India's Superbug Crisis: Lancet Data Misinterpreted, Says Government Body

A recent international study published in The Lancet eClinical Medicine triggered widespread worry after reports suggested that India had one of the world's highest burdens of "superbug infections." The study examined patients in India, Italy, the Netherlands and the United States and found that 83.1% of Indian patients carried at least one multi-drug resistant organism (MDRO). Many interpreted this as evidence that India is facing an unprecedented rise in drug-resistant infections.

However, the National Centre for Disease Control (NCDC) has clarified that the interpretation circulating in media reports is scientifically inaccurate and taken out of context. The figure represents colonisation, not infection. Colonisation simply means that bacteria, sometimes drug-resistant types, are present on the skin or in the gut but are not causing disease. This is common in healthcare settings worldwide and does not indicate treatment failure, rising illness or a collapse of antibiotic effectiveness.

The NCDC further notes that the study population consisted only of high-risk, hospital-exposed patients, many with chronic illnesses. Therefore, projecting these findings onto the general population is misleading. With national AMR surveillance data showing lower rates of several resistant infections compared to Western countries, officials emphasise that India is not experiencing the surge in superbug infections implied by misreported interpretations.

What the Lancet Study Actually Found

The Lancet eClinical Medicine study compared patients from India, Italy, the Netherlands and the United States and reported that 83.1% of Indian patients carried at least one multi-drug resistant organism (MDRO). Importantly, the study measured colonisation, not infection. Colonisation means bacteria are present on the body, often on the skin or in the gut, without causing illness.

According to the World Health Organization (WHO), colonisation is common among people with high exposure to healthcare facilities and does not by itself indicate treatment failure or rising infection rates.

"Colonisation Is Being Mistaken for Infection", Says NCDC

A senior official from the National Centre for Disease Control (NCDC) told reporters today that the findings have been interpreted incorrectly.

"Colonisation only indicates the presence of bacteria. It does not mean the patient is sick, nor does it indicate a superbug infection," the official clarified.

The official emphasised that the study evaluated a very specific, high-risk group of patients, that is, individuals with chronic illnesses who frequently visit hospitals and therefore naturally have higher chances of carrying harmless bacterial colonisation.

"These are not community-level data. Extending these findings to the general population is scientifically wrong and misleading," the official said.

India's Infection Rates Lower Than Western Countries, Says NCDC

Contrary to the perception created by misreported interpretations, national AMR surveillance data do not show a surge in drug-resistant infections in India. The NCDC official noted:

"Cases of Methicillin-Resistant Staphylococcus aureus (MRSA) are very low in India - about 1.4% of infections. In the U.S. and Europe, the percentage is much higher."

Similarly, the official added: "Vancomycin-Resistant Enterococci (VRE) infections in India are 7.4%. These numbers are far lower than several developed countries."

These figures align with ICMR's national antimicrobial resistance surveillance, which shows India's prevalence of several resistant infections is not the highest globally.

Why Colonisation Matters, But Should Not Trigger Alarm

Experts agree that colonisation must still be monitored because colonised patients can transmit resistant bacteria in healthcare settings. WHO and CDC guidelines recommend screening, rigorous hand hygiene and antibiotic stewardship to prevent colonisation from turning into infection or spreading to vulnerable patients.

However, NCDC stresses that this should not be misrepresented as evidence of a nationwide spike in superbug infections: "The study simply shows the presence of bacteria in a small, specific patient group. It is not proof of a national superbug crisis," the official stated.

The NCDC reiterated that India's healthcare system continues to manage AMR proactively through surveillance, stewardship programmes and improved infection control.

"Our data clearly shows that India's situation is better than that of many Western countries. Antibiotic resistance is a long-term challenge, but there is no sudden nationwide surge as some interpretations suggested."

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