India Facing a Pandemic of Antibiotics-Resistant Superbugs 63
An anonymous reader shares a report: At the 1,000-bed not-for-profit Kasturba Hospital in the western Indian state of Maharashtra, doctors are grappling with a rash of antibiotic-resistant "superbug infections." This happens when bacteria change over time and become resistant to drugs that are supposed to defeat them and cure the infections they cause. Such resistance directly caused 1.27 million deaths worldwide in 2019, according to The Lancet, a medical journal. Antibiotics -- which are considered to be the first line of defence against severe infections -- did not work on most of these cases.
India is one of the countries worst hit by what doctors call "antimicrobial resistance" -- antibiotic-resistant neonatal infections alone are responsible for the deaths of nearly 60,000 newborns each year. A new government report paints a startling picture of how things are getting worse. Tests carried out at Kasturba Hospital to find out which antibiotic would be most effective in tackling five main bacterial pathogens have found that a number of key drugs were barely effective.
A new report by Indian Council of Medical Research (ICMR) says that resistance to a powerful class of antibiotics called carbapenems - it defeats a number of pathogens - had risen by up to 10% in just one year alone. The report collects data on antibiotic resistance from up to 30 public and private hospitals every year. "The reason why this is alarming is that it is a great drug to treat sepsis [a life-threatening condition] and sometimes used as a first line of treatment in hospitals for very sick patients in ICUs," says Dr Kamini Walia, a scientist at Indian Council of Medical Research (ICMR) and lead author of the study.
India is one of the countries worst hit by what doctors call "antimicrobial resistance" -- antibiotic-resistant neonatal infections alone are responsible for the deaths of nearly 60,000 newborns each year. A new government report paints a startling picture of how things are getting worse. Tests carried out at Kasturba Hospital to find out which antibiotic would be most effective in tackling five main bacterial pathogens have found that a number of key drugs were barely effective.
A new report by Indian Council of Medical Research (ICMR) says that resistance to a powerful class of antibiotics called carbapenems - it defeats a number of pathogens - had risen by up to 10% in just one year alone. The report collects data on antibiotic resistance from up to 30 public and private hospitals every year. "The reason why this is alarming is that it is a great drug to treat sepsis [a life-threatening condition] and sometimes used as a first line of treatment in hospitals for very sick patients in ICUs," says Dr Kamini Walia, a scientist at Indian Council of Medical Research (ICMR) and lead author of the study.
Thanks, India! (Score:1)
Well no shit, India. (Score:1, Interesting)
Throwing corpses into the Ganges and then defecting in there non-stop, what did you people expect?
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Just pour more antibiotics in there, should fix the issue quick. /s
Re: how is this (Score:5, Interesting)
India manufactures *a lot* of the world's antibiotics, but have very few environmental controls.
Rivers near Indian medicine plants have thousands up to millions of times the acceptable limit of antibiotics in the effluent.
Phage Therapy is one answer (Score:3)
https://www.ncbi.nlm.nih.gov/p... [nih.gov]
"Phage therapy: An alternative to antibiotics in the age of multi-drug resistance
The practice of phage therapy, which uses bacterial viruses (phages) to treat bacterial infections, has been around for almost a century. The universal decline in the effectiveness of antibiotics has generated renewed interest in revisiting this practice. Conventionally, phage therapy relies on the use of naturally-occurring phages to infect and lyse bacteria at the site of infection. Biotechnol
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"Phage therapy: An alternative to antibiotics in the age of multi-drug resistance
Or bleach. A very stable genius told me that, although I haven't tried it yet.
If its happening in India then it's Endemic... (Score:5, Informative)
Pandemic (Pan) would mean its happening over most of the world.
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Give it a bit of time...
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Pandemic (Pan) would mean its happening over most of the world.
Uh...no it wouldn't? When has there been a requirement for it to happen "over most of the world"?
Re:If its happening in India then it's Endemic... (Score:4, Informative)
"When has there been a requirement for it to happen "over most of the world"?"
