Wednesday, May 31, 2017

 First Indian ‘One-Health’  Study on Antibiotic Resistance in Commensal Coliform from Humans, Animals, and Water from a Rural Community in India

Dr. Ashok J. Tamhankar

Antibiotic-resistance has become a threat to global public health. Animal and human fecal flora and the environment, including water sources, serve as natural habitats and reservoirs of antibiotic-resistant bacteria and resistance genes. Thus, within the community, resistant bacteria circulated from person to person or from animals and environment to person, or vice versa. Though the presence and patterns of antibiotic resistant commensal indicator bacteria E. coli isolates from humans, animals, and water have been studied in isolation, it is now recognized that they need to be studied together, i.e., using the ‘one-health’ approach.
Our research group (Drs Manju Raj Purohit  , Salesh Chandran , Harshada Shah , Vishal Diwan , Ashok J. Tamhankar and Cecilia Stålsby Lundborg)  therefore decided to phenotype and genotype antibiotic-resistant commensal Escherichia coli (E. coli) from humans, animals, and water from the same community with a ‘one-health’ approach. The samples were collected from a village belonging to demographic surveillance site of R.D. Gardi Medical College Ujjain, Central India. Commensal coliforms from stool samples from children aged 1–3 years and their environment (animals, drinking water from children's households, common source- and waste-water) were studied for antibiotic susceptibility and plasmid-encoded resistance genes. E. coli isolates from human (n = 127), animal (n = 21), waste- (n = 12), source- (n = 10), and household drinking water (n = 122) carried 70%, 29%, 41%, 30%, and 30% multi-drug resistance, respectively. Extended spectrum beta-lactamase (ESBL) producers were 57% in human and 23% in environmental isolates. Co-resistance was frequent for penicillin, cephalosporin, and quinolone. Antibiotic-resistance genes blaCTX-M-9 and qnrS were most frequent. Group D-type isolates with resistance genes were mainly from humans and wastewater. Colistin resistance, or the mcr-1 gene, was not detected. The frequency of resistance, co-resistance, and resistant genes are high and similar in coliforms from humans and their environment. This emphasizes the need to mitigate antibiotic resistance with a ‘one-health’ approach in India and everywhere. The details of this research can be accessed in the article in Int. J. Environ. Res. Public Health 2017, 14(4), 386; doi:10.3390/ijerph14040386

Thursday, May 11, 2017

Hand hygiene day at AIIMS Patna

Report by Dr Sayan Bhattacharyya, Microbiology department, AIIMS, Patna 
On 5th May, world hand hygiene day was celebrated in AIIMS Patna. Patients were made aware in OPD, about the importance of hand hygiene. They were also shown videos as to when and how one should wash hands ( 6 steps and 5 points). Packs of hand wash and hand sanitizers were distributed to the patients and their attendants. Doctors and nurses also participated in the program.
Two skits or street plays were also performed by students and staff in the OPD to make patients aware of the importance of hand hygiene in preventing infections. A questionnaire based survey was conducted on the patients to know their hand wash practices. About 80% said they washed hands before eating and after defecation. A few said that they scrubbed hands with ash/soil, which they were told by us not to. Then printed educative materials were also distributed to the patients, and they were shown how to wash and sanitize hands. After the program, all (100%) patients participating, could demonstrate the 6 steps of hand washing correctly.
The honourable Director, Dr Prabhat Kumar Singh addressed the students, residents, faculty and other staff and re-emphasized the importance of hand washing and discouraged handshaking.

Friday, November 18, 2016

 PRASANTH MANOHAR an IIMAR MEMBER and student of IIMAR, Vellore COORDINATOR  Professor Dr N. Ramesh  from VIT, Vellore wins YOUNG SCIENTIST award for developing a NEW THERAPY against ANTIBIOTIC RESISTANT BACTERIA 

Contributed by Dr. Ashok J. Tamhankar

PRASANTH MANOHAR, an IIMAR MEMBER and a research scholar at VIT University, Vellore, has bagged a prestigious science award for his research on ‘Phage therapy’. His research focuses on the preparation of freeze-dried preparation of cocktail phages to treat infections caused by superbugs- the Multi-Drug Resistant Bacteria.

