Lancet Study Finds Extremely High MDRO Carriage in Indian ERCP Patients

Overview

• Across four countries, 83.1% of Indian ERCP patients carried at least one multidrug‑resistant organism, compared with 31.5% in Italy, 20.1% in the United States, and 10.8% in the Netherlands.
• Among Indian patients, ESBL‑producing Enterobacterales were detected in 70.2% and carbapenemase‑producing Enterobacterales in 23.5%, indicating substantial resistance to commonly used and last‑line antibiotics.
• India recorded lower rates of MRSA (1.4%) and VRE (7.4%) than the United States and parts of Europe, reflecting variation in resistance patterns by organism.
• India’s National Centre for Disease Control said the study measured colonisation in a tertiary‑care, high‑risk group and should not be generalised to the wider population or interpreted as evidence of higher ERCP‑related infections.
• Study authors urge region‑specific measures such as preprocedural screening, antimicrobial stewardship, and consideration of single‑use duodenoscopes in high‑risk settings, noting elevated risk with chronic lung disease, heart failure, and prior penicillin use.