ArticleThe Indian journal of medical research2026
Carbapenem-resistant and other multidrug-resistant organisms in a South Indian tertiary care centre: A laboratory-based study.
Article in The Indian journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and objectives Carbapenem-resistant gram-negative pathogens are associated with limited treatment options and poor clinical outcomes. This study assessed the prevalence, distribution, antimicrobial susceptibility, and clinical outcomes of multidrug-resistant organisms from intensive care units and related wards in a South Indian tertiary care hospital over three years. Methods A retrospective laboratory-based study was conducted between October 2022 to May 2025, analysed culture-positive specimens from the selected locations using hospital information system data. Multidrug-resistant organisms were defined according to international criteria. Organisms included carbapenem-resistant Enterobacterales, carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus spp., and trimethoprim-sulfamethoxazole resistant Stenotrophomonas maltophilia. Demographics, specimen distribution, antimicrobial susceptibility, and outcomes were analysed using descriptive and inferential statistics. Results Of 8,704 specimens processed, 3,450 (39.6%) were culture-positive and 750 (34.2%) were multidrug-resistant. Carbapenem-resistant Enterobacterales accounted for (n=490,65.3%) of multidrug-resistant organisms, followed by carbapenem-resistant Acinetobacter baumannii (n=85,11.3%), carbapenem-resistant Pseudomonas aeruginosa (n=85,11.3%), methicillin-resistant Staphylococcus aureus (n=40,5.3%), vancomycin-resistant Enterococcus spp. (n=34,4.5%), and trimethoprim-sulfamethoxazole-resistant S. maltophilia (n=16,2.1%). Klebsiella pneumoniae predominated among carbapenem-resistant Enterobacterales isolates. Multidrug-resistant organisms were significantly more common in intensive care units (539/750,71.9%) and among patients aged >60 y (399/750,53.2%) (P<0.05). Enterobacterales showed high resistance to cephalosporins and fluoroquinolones, while A. baumannii demonstrated limited meropenem susceptibility (18/110,16.3%). Overall mortality among patients with multidrug-resistant infections was (191/750,25.5%), with 94% (180/191) of deaths clinically attributed to infection. Interpretation and conclusions Carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii are the predominant multidrug-resistant organisms, especially in intensive care units. These highlights the urgent need for strengthened antimicrobial stewardship, infection-control practices and ongoing antimicrobial resistance surveillance.
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