NCDC refutes Lancet AMR study, says high colonisation not infection risk

The National Centre for Disease Control (NCDC) has refuted claims made in an international study published by The Lancet that over 80 per cent of Indian patients hospitalised for a gastrointestinal procedure are colonised with at least one multi-drug-resistant organism (MDRO).

The study had stated that it found 83.1 per cent of Indian endoscopic retrograde cholangiopancreatography (ERCP) patients were colonised with MDROs, the highest rate among the 1,200 patients studied across four countries — India, Italy, the Netherlands and the United States.

An ERCP is an endoscopic procedure used to diagnose and treat problems in the gall bladder, the bile ducts and the pancreas.

What is the NCDC’s response to the colonisation findings?

In response, official sources in the NCDC pointed out that The Lancet dataset only reports colonisation of multi-drug-resistant organisms, not actual infections. They added that colonisation is a microbiological finding, but this does not imply clinical infection or treatment failure.

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 routine healthcare scenarios,” they added.

How does India compare with global drug-resistant infection rates?

The NCDC experts added that certain comparisons drawn between India and countries with lower infectious disease burdens may not reflect contextual realities.

The Lancet study indicates that India recorded significantly lower prevalence of drug-resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) at 1.4 per cent and vancomycin-resistant enterococci (VRE) at 7.4 per cent, in comparison to the US and parts of Europe, signalling the effectiveness of containment strategies for gram-positive infections in the country.

Does high colonisation translate to worse clinical outcomes?

“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,” it added.

NCDC experts said that while antimicrobial resistance remains a global concern, the 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,” they said.