends, time-series analysis, and correlation with antimicrobial consumption patterns.

Currently, the AMR surveillance system is operational in microbiology laboratories across 10 medical colleges in India and 3 in Africa. The system is interoperable with external platforms like WHONET and Laboratory Information Systems (LIS), enhancing data exchange and integration.

Designed with scalability and adaptability in mind, the system has recently been extended to include Veterinary AMR surveillance, broadening its impact in tackling antimicrobial resistance across multiple domains.

AMR Surveillance Application

Publications on Antimicrobial resistance

#TitlePublicationYearUrl
1Social and cultural determinants of antibiotics prescriptions: analysis from a public community health centre in North IndiaFrontiers in Pharmacology2024View
2Systems thinking based approaches to engage with health inequities shaping Antimicrobial Resistance in low and lower-middle-income countriesJournal of Infection and Public Health2023View
4Assessing feasibility of point-of-care Antibiotics Susceptibility Testing technologies for mitigating access gaps for peripheral communities 2023View
3Digital Monitoring of Antibiotic Resistance (ABR) in Low- and Middle-Income Countries: A Narrative Literature ReviewScandinavian Conference on Health Informatics2022View
5Strengthening digital monitoring of antibiotic resistance in low-resource settingsJournal of Global Health2022View
6Designing an Antibiotics Resistance (ABR) monitoring system to strengthen the evidence base for facilitating responsible antibiotics prescription by physicians: A case study from IndiaICIS 20222022View
7Routinizing practices and stabilizing institutional work: A case of digital monitoring of Antibiotic Resistance (ABR) in IndiaCommunications of the Association for Information Systems2022View
8Designing for Scale: Strengthening Surveillance of Antimicrobial Resistance in Low Resource SettingsIFIP Joint Working Conference on the Future of Digital Work: The Challenge of Inequality (IFIPJWC)2022View

Team

Gallery

AMR WORK in News

Every nine minutes, a newborn dies due to antibiotic resistance

Dr. Namrata Kumari, President of the Indian Association of Medical Microbiologists, said that antibiotic resistance leads to the death of one newborn every nine minutes. According to a 2015 survey, over 58,000 children died due to antibiotic resistance, and this number is increasing each year. India ranks second after China in antibiotic consumption. In 2010 alone, 12.5 billion antibiotic tablets were consumed in India.

A seminar on antimicrobial resistance was organized at Sri Krishna Medical College Hospital (SKMCH) by the Indian Association of Medical Microbiologists (Bihar Chapter), SKMCH, and Homi Bhabha Cancer Hospital & Research Centre. The event was inaugurated by Dr. Abha Rani Sinha, Principal of SKMCH, who emphasized that antimicrobial resistance is a natural process that cannot be stopped but can be controlled through proper use and guidelines.

Dr. Bharatendu Kumar stated that antimicrobial resistance can only be controlled through the cooperation of doctors, microbiologists, nursing staff, and healthcare workers. More than 200 doctors from various medical colleges in Bihar attended the seminar. Dr. Ravikant Singh and Dr. Priyanka Narayan from HBCHRC Muzaffarpur played significant roles in organizing the event. Dr. Priyanka mentioned plans to conduct similar seminars across various cities in collaboration with the health department and HBCHRC

Research teams from Norway and South Africa reveal misuse of antibiotics at SKMCH, NMCH, and DMCH

A research team from Norway and South Africa disclosed that antibiotics are being misused at SKMCH (Muzaffarpur), NMCH (Patna), and DMCH (Darbhanga). A three-member pilot project team found that doctors at these institutions prescribe antibiotics indiscriminately even for minor ailments like colds and coughs. The research is ongoing with participation from Dr. Sandeep Sahay (University of Oslo), Dr. Esmita Charani (South Africa), Dr. Arunima Mukherjee (University of Oslo), along with local researchers.

According to WHO, currently seven lakh deaths occur globally each year due to antibiotic resistance; this number could rise to one crore by 2050.

Seminar on Awareness of Microbial Resistance

Proper Use of Antibiotics Can Prevent Its Adverse Effects

Bharat News | Muzaffarpur
A seminar was organized on Monday at SKMCH (Sri Krishna Medical College and Hospital) on Antimicrobial Resistance and Its Dangers. The event was conducted by the Indian Association of Medical Microbiologists, Bihar Chapter, in collaboration with SKMCH and Homoeopathic Regional Cancer Hospital and Research Center, Tatlagarh.

The seminar began with the lighting of the lamp by Dr. Ajit Ranjan Singh, who emphasized that antimicrobial resistance is a natural process that cannot be completely stopped, but its impact can be minimized through proper use of antibiotics with the right advice and prescriptions.