Uh, since it was described as *pan*demic, "pan" being a Greek root meaning "all", as the original poster highlighted. The word's roots mean "all the people", meaning a disease that hits everyone everywhere.
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The Black Death hit every part of what was then the known world to people in Europe. Hence, pandemic.
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"of what was then the known world to people in Europe"
...but that term is not from the 14th century, so that makes absolutely no sense. Nobody called it "a pandemic" in the 14th century. "Then" is today for the purpose of that term.
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They certainly would've called it a pandemic if they had been using the term. The definition stands.
Re:If its happening in India then it's Endemic... (Score:4, Informative)
Pandemic (Pan) would mean its happening over most of the world.
Uh...no it wouldn't? When has there been a requirement for it to happen "over most of the world"?
Since the word was defined.
A pandemic is defined as “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people." -- https://www.ncbi.nlm.nih.gov/p... [nih.gov]
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Please read my reply to Chris Mattern. The "or" part of your definition is apparently important.
But not the "crossing international boundaries" part?
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When has there been a requirement for it to happen "over most of the world"?
Because that is what the word "Pan-Demic" means.
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Why should I read a post you answered to someone else?
The word "pandemic" means: it is an world wide event.
Get a dictionary?
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Thanks morons (Score:5, Interesting)
To all the morons who insist on their doctors giving them antibiotics for even a minor ailment whether it'll work or not - we salute you. You've sending us back to victorian times.
During covid I've lost count of the number of mouth breathers I heard on radio phone ins asking why they couldn't just be given antibiotics for it. Even when the presenter knew the difference between a virus and a bacteria (a big ask for most talk show hosts) and explained it to the caller, the morons often still didn't get it. If you've ever seen the but-it-goes-up-to-11 scene in Spinal Tap , thats the sort of people we're dealing with,.
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Probably has nothing to do with India being a giant petri dish...
Re:Thanks morons (Score:4, Insightful)
It may have a lot to do with the availability of antibiotics and a tendency to not take the full course if the cost is too high
Failing to use the complete course of prescribed antibiotics tends to leave "survivors", that may in turn have some mutation that will allow them to better survive the next encounter with antibiotics
Re:Thanks morons (Score:4, Insightful)
Vectors (Score:5, Informative)
Anti-bacterial resistant strains primarily come from two sources:
1. People not taking their full course of antibiotics. Overuse of antibiotics would be much less of an issue if people would take their full course, and all the bacteria that would die from the course would, you know, actually be killed.
2. The pervasiveness of these infections in hospitals, mostly, comes from cross-contamination. Most cross-contamination comes from doctors, nurses and orderlies not washing their hands enough, or not wearing and changing gloves enough. There have been studies where hospitals have enforced hand-washing and glove-changing between patients using human monitors, and the rate of cross-infection dropped by 50-60%.
Re:Vectors (Score:5, Informative)
Indeed, not taking the full course of antibiotics and hospital contamination are two reasons, but you missed perhaps one of the bigger sources -- animal agriculture. Antibiotics are routinely given on a massive scale because they promote growth, even in the absence of infection. These antibiotics end up in the environment and are a massive selective force for bacteria to evolve resistance.
Antibiotic Use in Agriculture and Its Consequential Resistance in Environmental Sources: Potential Public Health Implications
https://www.ncbi.nlm.nih.gov/p... [nih.gov]
Re:Vectors (Score:5, Informative)
This is also one of the reasons why almost all US meat isn't allowed to be imported in the EU.
They're basically considered poisoned for EU laws.
Re:Vectors (Score:4, Informative)
People not taking their full course of antibiotics.
People are a drop in the bucket compared to the massive amounts of antibiotics given to animals on corporate farms.
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Anti-bacterial resistant strains primarily come from two sources:
1. People not taking their full course of antibiotics. Overuse of antibiotics would be much less of an issue if people would take their full course, and all the bacteria that would die from the course would, you know, actually be killed.
