The Union health ministry plans to expand its surveillance for drug-resistant pathogens to secondary care hospitals across the country, people familiar with the matter said, a move meant to head off the growing threat from diseases that are becoming harder to treat.
Till now, random testing of samples for anti-microbial resistance (AMR) is limited to big hospitals in cities, or tertiary care facilities. According to a person aware of the details, the Indian Council of Medical Research (ICMR) will spearhead a new effort to expand AMR surveillance to smaller hospitals, reaching into grassroots locations.
AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness and death.
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The emergence of AMR has been seen as a major public health crisis in India and worldwide. According to World Health Organisation (WHO), AMR led to death of close to 5 million people globally in 2019; and if no action is taken, AMR could cost the world’s economy US $100 trillion by 2050.
“ICMR has taken the initiative to address this gap by establishing Antimicrobial Resistance Surveillance and Research Network (AMRSN) and implementing antimicrobial stewardship (AMS) programmes in tertiary care hospitals. Like ICMR, other antimicrobial surveillance and stewardship programmes being undertaken in the country have also been limited to tertiary care hospitals. Hence, the data collected through these initiatives do not adequately reflect the comprehensive picture of AMR in the country, particularly from community healthcare settings. Hence, it’s crucial to extend the reach of the existing initiatives to secondary care settings,” read an ICMR document on the new initiative. HT has seen the document.
{{/usCountry}}“ICMR has taken the initiative to address this gap by establishing Antimicrobial Resistance Surveillance and Research Network (AMRSN) and implementing antimicrobial stewardship (AMS) programmes in tertiary care hospitals. Like ICMR, other antimicrobial surveillance and stewardship programmes being undertaken in the country have also been limited to tertiary care hospitals. Hence, the data collected through these initiatives do not adequately reflect the comprehensive picture of AMR in the country, particularly from community healthcare settings. Hence, it’s crucial to extend the reach of the existing initiatives to secondary care settings,” read an ICMR document on the new initiative. HT has seen the document.
{{/usCountry}}“Lots of infections in India are becoming resistant to antibiotics. If antibiotics do not work anymore, bacterial infections will spread easily, adding a huge burden to the public health,” the Delhi Pharmaceutical Trust, which works in spreading awareness about AMR and overall consumer education in the country, said in a statement on Friday.
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The new project will involve identifying tertiary care hospitals working with secondary level public and private sector hospitals to mentor, support and guide them in building capacity for AMR surveillance, infection prevention and control (IPC) and AMS. The smaller hospitals will also be trained in how to monitor the implementation of these protocols and will also be aided in implementing data quality mechanisms and determining pathways of care for patients with certain infectious conditions or syndromes.
At present, the challenge lies in secondary care hospitals not being well-equipped to document patterns of local antibiograms and monitoring antibiotic usage due to factors such as lack of good clinical microbiology lab and absence of skilled staff.
“By using this approach, ICMR aims to address the challenge of fewer resources and expertise, the absence of antibiogram data due to limited access to microbiological support, absence of trained ID physicians etc in secondary level hospitals. The overarching objective is to expand the surveillance efforts and extend IPC and AMS interventions to secondary-care settings and also try to understand the care-seeking pathways for patients between secondary and tertiary level hospitals,” the document said.
ICMR will provide a centralised platform for data collection to ensure real time monitoring and track progress of data. It is in the process of selecting researchers who will be invited to develop a full research proposal and roll out the research project under the guidance of ICMR.