Antimicrobial resistance

Microorganisms can develop resistance to antimicrobial medicines like antibiotics, antifungal and antiparasitic drugs, rendering treatments ineffective. Antimicrobial resistance (AMR) makes routine infections harder to treat, increases the risk of severe illness and death, and facilitates the emergence and spread of drug-resistant pathogens.

With AMR projected to cause up to 10 million deaths annually by 2050^[1], understanding its burden, transmission patterns, and drivers is critical for designing effective prevention and control strategies.

How we address this challenge

Our aim is to generate evidence-based estimates of AMR burden in India to support context-specific interventions. To achieve this, we are developing methods to estimate AMR burden at the health facility level, providing evidence to inform antimicrobial stewardship, infection prevention strategies, and empirical treatment guidelines.

• Integrating isolate-level microbiology, clinical, and patient outcome data from participating hospitals.
• Applying the Global Burden of Disease (GBD) counterfactual framework to estimate deaths attributable to and associated with resistant infections.
• Profiling antimicrobial resistance across major pathogen-drug combinations.
• Quantifying the proportion of AMR burden that could potentially be averted through targeted interventions.

Ongoing work

We have integrated isolate-level microbiology, clinical, and patient outcome data across participating hospitals to enable consistent estimation of AMR burden at the health facility level. Using the Global Burden of Disease (GBD) counterfactual framework, we have quantified facility-specific mortality attributable to and associated with drug-resistant infections, disaggregated by pathogen, syndrome, and patient subgroup. We have also estimated the prevalence of resistance across multiple pathogen-drug combinations and characterised resistance patterns in major pathogens. To better quantify the public health impact of AMR, we have developed methods to estimate the avertible burden of resistant infections and built a modular disability-adjusted life year (DALY) estimation pipeline that incorporates stepwise sensitivity analyses to improve the robustness of burden estimates. Our analytical framework is available as an open source R package ‘anumaan’ that supports AMR burden estimation and related analyses.

References

1. World Health Organization. (2023, November 21). Antimicrobial resistance.
   https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
2. Jayaprakasan, A. K., Ghosh, A., Banerjee, B., Singh, M. M., & Solanki, H. K. (2025). Growing burden of antimicrobial resistance and the need for effective stewardship: An Indian perspective. One Health Bulletin, 5(4), 158-164. https://doi.org/10.4103/ohbl.ohbl_10_25