ICMR Study of 20 Hospitals Finds Drug-Resistant Infections Kill and Cost More

A new study by the Indian Council of Medical Research (ICMR) has highlighted the growing burden of antimicrobial resistance (AMR) in India. Conducted across 20 tertiary-care hospitals, researchers analysed the medical records of nearly 1.6 lakh hospitalised patients between April 2022 and April 2025, examining infections caused by four major Gram-negative bacteria: Escherichia coli (E. coli), Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa. The findings, published in The Lancet Regional Health – Southeast Asia, found that among 26,213 patients with confirmed infections from these bacteria, 61.1% had infections resistant to carbapenem antibiotics.

Carbapenem-resistant infections consistently resulted in higher mortality than drug-sensitive ones. For Klebsiella pneumoniae, mortality reached 31.2% among patients with resistant infections compared with 23.5% for susceptible infections; for E. coli it was 24.4% versus 17.3%; for Acinetobacter baumannii, 37.9% versus 32.8%; and for Pseudomonas aeruginosa, 28.9% versus 20.2%. The most severe outcomes occurred in carbapenem-resistant infections overall, with mortality rates ranging from 46.4% to 50.8%.

Drug-resistant infections also cost more to treat, ranging from 1.1 to 2 times higher than susceptible infections: treatment for drug-resistant E. coli averaged $420 per patient compared with $211 for susceptible infections, $587 versus $505 for K. pneumoniae, $655 versus $436 for A. baumannii, and $702 versus $510 for P. aeruginosa. Patients with resistant E. coli infections also stayed in hospital longer, an average of 23.1 days compared with 17.8 days for susceptible infections. "Antimicrobial resistance is already having a significant impact on patients and healthcare in India," said Dr. Kamini Walia, senior scientist at ICMR and an author of the study.

Researchers stressed that developing or prescribing stronger antibiotics alone will not solve the AMR crisis; effective management requires better infection prevention, timely diagnosis and responsible antibiotic use, since inappropriate use can eliminate susceptible bacteria while letting resistant ones survive and multiply. ICMR has monitored AMR through its Antimicrobial Resistance Surveillance and Research Network since 2013 and is now focusing on strengthening surveillance, infection prevention and rapid diagnostics, while also exploring alternative treatments such as bacteriophages and monoclonal antibodies.