Study of swab samples suggests 83 per cent patients in India could be carrying drug-resistant bugs

An analysis of swab samples taken from patients before they underwent an endoscopy has suggested that about 83 per cent of patients in India could be carrying multidrug-resistant organisms.

Rectal and throat-nose swabs were collected between January 2022 and October 2024 from 1,244 patients in tertiary health care centres in the Netherlands, India, Italy, and the US.

Overall, 462 or 37 per cent carried a multidrug-resistant organism. Of the nearly 350 patients screened in India, 290 or 83.1 per cent were found to harbour a multidrug-resistant organism.

“Prevalence was highest in India (290 of 349, 83.1 per cent) and lowest in the Netherlands (37 of 343, 10.8 per cent), with intermediate rates in Italy (66 of 209, 31.5 per cent) and the United States (69 of 343, 20.1 per cent),” authors wrote in the study published in the eClinicalMedicine journal.

The findings show how rates of prevalence of multidrug-resistant organisms in an individual vary globally and reflect underlying differences in antimicrobial resistance, they said.

‘Extended-spectrum beta-lactamase-producing Enterobacterales’ (ESBLE-E), known to be resistant to common antibiotics, was found to be the most prevalent among the patients in India, while MRSA—another “superbug”—was detected primarily among the patients in the US.”

According to the analysis, a patient in India might be about 100 times more likely to harbour a multidrug-resistant organism, while one in Italy might be 6.6 times more likely, compared to a patient in the Netherlands.

Other risk factors that significantly contributed to one’s likelihood of carrying a multidrug-resistant organism included having conditions such as chronic lung disease or congestive heart failure, or a history of taking penicillins.

Endoscope-related spread of multidrug-resistant organisms should be tailored to local patterns of antibiotic resistance, rather than adopting a universal approach, the researchers said.

Screening before a medical procedure and targeted strategies for preventing infection should be included within a broader, region-specific infection control framework, they added.