1 September 2026 Punjab Khabarnama Bureau : A major study across 20 tertiary-care hospitals in India has found that infections caused by antibiotic-resistant bacteria are associated with higher mortality and substantially higher treatment costs than infections caused by drug-susceptible strains.
The study, conducted between April 2022 and April 2025, analysed data from 159,336 hospitalised patients, including 26,213 patients with confirmed gram-negative bacterial infections. Of these infections, 61.1% were resistant to carbapenem antibiotics, highlighting the growing challenge of antimicrobial resistance in India.
Resistant Infections Linked to Higher Death Rates
Researchers found higher mortality among patients infected with carbapenem-resistant strains of four major bacteria: E. coli, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa.
For E. coli infections, 24.4% of patients with carbapenem-resistant infections died, compared with 17.3% among those with susceptible infections.
For K. pneumoniae, mortality was 31.2% in the resistant group versus 23.5% in the susceptible group. The corresponding figures were 37.9% versus 32.8% for A. baumannii and 28.9% versus 20.2% for P. aeruginosa.
Bloodstream Infections Particularly Dangerous
The mortality gap was especially concerning when resistant bacteria caused bloodstream infections.
Among patients with carbapenem-resistant bloodstream infections, mortality ranged from 39.3% for E. coli to 50.8% for A. baumannii. Mortality was 44.8% for K. pneumoniae and 46.4% for P. aeruginosa.
More than 85% of bloodstream infections involving the four bacteria were classified as healthcare-associated, underscoring the importance of hospital infection-control measures.
Treatment Costs Can Be Twice as High
The financial burden was also significantly higher for resistant infections.
The average antibiotic cost for a carbapenem-resistant E. coli infection was around ₹39,846 per patient, compared with ₹20,034 for a susceptible infection.
For K. pneumoniae, the figures were ₹55,688 versus ₹47,918. Treatment of resistant A. baumannii cost around ₹62,150 compared with ₹41,372, while resistant P. aeruginosa treatment cost about ₹66,599 versus ₹48,392.
Overall, antibiotic costs for carbapenem-resistant infections were approximately 1.1 to two times higher than for susceptible infections.
However, the researchers noted that these figures cover antibiotic costs alone and exclude hospital beds, diagnostic tests, doctors’ fees and supportive care. The actual financial burden can therefore be considerably higher.
Longer Hospital Stays Add to the Burden
Antimicrobial resistance can make infections harder to treat because doctors have fewer effective antibiotics available.
An earlier multicentre Indian cohort study also found that resistant infections were associated with greater treatment costs and longer hospital stays. In its prospective component, the median hospital stay was 23 days for resistant infections compared with 12 days for susceptible infections.
Families Can Face Financial Stress
The economic impact of antimicrobial resistance can extend beyond the hospital bill.
In the earlier cohort study, 46.5% of patients in the prospective component reported borrowing money to meet hospitalisation expenses, while 33.1% of families reported using savings.
This highlights how drug-resistant infections can create both a medical and financial burden for Indian households.
Why Carbapenem Resistance Matters
Carbapenems are important antibiotics used to treat serious bacterial infections.
When bacteria develop resistance to these drugs, treatment becomes more difficult and clinicians may have to rely on alternative medicines that can be less effective, more expensive or associated with additional complications.
The latest findings therefore underline the need for appropriate antibiotic use, stronger laboratory surveillance and effective infection prevention and control.
Study Highlights Need for Stronger Surveillance
Researchers cautioned that the mortality estimates should not be interpreted as the exact number of deaths that could be prevented by eliminating antibiotic resistance.
Factors such as the severity of illness, the timing of effective treatment and other clinical characteristics could not be fully accounted for in the analysis.
A Growing Public Health Challenge
Antimicrobial resistance is increasingly recognised as a major threat to healthcare systems because common infections can become harder and more expensive to treat.
The Indian findings provide patient-level evidence of the consequences of resistance, showing that the problem is not limited to laboratory reports of resistant bacteria but can directly affect survival, hospital stays and treatment costs.
Need for Prevention and Responsible Antibiotic Use
The findings strengthen the case for preventing infections before they become difficult to treat.
Hospitals can reduce the spread of resistant organisms through effective infection-control practices, while healthcare providers and patients can help slow resistance by using antibiotics appropriately and only when medically indicated.