0.1 Why in News

0.1.1 Rising antimicrobial resistance (AMR) has reduced the effectiveness of commonly used antibiotics.
0.1.2 AIIMS, New Delhi is leading India’s response against drug-resistant infections (superbugs) through research, diagnostics, and surveillance.

0.2 Antimicrobial Resistance (AMR): Key Facts

0.2.1 AMR occurs when bacteria evolve mechanisms to survive antibiotics meant to kill them.
0.2.2 AMR is projected to cause 10 million deaths globally by 2050.
0.2.3 In India, AMR was linked to 2.97 lakh deaths in 2019.
0.2.4 India is among the largest consumers of antibiotics, increasing resistance risk.

0.3 Institutional Role of AIIMS

0.3.1 AIIMS is running 15 research projects focused on resistance patterns and diagnosis.
0.3.2 AIIMS is the nodal centre for the Antimicrobial Resistance Surveillance Network (AMRSN).
0.3.3 AIIMS hosts an ICMR-designated Infectious Disease Research & Diagnostic Laboratory (IRDL).

0.4 Reducing Blind Antibiotic Use

0.4.1 Blind / empirical antibiotic use means starting antibiotics before identifying the exact bacteria.
0.4.2 This is common in emergencies but increases unnecessary antibiotic exposure.
0.4.3 AIIMS aims to speed up diagnosis so doctors can shift early to pathogen-specific treatment.

0.5 Preventing Sepsis Early (Clarified)

0.5.1 Sepsis is a life-threatening condition caused by the body’s extreme response to infection.
0.5.2 Delay in diagnosis can rapidly lead to organ failure and death.
0.5.3 AIIMS is identifying site-specific biomarkers to confirm whether infection is bacterial.
0.5.4 If no bacteria are detected, unnecessary antibiotics can be avoided.
0.5.5 Challenge: False-negative tests (infection present but not detected) → improved detection under development.

0.6 Improving Diagnosis

0.6.1 Biomarker-based diagnostics help identify infections faster than culture methods.
0.6.2 Focus on VBNC bacteria (Viable But Non-Culturable) → bacteria that are alive but cannot grow in labs.
0.6.3 Detecting VBNC bacteria helps avoid misdiagnosis and overtreatment.
0.6.4 Some E. coli strains require specialised molecular tests for accurate identification.

0.7 ESKAPE Pathogens (Explained)

0.7.1 ESKAPE pathogens are a group of bacteria that “escape” the effects of multiple antibiotics.
0.7.2 They are a major cause of hospital-acquired and drug-resistant infections.
0.7.3 Includes:
   0.7.3.1 Klebsiella pneumoniae
   0.7.3.2 Acinetobacter baumannii
   0.7.3.3 Pseudomonas aeruginosa
0.7.4 These pathogens are becoming increasingly resistant in India.

0.8 Testing New Antibiotics

0.8.1 AIIMS is generating India-specific data on antibiotic effectiveness.
0.8.2 Antibiotics being evaluated include:
   0.8.2.1 Eravacycline
   0.8.2.2 Omadacycline
   0.8.2.3 Plazomicin
   0.8.2.4 Sulbactam-Durlobactam
0.8.3 Objective: guide rational and evidence-based prescribing.

0.9 Non-Antibiotic Innovations

0.9.1 Quorum sensing is how bacteria communicate using chemical signals.
0.9.2 Quorum sensing inhibitors block this communication.
0.9.3 This prevents bacteria from acting together (e.g., biofilm formation).
0.9.4 Agents under study: furanone, metal-based compounds, gallium nitrate.
0.9.5 CRISPR-Cas9 is being explored to remove resistance or virulence genes from bacteria.

0.10 Infection Control Measures

0.10.1 Drug-resistant infections often emerge in ICUs due to heavy antibiotic use.
0.10.2 Strong hospital hygiene and infection control reduce spread.
0.10.3 Antimicrobial stewardship ensures antibiotics are used only when necessary.