Superbugs wriggle out of hospitals to infect community

The dangerous hospital strains - drug-resistant bugs that were earlier seen only in a medical set-up - have now spread into the community, among people who didn't go anywhere near a hospital for several months.

As a result, doctors are increasingly encountering cases where patients land up in the intensive care units of a referral hospital straight from home, thanks to these drug-resistant bacteria that can't be killed by common antibiotics.

The latest warning came from a new study involving more than 5,300 ICU patients in Delhi, out of which 3,822 were infected on the day of the admission or within 48 hours. Over 1,450 of them produced positive culture in pathology, suggesting high concentration of the infected pathogen in the body.

"Out of these 1,452 patients, as many as 201 (13.8%) were direct admissions from community with no documented contact with any healthcare facility in the last three months," reported the team from Sir Ganga Ram Hospital and City Hospital.

Fatal infections

The finding, reported in the Journal of Critical Care, indicates the huge potential public health threat as these dreaded infections found a way to escape the confines of a hospital and spread into the community. Also, death is more common in people having these infections.

"The resistance to high-end antibiotics by organisms contracted by patients in the community resulted in high mortality, as seen in our study. It is a cause for worry and needs further research and proper action plan," said Sumit Ray, vice chairman, department of critical care, Sir Ganga Ram Hospital, who led the study.

Infections due to multi-drug-resistant pathogens are of major concern worldwide. One of the troublesome types of bugs is called ESBL (extended spectrum beta lactamases) which is resistant to newer-generation antibiotics and can be easily transferred in the community.

While the ESBLs pose therapeutic challenges to the doctors, abuse of third-generation cephalosporins has been identified as one of the key reasons behind the rise of these superbugs.

The study appears days after a fresh government report demonstrated how life-saving antibiotics are abused by doctors and consumers.

"Between 2000 and 2015, the proportion of third-generation cephalosporins among total antibiotics increased significantly, while penicillin consumption remained constant and the use of fluoroquinolones decreased. This increased use of third-generation cephalosporins is consistent with the high prevalence of third-generation cephalosporin-resistant E.coli in India," said the scoping report on antimicrobial resistance, brought out by the Department of Biotechnology.