A Comprehensive Assessment of the Antimicrobial Resistance and Antibiogram Profiles in Healthcare Settings Among the Indian Population

Background:

Antimicrobial resistance is a critical global concern, impacting patient outcomes and healthcare costs. This study evaluates antibiogram data and resistance patterns among various sample cultures from a tertiary care center in India.

Methods:

A prospective cross-sectional study was conducted for the period of 2023 to 2025. Bacterial isolates from urine, blood, respiratory, and exudate cultures were identified using biochemical tests. The Kirby–Bauer disc diffusion method, which was recommended by CLSI's 2023 guidelines, was used to test for antibiotic susceptibility. The resistance patterns were analyzed for MRSA, ESBL, carbapenems, vancomycin, linezolid, tigecycline, and colistin. To look at the trends in resistance, antibiogram data were grouped for Gram-negative (E. coli, Klebsiella, Pseudomonas, Enterobacter, Morganella, Acinetobacter, and Proteus) and Gram-positive pathogens (Enterococcus, Staphylococcus, and CONS).

Results:

Among the Gram-negative bacteria, ESBL-producing E. coli (56%) and Klebsiella pneumoniae (62%) were predominant in the urine cultures, with K. pneumoniae showing 24% carbapenem resistance. The blood cultures showed that K. pneumoniae was resistant to 56% ESBL and 40% carbapenem. On the other hand, the respiratory cultures showed that Enterobacter spp. were resistant to ESBL the most (93.4%). The exudate cultures showed E. coli (75%) and K. pneumoniae (56%) with significant ESBL resistance. Among the Gram-positive bacteria, MRSA was found in 35.3% of blood infections and 27.3% of respiratory cultures. MRCONS exhibited 53.58% resistance in the blood, and VRE was detected in 9.1% of bloodstream infections. The antibiogram data showed that E. coli was highly susceptible to amikacin (93%) and imipenem (94%) in the urine, and Pseudomonas spp. were still highly susceptible to polymyxin B (100%) but not to ceftazidime (88%).

Conclusions:

This study shows that antimicrobial resistance is rising at an alarming rate, especially in bloodstream infections caused by ESBL-producing E. coli and K. pneumoniae, carbapenem-resistant Acinetobacter spp., and MRSA. These findings emphasize the need for stringent antibiotic stewardship to mitigate resistance spread, especially in developing countries.