Prasanth is currently working in ANTIBIOTIC RESISTANCE LABORATORY at VIT, University, Vellore, under the guidance of Professor Dr N. Ramesh, (on left in the photograph) of Antibiotic Resistance laboratory and HTS, SBST. He explains that ‘Our research work includes the identification of carbapenem, colistin and tigecycline resistant bacteria from clinical samples. And we are creating and conducting antibiotic resistance awareness programmes for the public through Indian Initiative for Management of Antibiotic Resistance-IIMAR. Our future aim is to develop our lab into an antibiotic resistant and phage therapy centre. We are currently pursuing our collaborative work in cooperation with six countries such as Turkey, Australia, USA, Saudi Arabia, Canada, and the UK. 

The young scientist competition was initiated in 2014 with the aim of giving young researchers from India and Europe a suitable podium to promote their research projects and ideas for Indo-European cooperation. Through such a competition, young scientists gain enormous exposure not only from their peers on social media platforms but also from the scientific community.
In 2016, young scientists from Europe and India submitted their ideas in the field of “bioeconomy, biotechnology and biobased-energy” to the competition. 4 young scientists, who made it past the scientific expert panel and Facebook video competition, presented their research in the finals held at the EU-India STI Cooperation Days 2016. Prasanth Manohar emerged the winner of the competition, bagging a fully paid trip to a conference of his choice in Europe. 

Explaining about his research Prasanth says, ‘My research topic is PHAGE THERAPY. I am currently working in identifying the prevalence and dissemination of antibiotic-resistant bacteria among clinical pathogens in India and isolating and characterizing novel  ‘lytic phages’ for therapeutic purpose against multi-drug resistant bacteria. I want to continue my research on phage therapy and want to develop it into a product that will save millions of people in the future.

Friday, September 23, 2016

Global Commitment at UN to Act on Antimicrobial Resistance

Contributed by: Dr. Tamhankar and Siddharth David

On 21st September 2016 at a meeting at the United Nations, world leaders signaled an unprecedented level of attention to curb the spread of infections that are resistant to antimicrobial medicines.
Speaking at the meeting, UN Secretary-General Ban Ki-moon said
 “It is not that it may happen in the future. It is a very present reality – in all parts of the world, in developing and developed countries; in rural and urban areas; in hospitals; on farms and in communities,” Mr. Ban noted. Read his entire speech here
Please read the details of the UN news story here 

The draft of the UN resolution can be read here
Margaret Chan (left), Director-General of the World Health Organization (WHO), José Graziano da Silva (center), Director-General of the Food and Agriculture Organization (FAO), and Monique Eloit (right), Director General of the World Organization for Animal Health (OIE), address journalists on the high-level meeting on antimicrobial resistance.

Wednesday, July 27, 2016

Workshop on Hand hygiene at All India Institute of Medical Sciences (AIIMS), Bhopal

Contributed by: Dr. Megha Sharma and Dr. A.J.Tamhankar; Edited by Siddharth David

The hospital infection control committee (HICC) and Department of Microbiology of All India Institute of Medical Sciences (AIIMS), Bhopal, invited Dr. A.J. Tamhankar, National Coordinator, Indian Initiative for management of Antibiotic Resistance (IIMAR) and Dr. Megha Sharma1, R.D.  Gardi Medical College, Ujjain (RDGMC) (both also affiliated to Karolinska Institute, Stockholm, Sweden) for conducting a 5 day workshop on hand hygiene for all categories of   healthcare workers at AIIMS and also the Medical and Nursing students, in August 2015. The series of workshops was inaugurated by the Medical Superintendent, AIIMS Bhopal Dr. K. C. Tamaria, in presence of Dr. Debasis Biswas, Dr. Shashank Purwar, Dr. T. Karuna and other faculty members. Overall six workshops were conducted for various categories of health care workers (HCWs), one for students and one also for OPD patients and hospital visitors.

