Syllabus: GS2/Health
In News
- The landmark NeoSep1 clinical trial, funded by the GARDP Foundation has expanded to India to address escalating rates of drug-resistant neonatal sepsis.
More About the News
- The trial is especially important for India as the bacteria that cause newborn sepsis are not the same as in high-income countries.
- While Group B Streptococcus is a major cause worldwide, in India, cases are primarily driven by drug resistant Gram-negative bacteria such as Klebsiella pneumoniae, Escherichia coli, Acinetobacter and Pseudomonas aeruginosa.
- In India, it accounts for 30-40% of neonatal deaths in India with an estimated 2-2.5 lakh preventable deaths occurring annually.
About Sepsis
- Neonatal sepsis is a life-threatening bloodstream infection that occurs in babies under 90 days old, often affecting premature or low-birth-weight infants.
- It is categorised into early-onset (occurring within the first 72 hours of life) and late-onset (occurring up to 28–90 days).
- Common signs of sepsis include fever, fast heart rate, rapid breathing, confusion and body pain. It can lead to septic shock, multiple organ failure and death.
- Good hygiene, safe food practices, clean water and sanitation, vaccination, a healthy diet and breastfeeding for newborns can reduce the risk of infection and prevent sepsis.
Antimicrobial Resistance (AMR)
- It is a condition in which bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines, which include antibiotics, antivirals, antifungals and antiparasitics.
- As a result, infections become difficult or impossible to treat, increasing the risk of disease spread, severe illness, disability and death.
- It is the result of evolution of microbes in a situation where there is a misuse or overuse of antibiotics.
Factors contributing to the rise of AMR in India
- Excessive use of Antimicrobial Drugs: The irrational excessive use of antimicrobial drugs leads to the creation of resistant or extremely resistant superbugs.
- Lack of Hygiene Practices: Inadequate hygiene practices and the lack of proper infection control in hospitals and clinics, facilitate the spread of resistant bacteria.
- Lack of Proper Diagnostics: The prescription of antibiotics by doctors without proper diagnostics of the patient, relying solely on symptoms to determine the likely cause of the infection.
- Pharmaceutical waste: Pharmaceutical waste from antibiotic manufacturing can facilitate the emergence of new drug-resistant bacteria, which can spread globally and threaten our health.
- Unregulated Access to Antibiotics: An area of great concern is the unregulated access to antibiotics in the animal husbandry, dairy, and poultry sectors.
- Social & Cultural Practices of India: India’s vibrant culture of massive religious festivals (e.g., Kumbh Mela), political rallies, and large family weddings creates ultra-high-transmission environments.
Initiatives undertaken to combat AMR
- National Programme on AMR Containment: It was launched during the 12th Five Year Plan (2012-17). The main objectives of this program are:
- Establish a laboratory-based antimicrobial resistance (AMR) surveillance system in the country to generate high-quality data on antimicrobial resistance.
- Conduct surveillance of antimicrobial usage in different healthcare settings.
- Strengthen infection control practices and promote the rational use of antimicrobials through antimicrobial stewardship activities.
- Awareness through the Red Line Campaign.
- National Action Plan (NAP) on AMR: India was among the first countries to develop a comprehensive NAP on Antimicrobial Resistance in 2017.
- The plan focuses on a One Health approach, involving various stakeholder ministries and departments.
- AMR Surveillance Network: ICMR established the Antimicrobial Resistance Surveillance and Research Network (AMRSN) in 2013 to collect evidence, track trends, and identify patterns of drug-resistant infections in the country.
- Research & International Collaboration on AMR: ICMR has also initiated international collaborations to develop new drugs and strengthen medical research in AMR.
What more needs to be done?
- Regulating use of antibiotics in various sectors: Usage of antibiotics in various sectors must be regulated to address the challenge of rising antimicrobial resistance (AMR) in India.
- Governments should strictly control the use of antibiotics in poultry farms.
- India ranks top in antibiotic use across the world. Every year, we see a rise in antibiotic use, 7–8% in outpatients and 11 % in indoor patients
- Effective Sanitation & Hygiene: Awareness should be increased among the people about the importance of hygiene, as various types of infections can be prevented by improving sanitation, implementing hygienic practices, and promoting vaccination.
- Prioritise implementation of NAP on AMR: Efficient implementation of NAP-AMR should be prioritised. The suboptimal implementation of it in the absence of resources should be addressed.
- Promotion of Responsible Behaviour among Citizens and Doctors: People should be educated on the dangers of overusing antibiotics.
- Doctors must be educated to ensure appropriate use of antibiotics, saving the stronger ones for hospital based patients, and getting the patients tested to see which infection they have.
- One Health Approach: The environment plays a crucial role in the development, transmission, and spread of AMR. Therefore, the response must be based on a One Health approach, recognizing that humans, animals, plants, and the environment are interconnected and indivisible at the global, regional, and local levels.
Source :TH
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