Over 45% eye infection bacteria drug-resistant, study flags AMR threat

Hyderabad: A joint study by CSIR-Centre for Cellular and Molecular Biology (CCMB) and LV Prasad Eye Institute (LVPEI) has flagged a worrying rise in antimicrobial resistance (AMR) in eye infections, with more than 45% of bacterial isolates from patients found to be multidrug-resistant.The study, published in ‘Communications Biology', also reported widespread resistance to fluoroquinolones across all pathogens examined, raising concerns over current treatment approaches in ophthalmic care. Researchers described the work as one of the most comprehensive genomic analyses of eye pathogens from India to date. The study was led by Karthik Bharadwaj and Divya Tej Sowpati from CCMB and Dr Joveeta Joseph from LVPEI. While CCMB handled genomic and bioinformatics analysis, LVPEI contributed clinical expertise, patient samples and microbiological characterisation. "To understand and solve a problem like AMR, it is essential for clinicians and scientists to come together and contribute through their expertise. This is not a problem to be solved with model organisms but rather with real patient samples," said Dr Vinay K Nandicoori, director, CSIR-CCMB. The team isolated bacteria from patient samples and tested them against commonly used antibiotics. "We found samples with vancomycin-resistant Staphylococcus aureus and extensively drug-resistant (XDR) Klebsiella pneumoniae strains involved in eye infections. These findings are worrying because they can spread their AMR genes to other bacteria too. Also, these pathogens can infect other parts of our bodies," said Bharadwaj. Whole-genome sequencing helped identify new resistance mechanisms and mutations, offering deeper insight into how these pathogens evolve and spread.Researchers said the high prevalence of resistance makes such an approach increasingly unreliable. The study underscores the need for microbiology-guided diagnosis and treatment, particularly in severe infections such as microbial keratitis and endophthalmitis. "While genomic tools are not yet part of routine clinical workflows, the insights generated through this study provide a critical foundation for developing region-specific treatment guidelines and strengthening antimicrobial stewardship efforts in ophthalmology," said Dr Joseph, head of microbiology at LVPEI. Researchers also stressed that eye infections should not be viewed in isolation. The microbes involved often originate from the skin or environment, linking ophthalmic infections to the broader AMR burden. "This study positions eye as a valuable site for AMR surveillance in the environment around us," said Dr Prashant Garg, executive chair, LVPEI.