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Antimicrobial resistance
India's resistance problem is at its sharpest inside hospitals, and that is where the newest evidence comes from. An Indian Council of Medical Research study of tertiary care hospitals, reported in September 2026, found most Gram-negative infections there resistant to carbapenems, the antibiotics kept in reserve for exactly such cases, and found patients carrying resistant strains likelier to die and costlier to treat.
UPSC has asked
- Prelims 2019: reasons for multi-drug resistance in microbial pathogens in India
Why Gram-negative resistance is the hard case
- The Gram stain, devised by Hans Christian Gram in the 1880s, sorts bacteria by whether their cell wall holds crystal violet.
- Gram-negative bacteria such as Escherichia coli and Klebsiella pneumoniae cause many hospital infections.
- Their outer membrane, which Gram-positive bacteria lack, keeps many antibiotics out.
- Once such a strain resists carbapenems, few medicines remain.
What has happened
2 Sep 2026
An Indian Council of Medical Research (ICMR) study of tertiary care hospitals found carbapenem resistant Gram-negative infections common, deadlier and costlier.
- Over 61 per cent of the Gram-negative infections studied were carbapenem resistant.
- Relative risk of death against susceptible strains ran 1.16 to 1.43, antibiotic cost 1.1 to 2 times.
- Over 85 per cent of bloodstream infections were healthcare associated.
- Priorities: infection prevention and control, integrated surveillance, antimicrobial stewardship and newer antibiotics.