Hyderabad: In a significant scientific development with serious public health implications, researchers from the CSIR-Centre for Cellular and Molecular Biology (CCMB) and the LV Prasad Eye Institute (LVPEI) have uncovered worrying levels of antimicrobial resistance (AMR) in bacteria responsible for eye infections.
The collaborative study, published in the journal Communications Biology, is among the most comprehensive genomic analyses of ocular pathogens conducted in India to date. It was led by Dr Karthik Bharadwaj and Dr Divya Tej Sowpati from CCMB, along with Dr Joveeta Joseph from LVPEI.
Bringing together advanced genomics and clinical expertise, CCMB scientists carried out genomic and bioinformatics analyses, while LVPEI contributed patient samples, microbiological characterisation, and clinical insights.
Highlighting the importance of such collaborations, Dr Vinay K Nandicoori, Director of CCMB, said tackling AMR requires a combined effort from both clinicians and scientists. “This is not a problem that can be solved using model organisms alone—it must be addressed through real patient samples,” he noted.
The study analysed bacterial samples isolated from patients and tested their response to commonly used antibiotics. The findings are alarming: over 45 per cent of the isolates were found to be multidrug-resistant, spanning both Gram-positive and Gram-negative bacteria.
Among the most concerning discoveries were vancomycin-resistant Staphylococcus aureus and extensively drug-resistant (XDR) Klebsiella pneumoniae strains implicated in eye infections. Experts warn that such pathogens not only complicate treatment but also carry the potential to transfer resistance genes to other bacteria and infect other parts of the body.
Using whole genome sequencing, researchers also identified novel resistance mechanisms and mutations, further deepening concerns about the evolving nature of AMR.
From a clinical perspective, the study calls for a re-evaluation of current treatment practices. Doctors often rely on “empirical therapy”—initiating treatment based on experience before laboratory confirmation—since identifying the exact pathogen can take several days. However, the high prevalence of drug resistance is increasingly undermining the effectiveness of this approach.
Particularly concerning is the widespread resistance to fluoroquinolones, a commonly prescribed class of antibiotics. The study found resistance to this class across all major eye pathogens examined.
Experts say these findings underscore the urgent need for microbiology-guided diagnosis and more targeted treatment strategies, especially in severe conditions such as microbial keratitis and endophthalmitis.
Dr Joveeta Joseph, Head of Microbiology at LVPEI, emphasised that while genomic tools are not yet part of routine clinical workflows, studies like this lay the groundwork for region-specific treatment protocols and stronger antimicrobial stewardship in ophthalmology.
Importantly, researchers caution that eye infections are not isolated incidents. The microbes responsible often originate from the skin and surrounding environment, meaning the findings reflect a broader and growing AMR crisis.
“This study positions the eye as a valuable site for monitoring antimicrobial resistance in our environment,” said Dr Prashant Garg, Executive Chair of LVPEI.
The findings add to the growing body of evidence that antimicrobial resistance is no longer a distant threat but an immediate and evolving challenge—one that demands urgent, coordinated action across scientific, clinical, and public health domains.
