Kerala is facing a rapidly worsening antimicrobial resistance (AMR) crisis, according to the latest data released by the Kerala Antimicrobial Resistance Surveillance Network (KARSNET) for 2025. The report paints an alarming picture of drug-resistant infections that have moved beyond hospital walls and are now deeply entrenched in community settings across the state.
For years, antimicrobial resistance was largely viewed as a problem confined to intensive care units and large tertiary hospitals, where patients with severe illnesses were most vulnerable. But the 2025 figures show that the situation has fundamentally shifted. Resistant strains of bacteria are no longer isolated incidents — they have become the everyday reality for doctors and patients alike in Kerala's healthcare system.
One of the most concerning findings in the report is the rising resistance of Shigella, a bacterium that causes shigellosis, a common intestinal infection characterized by severe diarrhea, fever, and stomach cramps. Shigella was once treatable with a handful of inexpensive, widely available antibiotics. Today, the pathogen has developed resistance to several first-line drugs, leaving clinicians with far fewer effective options. This is particularly worrying because shigellosis affects people across all age groups and is prevalent in communities with limited access to clean water and sanitation.
The report also highlights that highly resistant pathogens continue to circulate within intensive care units, where patients are already critically ill and their immune systems are compromised. These organisms, often referred to as "superbugs," can make routine medical procedures — such as surgeries, catheter insertions, and ventilator support — significantly riskier.
Public health experts have long warned that AMR is one of the greatest threats to global health in the 21st century. The World Health Organization estimates that drug-resistant infections cause hundreds of thousands of deaths worldwide each year. In India, where antibiotic use is extremely high and largely unregulated, the problem is especially acute. Kerala, despite having one of India's best healthcare infrastructure and literacy rates, is not immune — and the 2025 KARSNET data suggests the state may be falling further behind.
Health officials are urging stricter antibiotic stewardship programs in hospitals, better public awareness about the dangers of self-medication, and continued investment in infection prevention and control measures.
