Supporting Microbiology Services in India

Building on Ivor Mitchelmore’s (Chief Biomedical Scientist (Retired) Luton & Dunstable University Hospital), long-standing work at Khristiya Seva Niketan Hospital (KSN) Hospital in rural West Bengal, Ivor and David Westrip recently returned together to take the next step in developing the hospital’s microbiology service. With support from Mast Group, who have been involved since Ivor reached out to diagnostic companies in 2020, the latest trip focused on setting up antimicrobial resistance (AMR) testing. It was another practical and positive step towards strengthening local laboratory services and supporting safer, more informed treatment for the communities served by KSN Hospital.

Antimicrobial resistance is of significant global concern and in the literature, India is frequently highlighted as an area of concerningly high resistance levels. The reasons for this are well documented but one thing which is not always easy to determine from the available data is more regional and local resistance patterns. Whilst national data is available few studies have looked at regional or local resistance patterns. Even within the UK carbapenem resistance in Gram negatives seems of higher prevalence in large urban populations and much lower in remote or rural communities. India is approximately 13 times larger and is considerably more geographically and socially diverse

In 2025 I visited as part of a small group and with the generous support of MAST was able to collaborate with the local technical staff to introduce some screening for resistance mechanisms. Using the Mast D72 and D73 discs we initially tested 45 isolates derived from urine cultures to assess the predominant resistance patterns in the local population. From this initial testing we were able to determine that around 38% (17/45) exhibited some form of resistance mechanism the overwhelming majority of which was AmpC (13/17). Other findings including ESBL (2/17) carbapenemase activity (1/17, confirmed as NDM) and ESBL/AmpC co-expression (1/17).

Through collaboration with the local staff, we were able to provide training in this new method and introduce it into routine use. Using Meropenem and Cefpodoxime discs as an initial screen for resistance and then confirming using the D72 and D73 discs we were able to introduce a sustainable and reliable method to provide better susceptibility data to the medical staff. It’s true that the numbers in this study were small and only represent a small snapshot of the situation. Nonetheless, it provided useful data which we were able to feed directly back to the medical teams which will allow them to make more informed prescribing decisions.