2. The pervasiveness of these infections in hospitals, mostly, comes from cross-contamination. Most cross-contamination comes from doctors, nurses and orderlies not washing their hands enough, or not wearing and changing gloves enough. There have been studies where hospitals have enforced hand-washing and glove-changing between patients using human monitors, and the rate of cross-infection dropped by 50-60%.
Here's another.
I was at a talk given by a researcher at Emory University. The talk was actually about something else, but he answered a question and mentioned that the resistance problem in the USA isn't coming from relatively healthy people getting unneeded antibiotics or not finishing their doses - healthy people usually kill all the infection.
The big problem here is very sick immuno-compromised patients that are on antibiotics for months of even years. They're being kept alive thanks to modern medicine a
Re:Thanks morons (Score:5, Interesting)
That is a problem, but this is a problem on a different scale. The issue you have in a country like India, is that it looks like a rich country, having now become the 5th largest economy in the world, but in practice due to its population only has a GDP per person of around $8000. That doesn't leave a lot of room for spending on things like education and healthcare.
So what you have is a country desperately trying to tout itself as one of the greatest, most wealthy in the world with its 5th place GDP ranking, actually being a country that has a poor education system (it's best university is number 368 in the global rankings...), and a poor healthcare system and that is densely populated. Expectations of anti-biotics stem from "but we're a rich country, look at our GDP!" coupled with poorly educated people and medical staff densely packed together. The net result is a breeding ground for these kind of superbugs.
India doesn't help itself because it decides to focus on things like space programmes and nuclear weapons programmes rather than getting the basics right, like education and healthcare.
China for all its faults at least understood this, which is why it's education and healthcare systems are much more solid than India's. Of course, I'm not defending China - China has other problems, like the fact the Chinese want to eat anything and everything and so create wet markets comprising of everything from wolf pups to dogs, sharks to pangolins, koalas to rats, and monkeys to bats and everything else in between mixed into tightly packed unsanitary wet markets. Mixing so many species from so many places which don't have immunity to each other's diseases due to never normally coming into contact with each other is why we got covid.
Frankly, we should be holding these countries to account as an incentive for them to focus on the important things. Countries like the UK for example saw strict restrictions on its farming produce as a result of CJD, yet for some reason we seem to think we have to go easy on poorer countries like India, China, etc. when they produce far more dangerous, far more costly super-bugs. Countries like the US really should've said they'd cancelling some of the debt they owe China as reparations for covid, but that for what it's worth is the real reason China tried to block and hamper investigations into the origins of covid. If it could create uncertainty as to the origins of covid, it could make it harder to take such legal action in international courts.
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You won't find bats on wet markets in China. Unless they live there under the roof ...
The super bugs are "produced" in hospitals. Not on farm land ...
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You won't find bats on wet markets in China. Unless they live there under the roof ...
Bats are not popular in China, much moreso in Indonesia, but if you want them they can get them.
https://www.aljazeera.com/news... [aljazeera.com]
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If you want them, you might be able to acquire them.
However as Chinese do not eat bats - why would one want to acquire them, and how should there be a reason to sell a species on a wet market where every animal dies after the market closes: because you can not feed them?
Makes no sense to catch a bat in a 1000km away cave, try to sell a dozen, and let the ones you can not sell die.
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The Chinese will eat anything with four legs except a table, anything that flies except a kite and anything that swims except a boat.
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Indeed. Well, the average person is a moron that understands _nothing_. But then there are the roughly 50% below average ones...
Tragedy of the commons all over. Again and again and again. Always the same crap with the human race.
Wrong address, moron. (Score:2)
To all the morons who insist on their doctors giving them antibiotics for even a minor ailment whether it'll work or not - we salute you. You've sending us back to victorian times.
I've said it before [slashdot.org] and I must say it again - the moment you hear "personal responsibility", go take a peek behind the curtain.
Generally, regardless if it is global warming, environmental pollution, systemic poverty, obesity epidemic, US school shootings, US opioid epidemic... there's a businessman behind the curtain causing the problem.