Preventing the Adverse Effects of Antibiotics

The President of the Indian Association of Medical Microbiologists, Dr. Maya Kumari, stated that antimicrobial resistance is a growing global concern. According to research, excessive and incorrect use of antibiotics can cause severe health issues. She noted that antibiotics should be taken only under medical supervision to ensure their effectiveness and reduce harmful effects.

Rising Deaths Due to Antibiotic Resistance

Statistics show that in one year, over 58,000 children’s deaths were linked to antibiotic resistance in India, and this number is increasing annually. The Head of the Medicine Department, Prof. Bharati Kumar, further explained that excessive use of antibiotics reduces their effectiveness over time, making infections harder to treat.

Experts Present at the Event

The seminar was attended by several experts, including Prof. Gopal Shankar Sahni, Dr. Poonam Kumari, Dr. Priti Rishi, Dr. Pratima, Dr. Priti Chaudhary, Vivekanand Thakur, Ayurved Bhardwaj, Raktik Kumar, and Vivek Kumar, along with many doctors and staff members from the Microbiology Department.

 

Resistance to last-resort antibiotics growing in India, says ICMR report

Alarming Rise in Antibiotic Resistance

Mumbai: The majority of the country’s sickest patients may no longer benefit from carbapenem, an antibiotic that effectively treated pneumonia and septicemia until a decade ago, according to the latest Indian Council of Medical Research (ICMR) study on antimicrobial resistance.

Findings of the Study

The study, released on Friday, found that misuse of antimicrobials—whether antibiotics, antivirals, or antifungals—has led to widespread resistance to these drugs. The ICMR gathered data from 21 tertiary-level hospitals across the country, including BMC-run LTMG Hospital in Sion and Hinduja Hospital in Mahim, between January 1 and December 31, 2022.

Approximately 1 lakh culture isolates from ICU patients were studied to analyze hospital-acquired infections, finding 1,747 pathogens, with E. coli being the most common culprit, followed by Klebsiella pneumoniae.

Declining Response to Carbapenem

The report revealed that if eight out of 10 patients with a drug-resistant E. coli infection responded to carbapenem in 2017, only six responded in 2022. The situation is even worse for infections caused by Klebsiella pneumoniae, where six out of 10 patients found the medicine unhelpful in 2017, but now four out of 10 struggle to find an effective drug.

New Antibiotics May Not Work on Indian Strains

Even newly developed antibiotics in the West may not work effectively against drug-resistant Indian E. coli strains, said Dr. Kamini Walia, a senior ICMR scientist and one of the study’s authors.

While some findings showed stabilized resistance levels over the past five to six years, there were no signs of improvement.

Discovery of a Unique Resistance Mechanism

Scientists also identified a molecular mechanism of resistance seen in all superbugs. The NDM (New Delhi Metallo-beta-lactamase) enzyme was frequently detected in multi-drug-resistant pseudomonas. This is a unique phenomenon seen only in India, which could help develop new antibiotics tailored for Indian needs, said Dr. Walia.

Misuse of Broad-Spectrum Antibiotics

Doctors highlighted that the indiscriminate use of broad-spectrum antibiotics is a major reason for growing resistance. Even common diarrhea drugs like norfloxacin or ofloxacin are no longer as effective.

“If we were to introduce a new drug but misuse it the same way, resistance would develop just as fast,” Dr. Walia warned.

India’s Resistance Levels Among the Highest

In Western countries, a 20% resistance level is considered alarming, but in India, 60% resistance levels are common, highlighting the urgency of the issue.

Call for Stricter Antibiotic Prescriptions

Dr. Walia emphasized that antibiotic prescriptions should be taken more seriously, with drugs only given when absolutely necessary.

 

Obtain Proper Information About Patients Along with Samples

A team from the Antimicrobial Resistance (AMR) Project from Muzaffarpur visited Darbhanga Medical College’s Microbiology Department on Friday.

Discussion on Bacteriology Section Improvements

After inspection, the team members stated that the Bacteriology Section of the department has been operational for some time now. There were discussions on improving culture and sensitivity testing in the bacteriology section. The importance of culture testing before prescribing antibiotics was also discussed in detail.

Recording Accurate Patient Data for Lab Investigations

The team informed that proper formatting of patient details for laboratory testing is essential. The required details include:

  • Patient’s Name
  • OPD/IPD Number
  • Registration Number
  • Date of Sample Collection
  • Age, Address, and Department Name
  • Ward Number, Sample Type, and History

By maintaining these records properly, it will become easier to upload data to the LIMS (Laboratory Information Management System) portal, ensuring accurate patient data.

