National programme on

containment of antimicrobial
resistance
 AMR- Antimicrobial Resistance
occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to
medicines making infections harder to treat and increasing the risk of disease spread, severe
illness and death
National programme on AMR CONTAINMENT
Resistance has emerged even to newer & more potent antimicrobial agents and drugs

The rapid spread of multi-drug resistant bacteria and the lack of new antibiotics to treat
infections caused by the organisms pose a rapidly increasing threat to human health which
urgently needs to be tackled to prevent untreatable illness from becoming a reality.

Government of India launched the “National Programme on AMR Containment” during

the 12th five-year plan in the year 2013.
The programme is being coordinated by the Centre for Bacterial Diseases and Drug
Resistance
 Objectives of the programme
• Establish a laboratory-based AMR surveillance system in the country to generate
quality data on antimicrobial resistance

• To strengthen infection control practices and establish surveillance of Healthcare

associated infections

• To conduct surveillance of antimicrobial usage in different health care settings &

promote rational use of Antimicrobials through Antimicrobial stewardship practices

• To generate awareness amongst health care providers and community for AMR and
rational use of antimicrobials.
 Activities carried out under the programme
1. AMR SURVEILLANCE
National AMR Surveillance network[NARS] is required to submit AMR surveillance data of seven
priority bacterial pathogens of public health importance:
Staphylococcus aureus,
Enterococcus spp.
Klebsiella spp.,
Escherichia coli,
Pseudomonas aeruginosa,
Acinetobacter baumannii/ Acinetobacter calcoaceticus complex,
Salmonella enterica serotypes [Typhi and Paratyphi]
Since the year 2020-21, AMR Surveillance has been expanded to include Candida spp, from
bloodstream infections.
Two more bacterial pathogens have been included in the priority pathogens list for AMR surveillance in
2023 namely Shigella species and Vibrio cholerae.
 National AMR Surveillance network[NARS]

1.National reference labs- one for bacterial pathogens and another one for fungal
pathogens in Delhi

2. Sentinel AMR Surveillance sites: The programme is supporting the state medical
colleges for strengthening AMR detection and containment.
Currently the programme includes 40 labs in 31 states in India
2 labs are in Tamilnadu- Trichy and Coimbatore

3.AMR surveillance data is submitted by the network labs to NCDC[National center for
disease control] .
The National AMR surveillance data is also uploaded annually onto GLASS
(Global AMR Surveillance system)
4. Confirmation of emerging AMR alerts: Network sites are mandated to submit
emerging AMR alerts as defined under the programme

5.External Quality Assessment Scheme: The quality of data submitted under the
National AMR surveillance network is ensured through External Quality Assessment
Scheme (EQAS) conducted by NCDC

6. To standardize the lab testing and data being collected across the network sites under
the programme
1.AMR Surveillance in Priority Bacterial Pathogens under NARS-Net
1. Broth microdilution colistin susceptibility test for aerobic Gram-negative bacteria
2. Broth microdilution (BMD) vancomycin susceptibility test for aerobic Gram-positive cocci
3. Colistin agar test for colistin resistance for Enterobacterales and Pseudomonas aeruginosa
4. Vancomycin agar screen test for Staphylococcus aureus and Enterococcus species
5. Internal Quality Control for disk diffusion AST
6. Preservation of bacterial isolates/control strains
7. Submission of AMR Surveillance EQAS isolates and reporting emerging AMR Alerts

2. WHONET data entry and reporting

•Facility level Antibiogram development tools
•Alert form for submitting AMR emerging Alerts