Copyright thehindu
The State’s antibiogram or the antimicrobial resistance (AMR) surveillance report 2025 was released by Health Minister Veena George. The data show there is a slight dip in AMR. The annual report of 2025 depicts AMR data from January 1 to December 31, 2024, collected from 47 surveillance laboratories from 13 districts which are part of the Kerala Antimicrobial Resistance Surveillance Network (KARS-NET). Data from 55,640 unique patient isolates were analysed and included in the report. KARS-NET collects antimicrobial susceptibility testing (AST) data from 59 labs and around 185 spokes across 14 districts and is the largest State-level AMR surveillance network in the country. “In the past two years, we have brought down the sale of antibiotics over the counter by 20-30%. But this dip was a result of stringent enforcement of regulations and not because of increased awareness on AMR. Our attempt is to improve antibiotic literacy among the public so that people understand the dangers of misusing antibiotics and voluntarily desist from its improper use,” says R. Aravind, convener of the Kerala Antimicrobial Resistance Strategic Action Plan (KARSAP). Effective surveillance of antimicrobial resistance is possible only through systematic data collection and analysis, from which resistance patterns and trends can be evolved. The resistance patterns help clinicians make informed decisions regarding treatment and help health authorities design targeted interventions. KARS-Net at present includes surveillance of AMR in nine key priority pathogens responsible for high antibiotic resistance rates among bacteria that commonly cause human infections. The nine priority pathogens monitored by KARS-NET are Staphylococcus aureus, Enterococcus species, Klebsiella species, Escherichia col, Acinetobacter species, Pseudomonas species, Salmonella enterica serovar Typhi and Paratyphi, Shigella species, and Vibrio cholerae E. coli was the most common priority pathogen isolated from OPD (47%), IPD (36%) and ICU (31%) settings in 2024 and similar pathogen burden in respective location types were seen in the previous year also. Similar rates of MRSA among the S. aureus isolates from blood was noted in 2024 (32%), compared to the previous year (33%). Enterococcus spp. isolated from blood cultures showed 3% resistance to Vancomycin similar to the previous year. About 9% of E. coli and 43% of Klebsiella spp. isolated from blood were found to be resistant to Carbapenems, a class of broad spectrum antibiotics often used as a last resort for difficult infections. Trends of AMR The trends of AMR in Kerala over five years from 2018 show that ESBL production (Extended-Spectrum Beta-Lactamase, which are enzymes produced by some bacteria that make certain antibiotics ineffective) as well as Carbapenem resistance has been increasing over the years except for E. coli. ESBL-producing bacteria pose a significant public health threat, especially in healthcare settings, and require strict hygiene and infection control measures to prevent their spread. ESBL was observed in 71% of E. coli and 68% of Klebsiella spp. isolated from blood. About 9% of E. coli and 43% of Klebsiella spp. isolated from blood were found to be resistant to Carbapenems, a class of broad spectrum antibiotics often used as a last resort for difficult infections. Slight increases in MRSA rates were observed during the past year. But the VRE (Vancomycin-Resistant Enterococci) rates have shown a decreasing trend Despite the relatively high resistance levels amongst Gramnegatives isolates in general, the overall resistance to Colistin (a last resort antibiotic used to treat severe infections caused by multi-drug-resistant gram negative bacteria) in gram negative isolates was only 0.2%.
