56% of those with secondary infections died: ICMR Study

NEW DELHI: A study by the Indian Council of Medical Research, released on Monday, said that there were no instances of mucormycosis (black fungus disease), in 10 hospitals where researchers tracked secondary bacterial and fungal infections in Covid-19 patients during the first wave of the pandemic.

The study was conducted between June and August last year, on 17,534 patients in 10 hospitals (Two in Delhi, two in Mumbai, one each in Vellore, Jodhpur, Bhopal, Pondicherry, Chennai, and Kolkata) and its findings are interesting at a time India is combating an unprecedented spate of black fungus cases.

The Union government said last week that there were 5,000 cases of the disease, which has a fatality of at least 50%, around the country.

According to the study, secondary bacterial and fungal infections affected around 3.6% (ranging from 1.7% to 28% between hospitals) of patients hospitalised with Covid-19 . And the mortality in patients with these secondary infections was 56.7% as against 10.6% among other hospitalised patients. The mortality in those with secondary infections was as high as 78.9% in one of the hospitals, the data showed.

“What we found was that most of these secondary infections, 78% of them, were acquired at the hospital; the indication for infections started two days after hospitalisation and most of the samples had gram negative bacteria showing that they were hospital-based infection. This could be because infection control policies at the hospitals went for a toss amid the pandemic...,” said Dr Kamini Walia, corresponding author of the paper and a scientist with ICMR’s epidemiology and communicable diseases department.

She added, “The most common pathogens causing the infection were klebsiella pneumoniae and acinetobacter baumannii; usually E coli is the most common pathogen found as per previous ICMR reports...” The study cautions about the increase in antimicrobial resistance due to excessive use of stronger medicines. Around 74.4% of the total antimicrobials prescribed in the hospitals were from the Watch and Reserve category of the World Health Organization (WHO).

WHO classifies all antibiotics in three categories – Access drugs that can treat commonly encountered pathogens and have lower resistance potential, Watch drugs that have higher resistance potential and are critical for treatment, and Reserve drugs that need to be saved as last resort.