The workshop sessions started with a short address on Hand Hygiene by Dr. Tamhankar. Thereafter, Dr. Megha Sharma, the main resource person, who conducted the workshops, took over. Dr. Megha Sharma initially made a presentation focusing on the importance of hands in daily routine and during clinical work. She also explained the ways of spread of microorganisms, including pathogens, from one person to another. She emphasized that healthcare worker`s contaminated hands can transfer various infections not only to the patients they are taking care of, but also to coworkers who are also at the risk for cross infections. These infections, also known as Health care associated infections (HAIs) are responsible for increasing morbidity, which leads to a chain of events like increased antibiotic use, increased antibiotic residues in environment, increased antibiotic resistance in bacteria, increased untreatable infections, increased loss of productive man-hours and in extreme cases mortality, all of which can have a negative impact on the public health and economy of a country.
Dr. Sharma further emphasized on the most effective and worldwide accepted precaution for controlling spread of infections, which is 'Hand Hygiene'. Hand hygiene could be maintained either by use of soap and water or by using alcohol based hand rub, commonly known as sanitizer. The participants were trained to follow steps to maintain hand hygiene using these materials. The steps of 'How and when to wash hands with soap and water?' and 'How and when to use an alcoholic hand rub?' as recommended by world Health Organization; were demonstrated and practiced. Various activities, such as Oath
taking, best slogan competition, and cross word puzzle; were planned in order to maintain a high level of interest amongst the participants. The winning participants received prizes and all participants received a certificate of participation at the end of each workshop.
On the fifth day of the workshop, an exclusive open session was conducted for common public visiting the out-patient departments at AIIMS, Bhopal. Dr. M. Sharma, Dr. T. Karuna (AIIMS) and the team helping Dr. sharma from R. D. Gardi Medical College, Ujjain and AIIMS, Bhopal demonstrated the right way to wash hands using soap and water that was practiced by the participants.  A sticker, developed by the APRIAM2 Hygiene Team, was distributed to each participant showing 'When to wash hands with soap and water'?   An estimated 700 members of the general community benefitted from the session
conducted for OPD patients, their caretakers and relatives.
On the final day, Dr. Tamhankar gave a lecture on the topic “Antibiotic use, Antibiotic Residues, Antibiotic Resistance & Environment” which was attended in large numbers by the faculty and the staff of AIIMS and also the participants. In the lecture Dr. Tamhankar explained the ‘Interrelation between Environment, Antibiotic use, Antibiotic Residues and Antibiotic Resistance’.
In the end, Dr. Tamhankar and Dr. Sharma were felicitated by AIIMS.
Hard work of Mr. Amit Pawar, Mr. Abdul Shadab, Mr. Jeetendra Jat and Ms. Sunita Parmar of APRIAM2 Hand Hygiene Team, RDGMC, Ujjain is appreciated for making these training sessions a success.
1. Dr. Megha Sharma  leads a campaign titled 'Swachcha Bharat- Swastha Bharat' since 2011. The campaign is conducted by APRIAM2 Hygiene Team with an aim to improve hygiene practices among present and future health care workers and the community. The team led by Dr. Megha Sharma interacts with school children, anganwadis and health care workers at C.R. Gardi Hospital, Ujjain charitable trust hospital and Government district hospital, Ujjain. Training sessions and workshops at these places are conducted on regular basis. The linkage between cleanliness, hygiene and health is focused in the activities and presentations. The team has introduced in-house prepared alcohol based hand rub in the hospitals to maintain hand hygiene ( ).
2. APRIAM project is an ongoing collaborative research project between R. D. Gardi Medical College, Ujjain and Karolinska Institutet, Stockholm, Sweden. Prof. (Dr.) Cecilia Stålsby Lundborg is principal investigator of the project and Dr. A. J. Tamhankar is senior scientific advisor.