Experts Present at the Meeting

The event was attended by:

  • Dr. R.S. Prasad (Head of Department)
  • Dr. Arun Sharma (Bacteriology Section In-charge)
  • Assistant Professor Dr. Ahmad Hamidi
  • Medical Technicians Anil Ahmad and Ghanshyam Kumar
  • Ayush Bhardwaj and Baiju Kumar

Three-day workshop organized at Homoeo Bhagat Cancer Hospital

Doctors Should Write Medicine Names Clearly on Prescriptions: Dr. Ismita

  • Three-day workshop organized at Homoeo Bhagat Cancer Hospital
  • Doctors discussed the rising dangers of antibiotic misuse

Muzaffarpur, Health Correspondent
Dr. Ismita Chandra, an Associate Professor at the University of Cape Town, emphasized that the clarity of prescriptions is essential for accurate treatment. If the doctor’s handwriting is unclear, patients might not receive the correct medication, leading to ineffective treatment.

Discussion on Antibiotic Resistance

A three-day workshop was held at Homoeo Bhagat Cancer Hospital, where doctors from various departments participated. The workshop focused on the dangers of antibiotic resistance and the need for proper prescribing practices.

The event was attended by specialists from SKMCH (Sri Krishna Medical College and Hospital), AMR Project, and DHIS2 Microbiology Department. Notable participants included Dr. Arunima Gupta, Dr. Vishwanath, and other health experts.

Advantages of Digitalizing Medical Data

During the workshop, Dr. Satyavrat Sahay from the University of Oslo explained the importance of digitizing medical records. He introduced the Antimicrobial Sensitivity Testing (AST) process, which helps doctors select effective antibiotics based on previous patient records.

Antibiotic Resistance Causing Millions of Deaths

According to the World Health Organization (WHO), antibiotic resistance causes one million deaths annually, and by 2050, this number could reach ten million. Though antibiotics are essential for treating bacterial infections, their misuse can lead to drug resistance, making treatments ineffective.

Dr. Ravikant Singh from Cancer Hospital emphasized the need for government intervention in Bihar to control antibiotic overuse. He suggested setting up state-level action plans to combat antimicrobial resistance.

Unnecessary Use of Antibiotics Poses a Health Risk

Unnecessary Use of Antibiotics Poses a Health Risk

For the first time in Bihar, a discussion was held on the excessive use of antibiotics and its dangers. On Friday, experts gathered to mark World Health Day, where the World Health Organization (WHO) reported that 10 out of every 1,000 people worldwide consume antibiotics unnecessarily. Some countries have taken strict measures to regulate their use.

In Bihar, the first dedicated program on antibiotic misuse was conducted, in which doctors from Patna AIIMS, IGIMS, PMCH, and various other hospitals participated. The Microbiology Department of Muzaffarpur also played an active role in this initiative.

The program was organized under the leadership of the Bihar government, which collaborated with hospitals and medical colleges from across the state. Discussions were held on the dangers of antibiotic resistance and the growing risk of superbugs.

The Alarming Rise of Antibiotic Resistance

According to WHO, over 1 million deaths occur every year due to antibiotic resistance, and by 2050, this number could rise to 10 million. Experts highlighted that excessive use of antibiotics for minor infections leads to bacterial resistance, making these drugs ineffective in the long run.

Doctors emphasized that antibiotics should be taken only when prescribed by a qualified physician. They also discussed alternative treatments for infections that do not require antibiotics.

Misuse of Antibiotics is Dangerous

Health Correspondent, Patna
For the first time in the state, a health forum was conducted to address antibiotic misuse. Experts from various medical institutions and microbiologists attended the event to discuss its harmful effects.

Doctors Urge Controlled Use of Antibiotics

Medical professionals stated that antibiotics should be used only when absolutely necessary. They warned that improper use can weaken the body’s ability to fight infections, leading to more severe health complications in the future.

Experts also stressed the importance of proper antibiotic prescriptions. A research report presented during the event suggested that antibiotics should not be used for viral infections like colds and flu, as they only work against bacterial infections.

Global Concern Over Antibiotic Resistance

WHO and various health organizations have issued strict guidelines for the use of antibiotics. Studies show that in some countries, resistance levels have reached 60%, meaning that most commonly used antibiotics no longer work effectively.

Experts concluded that awareness campaigns and strict regulations are necessary to control the overuse of antibiotics, ensuring that future generations do not suffer from untreatable bacterial infections.

I want to split the offering capacity building into Education and Capacity Building for the HISP India Website. In Education we are creating courses on Digital Health for Master Students and Public HEalth Professionals like DMgtasia project and in capacity building we organize capacity building workshops for different govt, private organizations and NGO’s.

Give a a two lines into of the these offering for the homepage of hisp india. Use the context from the uploaded documents also if needed.