Which of the following are the reasons for the occurrence of multi-drug resistance in microbial pathogens in India? 1. Genetic predisposition of some people 2. Taking incorrect doses of antibiotics to cure diseases 3. Using antibiotics in livestock farming 4. Multiple chronic diseases in some people Select the correct answer using the code given below.

(a) 1 and 2
(b) 2 and 3 only
(c) 1, 3 and 4
(d) 2, 3 and 4 ✓ UPSC's answer

Why the answer is (d)

• Antimicrobial resistance evolves in microbes exposed to antibiotics; it is a property of the pathogen, not of the patient's genes.

• Incomplete or incorrect antibiotic courses (2) let partially resistant bacteria survive and multiply; India's over-the-counter antibiotic use is a major driver.

• Antibiotic use as growth promoters and prophylaxis in poultry and livestock (3) breeds resistant strains that reach humans through food and the environment.

• People with multiple chronic diseases (4) undergo repeated antibiotic courses and hospitalisation, creating selection pressure for resistant strains.

• Genetic predisposition (1) of people does not create resistance in microbes.

• Hence 2, 3 and 4, option (d).

Why the other options are wrong

(a) 1 and 2: Human genetic predisposition does not cause microbial resistance.
(b) 2 and 3 only: Chronic disease patients also drive resistance through repeated antibiotic use.
(c) 1, 3 and 4: Item 1 is wrong; item 2 is a major cause.

Asked in the GS Paper I of the UPSC Civil Services Preliminary Examination 2019, held on 2 June 2019. Question and answer key: Union Public Service Commission. Explanation: UPSC Answer Check.