I.e. It is not an individual and their personal responsibility - it's corporations and their greed causing the issue.
Again...
70-80% of all antibiotics in the US [iccr.org] are used in
Candy (Score:4, Interesting)
Public health experts believe many doctors in India prescribe antibiotics indiscriminately.
Doctors have been giving out antibiotics like candy for so long.. The good ones won't unless it's truly a bacterial infection that needs antibiotics, but I myself have even been to doctors that, after having glanced at something on my hand for ten seconds, pronounced "Eh, it might be something, we'll give you some amoxicillin just in case".
Also for so long people were not educated on how to use them properly, the biggest issue being to take the full course and not stop just because you started to feel better.
There's at least one startup I know of that is trying to provide rapid testing of samples and allowing doctors to quickly identify the best choice of antibiotics to use. I hope they can keep up with these trends before we're in serious world of hurt.
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It tends to be one of the culture shocks for people from the US migrating to Germany or France or similar countries. That they can't just get some opiates and antibiotics whenever they feel bad.
A friend of mine was complaining about the fact his doctor didn't want to give him antibiotics "Because he didn't need them.". So a week later, when he was feeling fine again, he had to admit that he probably didn't need them after all.
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The other thing about third world counties is that some have a very strong culture of caveat emptor. There's a long history in India of companies producing substandard or adulturated drugs, and adulturation occurs at every level in the supply chain.
So if you obtain a bottle of pills marked 500mg amoxicillin, it may actually be only 50 mg. Because that's not enough (amoxicillin has a half-life of about one hour), you might take it for it for a couple-three months before giving up. The extended period of insu
All about priorities (Score:2)
or they can do research on antidepressants, to which a patients can be made addicted for a lifetime.
And now we pay the price for that choice.
True but witch hunting (Score:3)
Big Pharma is an easy target, and their unwillingness to invest in new antibiotics is, of course, well known. However when you are willing to have your savings invested in something you KNOW means that your savings won't be worth anything like as much, you can yell at Big Pharma for their choices.
PSA (Score:2)
That's one way (Score:2)
of controlling the population. Have an army of antibiotic-resistant super bugs rampaging through the second most populous country on the planet which also happens to have its population in dense packed cities.
Coming attractions (Score:2)
Coming to a theater near you soon.
No real concept of "prescription drugs" in India (Score:5, Interesting)
It's not just that "doctors prescribe antibiotics".
The concept of controlled drugs that can be dispensed only with a prescription is a joke in India. People just stroll up to the nearest neighborhood pharmacy and demand antibiotics for just about anything, and the pharmacist usually has a "doctor" in the back room who'll sign anything.
The good, or bad, thing is that most of these antibiotics are so cheap in India, that even slum-dwellers can afford them. Unlike the US, where they charge you an arm and a leg, especially if you don't have insurance.
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Unlike the US, where they charge you an arm and a leg, especially if you don't have insurance.
I don't know how much your arm and leg are worth, but antibiotics aren't the poster child for expensive US health care. I just looked up the prices for a round of the top 5 antibiotics, with and without goodrx (free discount card):
amoxicillin $6 / $6
azithromycin $8 / $24
augmentin $8 / $34
cephalexin $7 / $11
ciprofloxacin $13 / $17
For most people, the copay for the doctor's visit will be more than the cost of the drugs.
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I also ran into this in a dive shop. In the US dive equipment requires a qualification card to rent. There I ran into the attitude that if I knew what to ask for, I probably knew how to use it. I ended up not renting any equipment after I went in the back and saw the condition of their compressor. it might have been safe. I decided not to risk it.
There's the reason (Score:2)
"The reason why this is alarming is that it is a great drug to treat sepsis [a life-threatening condition] and sometimes used as a first line of treatment in hospitals for very sick patients in ICUs,"
Give a patient the antibiotic before you know if it's the best choice. Before too long the bugs will develop resistance.