India is stepping up its fight against antimicrobial resistance (AMR). For the first time, a standard operating procedure will be rolled out for hospitals to not only map drug-resistant infections acquired during hospital treatment, but also bring down infection rates.
In events coincidentally placed within 10 days of each other, the Centre signed a letter of intent with Japan to collaborate on research on AMR on April 16, even as microbiologists from six major hospitals of the country are scheduled to meet in Delhi this week to deliberate on the roadmap to tackle AMR.
These six facilities — PGI in Chandigarh, JIPMER in Pondicherry, AIIMS in Delhi, CMC in Vellore, PD Hinduja in Mumbai, and Assam Medical College in Dibrugarh — which are known for their effective infection-control mechanism will at a later stage go on to help build capacities in smaller hospitals.
“The ICMR had released infection-control guidelines earlier this year,” said Dr Kamini Walia, deputy director, ICMR, and lead investigator from India’s side for the collaboration. “We want to apply these in each hospital. Also, as part of the agreement with Japan, we will be bringing in practices of JANIS (Japan Nosocomial Infections Surveillance), a network of 1,600 hospitals across Japan, to bring down hospital-acquired infections in India.”
The US government had last year given a funding of $8 million through Centres for Disease Control and Prevention (CDC) for a project, ‘Capacity building and strengthening of hospital infection control to detect and prevent antimicrobial resistance in India. This project is being jointly executed by CDC, ICMR and AIIMS.
“AIIMS has been developing a module, a standard operating procedure [to tackle AMR]. The idea is to develop a network of quality-assured labs,” said Dr Purva Mathur, principal investigator of the CDC-funded project. Dr Mathur said CMC Vellore will develop an antibiotic stewardship programme, while AIIMS, Hinduja and JIPMER will start the surveillance work on blood stream infections in hospital settings. PGI Chandigarh will take the lead in the laboratory assistance and strengthening systems. This is the first meeting as part of the project.
Dr Mathur said that AIIMS already has an SOP, which will be released in the meeting: “This is the first SOP that has been made, using which the methodology regarding defining a case or recording a case will be streamlined. We will also release an infection control manual.” Critically, a standard procedure to calculate infection rates will be given out. “Hospital-acquired infection varies from one hospital to another. Now, a systematic way will be followed of defining an infection rate. AIIMS is developing a central software for everyone to pool the data – which will work as a national registry.”
The ICMR has been on the resistance trail since 2014 when it set up six nodal centres in four hospitals to record and report drug resistance.
