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

Hand hygiene day at AIIMS Patna

Report by Dr Sayan Bhattacharyya, Microbiology department, AIIMS, Patna 

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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.