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High Burden of Antimicrobial Resistance and Mortality Among Adults and Children With Community-Onset Bacterial Infections in India

TitleHigh Burden of Antimicrobial Resistance and Mortality Among Adults and Children With Community-Onset Bacterial Infections in India
Publication TypeJournal Article
Year of Publication2017
AuthorsMave, V, Chandanwale, A, Kagal, A, Khadse, S, Kadam, D, Bharadwaj, R, Dohe, V, Robinson, ML, Kinikar, A, Joshi, S, Raichur, P, McIntire, K, Kanade, S, Sachs, J, Valvi, C, Balasubramanian, U, Kulkarni, V, Milstone, AM, Marbaniang, I, Zenilman, J, Gupta, A
JournalJ Infect Dis
Volume215
Pagination1312-1320
Date PublishedApr 15
ISBN Number0022-1899
Accession Number28329303
Keywordsantimicrobial resistance, clinical isolates, community onset, India.
Abstract

Background.: In India, antimicrobial consumption is high, yet systematically collected data on the epidemiology, risk factors, and outcomes of antimicrobial-resistant infections are limited. Methods.: A prospective study of adults and children hospitalized for acute febrile illness was conducted between August 2013 and December 2015. In-hospital outcomes were recorded, and logistic regression was performed to identify independent predictors of community-onset antimicrobial-resistant infections. Results.: Among 1524 patients hospitalized with acute febrile illness, 133 isolates were found among 115 patients with community-onset infections; 66 isolates (50.0%) were multidrug resistant and, of 33 isolates tested for carbapenem susceptibility, 12 (36%) were resistant. Multidrug-resistant infections were associated with recent antecedent antibiotic use (adjusted odds ratio [aOR], 4.17; 95% confidence interval [CI], 1.19-19.7) and were independently associated with mortality (aOR, 6.06; 95% CI, 1.2-55.7). Conclusion.: We found a high burden of community-onset antimicrobial-resistant infection among patients with acute febrile illness in India. Multidrug-resistant infection was associated with prior antibiotic use and an increased risk of mortality.