Image used for representation
The National Centre for Disease Control (NCDC) has refuted claims made in an international study published by The Lancet that over 50% of Indian patients hospitalised for a specific gastrointestinal procedure are colonised with at least one multi-drug-resistant organism (MDRO).
The study has raised alarm over soaring antimicrobial resistance in India, describing it as a rapidly escalating superbug crisis and a “global threat”.
In response, the NCDC, which is mandated to prevent, detect, and control diseases of public health importance in India, pointed out that The Lancet dataset only reports colonisation of multi-drug-resistant organisms, not actual infections.
“Colonisation is a microbiological finding, but not a clinical failure,” it said, adding that the results refer to specific high-risk clinical groups and cannot be generalised for all patients or the general population in India.
Patients with comorbidities
The research paper, published in The Lancet’s journal eClinicalMedicine, is titled Preprocedural screening for multidrug-resistant organisms in endoscopic retrograde cholangiopancreatography (ERCP): an international, multicentre, cross-sectional observational study’. An ERCP is an endoscopic procedure used to diagnose and treat problems in the gall-bladder, the bile ducts, and the pancreas. The study screened more than 1,200 patients across four countries — India, Italy, the Netherlands, and the United States.
Sources in the NCDC explained that these findings pertain to a highly specific group of patients who already have multiple comorbidities, frequent healthcare exposure, and higher antibiotic use. They cannot be generalised to the broader Indian population or to routine healthcare scenarios, they emphasised.
Lower MRSA, VRE infections
The study also indicates that India recorded significantly lower prevalence of methicillin-resistant Staphylococcus aureus (MRSA) (1.4%) and vancomycin-resistant Enterococci (VRE) (7.4%), in comparison to the U.S. and parts of Europe, signalling the effectiveness of containment strategies for gram-positive infections in the country.
Experts further pointed out that the study does not report higher ERCP-associated infection or mortality risk among Indian patients, reinforcing that high colonisation rates do not necessarily translate into adverse clinical outcomes.
The NCDC experts added that certain comparisons drawn between India and countries with lower infectious disease burdens may not reflect contextual realities. “Microbial resistance trends vary across regions and must be understood considering differential population density, morbidity patterns, and healthcare access. The study itself recommends region-specific prevention strategies,” an expert noted.
‘Cannot link to antibiotic usage’
Sources in the NCDC also cautioned against linking the findings to alleged excessive antibiotic use in India, clarifying that cross-sectional studies, such as the current one, cannot establish causation. Moreover, the study does not assess or report community-level spread of MDR organisms.
NCDC experts reiterated the importance of interpreting such scientific data within the clinical context. “While antimicrobial resistance remains a global concern, this study should not be misrepresented as a marker of systemic failure. The findings underscore the need for continued surveillance, infection control, and stewardship, not alarmism.”
Published – November 19, 2025 07:07 pm IST
Leave a Reply