title: Antimicrobial resistance surveillance among commensal Escherichia coli in rural and urban areas in Southern India.
abstract: OBJECTIVE
  To assess antimicrobial resistance (AMR) in Tamil Nadu, India.
  
  
  METHODS
  Data on AMR of commensal and uropathogenic Escherichia coli were collected from one urban (Christian Medical College Hospital, Vellore) and one rural (CMCH Rural Unit for Health and Social Affairs) centre in Tamil Nadu at monthly intervals for 1 year.
  
  
  RESULTS
  Forty-two per cent of commensal E. coli was resistant to one or more of the tested antimicrobials. 8.4% were resistant to three drugs commonly used for the treatment of urinary tract infections, namely ampicillin, co-trimoxazole and nalidixic acid. 1.5% of isolates were resistant to nitrofurantoin. There was no significant difference between resistance rates in commensal E. coli collected in rural and urban areas. Resistance was more common in infecting than commensal strains.
  
  
  CONCLUSIONS
  Resistance to most antimicrobials is high both in urban and rural areas. Higher resistance to antimicrobials used widely for the treatment suggests that drug use contributes to it. Hence unnecessary use of antimicrobials must be avoided. Surveillance among commensal E. coli can be used to monitor changes in AMR over time.
authors.affiliation: Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, India. mathaim@yahoo.com
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mathai
authors.forename: Sujith
authors.initials: S
authors.lastname: Chandy
authors.forename: Kurien
authors.initials: K
authors.lastname: Thomas
authors.forename: Belavendra
authors.initials: B
authors.lastname: Antoniswamy
authors.forename: Inbakumar
authors.initials: I
authors.lastname: Joseph
authors.forename: Matthews
authors.initials: M
authors.lastname: Mathai
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Sorensen
authors.forename: Kathleen
authors.initials: K
authors.lastname: Holloway
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D011159:Population Surveillance; D015995:Prevalence; D012424:Rural Population; D014505:Urban Population; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents