Das Saurabh K, Joshi Ziyokov, Govil Deepak, Shah Mehul S, Jakaraddi Gunavathy N, Sinha Sharmili, Singhal Ankit, Krupanandan Ravikumar, Gupta Manish, Sharma Shubha, Chandankhede Shweta R, Samantaray Dharma J, Saravanabavan Lakshmikanthcharan, Gundlapally Shilpa, Kurhade Aniket A, Goyal Manish, Gupta Nupur, Jeswani Deepak R, Kumar Anil, Periwal Rakesh, Hegde Ashit, Gupta Ajay, Kaur Jasvir, Patel Sweta J, Nokewal Simranjit, Shaikh Ayesha, Karan Priyabrat, Kapalavai Sudeep K, Ahmed Meraj, Raviraj Guduru Sharab, Kolar Brinda, Jeswani Deepti, Sodhi Kanwalpreet
Department of Critical Care Medicine, Max Super Specialty Hospital, Shalimar Bagh, New Delhi, India.
Department of Critical Care, Tagore Heart Care and Hospital, Jalandhar, Punjab, India.
Indian J Crit Care Med. 2025 Jun;29(6):504-509. doi: 10.5005/jp-journals-10071-24988. Epub 2025 Jun 5.
India witnessed the exponential rise of antibiotic resistance due to the high burden of communicable disease. The Indian Council of Medical Research reported , and (PEAK organisms) as the most common gram-negative isolates, constituting 65.5% of total isolates. The present study aimed to observe the demographics and clinical outcomes of patients infected with these four common gram-negative bacteria in ICUs across India.
This prospective multicentric observational study was conducted in ICUs of 19 hospitals across India. The data collected for each patient included: demography, diagnosis, disease severity score, site of infection, PEAK organism, risk factors for multidrug resistance, antibiotic sensitivity, resistance pattern, total ventilator days, and 28-day mortality. Subgroup analysis of 28-day mortality was done for community-acquired vs hospital-acquired infection, appropriate empirical antibiotic, Carbapenem- and Colistin-resistant infections.
A total of 936 patients were included in the analysis. Resistance to Cephalosporin, Fluroquinolones, Piperacillin Tazobactam, Carbapenem, Aminoglycosides, and Colistin was observed in 84, 68, 55, 47, 37, and 4.2% of patients, respectively. The 28-day crude mortality rate was 23.5%, which was higher in the subgroup with isolates resistant to empiric antibiotics compared to those with sensitive isolates (29.6 vs 21.4%, > 0.05). Moreover, 32 and 27% mortality rates were observed in patients who were infected with Carbapenem-resistant and Colistin-resistant PEAK organisms, respectively.
The present study observed a high prevalence of antibiotic resistance in Indian ICUs, contributing to a crude mortality rate of 23.5%. Patients with Carbapenem and Colistin resistance may exhibit higher 28-day crude mortality.
Das SK, Joshi Z, Govil D, Shah MS, Jakaraddi GN, Sinha S, . Epidemiology and Clinical Outcome of Common Multi-drug Resistant Gram-negative Bacterial Infections in a Network of Hospitals in India (IMPRES): A Multicenter Intensive Care Unit-based Prospective Clinical Study. Indian J Crit Care Med 2025;29(6):504-509.CTRI identifier: CTRI/2023/01/049121.
由于传染病负担沉重，印度出现了抗生素耐药性的指数级增长。印度医学研究理事会报告称，[具体细菌名称1]、[具体细菌名称2]、[具体细菌名称3]和[具体细菌名称4]（高峰病原体）是最常见的革兰氏阴性分离株，占总分离株的65.5%。本研究旨在观察印度各重症监护病房（ICU）中感染这四种常见革兰氏阴性菌的患者的人口统计学特征和临床结局。
这项前瞻性多中心观察性研究在印度19家医院的ICU中进行。为每位患者收集的数据包括：人口统计学信息、诊断、疾病严重程度评分、感染部位、高峰病原体、多重耐药危险因素、抗生素敏感性、耐药模式、总机械通气天数和28天死亡率。对28天死亡率进行亚组分析，比较社区获得性感染与医院获得性感染、适当的经验性抗生素、对碳青霉烯类和黏菌素耐药的感染情况。
共有936例患者纳入分析。分别有84%、68%、55%、47%、37%和4.2%的患者对头孢菌素、氟喹诺酮类、哌拉西林他唑巴坦、碳青霉烯类、氨基糖苷类和黏菌素耐药。28天粗死亡率为23.5%，与敏感分离株患者相比，经验性抗生素耐药分离株亚组的死亡率更高（29.6%对21.4%，P>0.05）。此外，感染碳青霉烯类耐药和黏菌素耐药高峰病原体的患者死亡率分别为32%和27%。
本研究观察到印度ICU中抗生素耐药性普遍存在，导致粗死亡率达到23.5%。对碳青霉烯类和黏菌素耐药的患者28天粗死亡率可能更高。
达斯·SK、乔希·Z、戈维尔·D、沙阿·MS、贾卡拉迪·GN、辛哈·S等。印度医院网络中常见多重耐药革兰氏阴性菌感染的流行病学和临床结局（IMPRES）：一项基于多中心重症监护病房的前瞻性临床研究。《印度重症监护医学杂志》2025年；29(6):504 - 509。临床试验注册号：CTRI/2023/01/049121 。
