title: Antibiotic Resistance in an Indian Rural Community: A 'One-Health' Observational Study on Commensal Coliform from Humans, Animals, and Water.
abstract: Antibiotic-resistant bacteria are an escalating grim menace to global public health. Our aim is to phenotype and genotype antibiotic-resistant commensalEscherichia 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 Ruxmaniben Deepchand (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. coliisolates 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 in penicillin, cephalosporin, and quinolone. Antibiotic-resistance genesblaCTX-M-9andqnrSwere most frequent. Group D-type isolates with resistance genes were mainly from humans and wastewater. Colistin resistance, or themcr-1gene, 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.
authors.affiliation: Department of Public Health Sciences, Global Health-Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177 Stockholm, Sweden. manjuraj.purohit64@gmail.com.|Department of Pathology, R.D. Gardi Medical College, Ujjain 456006, India. manjuraj.purohit64@gmail.com.
authors.forename: Manju Raj
authors.initials: MR
authors.lastname: Purohit
authors.affiliation: Department of Public Health Sciences, Global Health-Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177 Stockholm, Sweden. saleshp@gmail.com.|Department of Microbiology, R.D. Gardi Medical College, Ujjain 456006, India. saleshp@gmail.com.
authors.forename: Salesh
authors.initials: S
authors.lastname: Chandran
authors.affiliation: Department of Microbiology, R.D. Gardi Medical College, Ujjain 456006, India. sharshada1955@yahoo.com.
authors.forename: Harshada
authors.initials: H
authors.lastname: Shah
authors.affiliation: Department of Public Health Sciences, Global Health-Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177 Stockholm, Sweden. vishal.diwan@ki.se.|International Centre for Health Research, Ujjain Charitable Trust Hospital and Research Centre, Ujjain 456006, India. vishal.diwan@ki.se.|Department of Public Health and Environment, R.D. Gardi Medical College, Ujjain 456006, India. vishal.diwan@ki.se.
authors.forename: Vishal
authors.initials: V
authors.lastname: Diwan
authors.affiliation: Department of Public Health Sciences, Global Health-Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177 Stockholm, Sweden. ejetee@gmail.com.|Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Ujjain 456006, India. ejetee@gmail.com.
authors.forename: Ashok J
authors.initials: AJ
authors.lastname: Tamhankar
authors.affiliation: Department of Public Health Sciences, Global Health-Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177 Stockholm, Sweden. cecilia.stalsby.lundborg@ki.se.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Stålsby Lundborg
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002675:Child, Preschool; D060766:Drinking Water / Q000382:microbiology; D004352:Drug Resistance, Microbial / Q000235:genetics*; D004784:Environmental Monitoring; D004926:Escherichia coli / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification*; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D010957:Plasmids / Q000235:genetics; D012424:Rural Population; D062065:Wastewater / Q000382:microbiology; D014871:Water Microbiology; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D060766:Drinking Water; D062065:Wastewater; D001618:beta-Lactamases
keywords: India; antibiotic resistance; coliforms; commensal; community; environment