India`s First Nationwide Antimicrobial Resistance Awareness Campaign

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Indian Initiative for Management of Antibiotic Resistance (IIMAR)

Antimicrobial Resistance Awareness Week

November 13th to 19th, 2017

Dr. Ashok  Tamhankar 
National Coordinator, IIMAR
You can view the progress of the campaign on the map at   IIMAR`s Antibiotic Resistance Awareness campaign 2017

IIMAR has planned to conduct India’s first nationwide antimicrobial resistance awareness campaign during November 13th to 19th, 2017 in association with Doctors For You -DFY, Mumbai and Antibiotic Resistance Lab, VIT university, Vellore. WHO has announced world antibiotic awareness week during Nov, 13th-19th, 2017 with a theme “Seek advice from a qualified healthcare professional before taking antibiotics” and we will emphasize this in our campaign.

In line with the thought process of the "Action against Antimicrobial Resistance operationalization plan consultation" held in Delhi, we propose to organize a sensitisation and awareness campaign among medical, nursing and pharmacy workforce and general public across states in India.

The campaign will involve components such as lectures, videos, distribution of pamphlets/ brochures, poster making competition, slogan competition, essay competition,  media campaigns, internet based social media etc.

We also plan to disseminate the antibiotic resistance awareness message through community radio stations across India.

We invite you to join and help us in any way you can (human resource, materials, funds etc as per your wish).  Please mail us at iimaraction@gmail.com or antibio.resistance@gmail.com

“THE COLISTIN - THE LAST RESCUER OF LIFE”

“THE COLISTIN - THE LAST RESCUER OF LIFE”

Archana L, Prasanth M, Shanthini T, Ramesh N, A.J.Tamhankar

Colistin the last defence of antibiotics has procured resistance to most of the Gram negative pathogens; the first emerging case was reported in china, now the vast majority of the nations around 30 nations in the world are encountering resistance, in which 44% of cases are reported in India. This Colistin was found from the 40 years old exile in the year 2005. Till date the carbapenem resistance was reported increasingly all over the world, which was treated by the colistin - the high end antibiotics. The real reason that made the boundless procuring of resistance to colistin was because of indiscriminate utilization of the antibiotics to the horticulture field, poultry cultivation in China that caused a selective pressure among the pathogens bringing about versatile resistance, hence to this worry china prohibited the utilization of antibiotics to the field in 2016.

Initial reports of colistin resistance were in Acinetobacter isolates. The colistin resistances in Gram negative bacteria were reported in India, especially for Acinetobacter, Klebsiella, P. aeruginosa, of which 25% were due to the colonization rather than acquired infection. A few investigations observed inhaled colistin to be in charge of the resistance to colistin particularly in pseudomonas infection of the lungs. The innate of the resistance is not only in view of the ecological factors alone, they can be a result of numerous things in which report by UC Santa Clause Barbara scholar Michael Mahan says that the invitro and invivo method of study varies significantly in which the present antibiotic assay standardized in 1961 by the World Health Organization and utilized around the world is conceivably defective. Presently, Mahan and co-workers have utilized a mouse model to show that an assortment of anti-infection agents work distinctively against different pathogens when inside the mammalian body. So there is a need for the development of same environment in-vitro as in-vivo to determine the exact antibiotic for treatment. Their findings was mentioned in the journal of EBioMedicine

On Jun 28, 2017 the research team in China has found another new gene (mcr-3) that presents resistance to colistin that was found from the fecal sample of healthy pig. The gene was gathered from colistin resistance Escherichia coli, on the plasmid that contained 18 extra antibiotic resistance genes. The major concern about colistin is that they have highly mobile pieces of DNA that can be shared within and between different classes of species which depicts that it can spread very fast without any selective pressure. One of the major concerns about mcr-1 and its offshoots is that it's often located on plasmids that contain other antibiotic resistance genes. That raises the possibility of bacterial infections that will not respond to any antibiotic.

Among current endeavors to address this issue, phage therapy offers a promising contrasting option to battle infection caused by colistin resistant organisms. Compared with other conventional therapeutic approaches, phage therapy could be more effective in treating emerging resistant pathogenic bacterial strains. It can kill the biofilm forming bacteria also have low inherent toxicities. It generally do not affect beneficial bacteria, side-effects are uncommon in phages and do not affect eukaryotic cells.

             Protocol of A Study of Antibiotic and Metal Residues, Antibiotic Resistance and Resistance Genes, in the River ‘Kshipra’- Associated with Religious Mass  Bathing  event ‘KUMBH MELA’  in India

Dr. Ashok J. Tamhankar

Protocols of studies undertaken by researchers are not generally published from India. 

Mahadik, Cecilia Stålsby Lundborg and Ashok J. Tamhankar affiliated to R.D. Gardi Medical college   Ujjain in Madhya Pradesh and Karolinska Institutet at Stockholm in Sweden recently published the protocol for a three year study for detecting Our research group consisting of Drs. Vishal Diwan , ManjuPurohit, SaleshChandran, VivekParashar, Harshada Shah, Vijay Antibiotic and Metal Residues, Antibiotic Resistance and Resistance Genes, from the river Kshipra flowing through Ujjain city which is  famous for its religious mass bathing events particularly the KUMBH MELA which is held every twelve years. We took advantage of the  KUMBH MELA event that occurred in 2016 and conducted studies during that time. 

Antibiotic resistance  has been declared by the WHO as a major health emergency of the 21^st century for the global society. Little is known about the Antibiotic resistance  of environmental bacteria and therefore it is important to understand Antibiotic resistance  reservoirs in the environment and their potential impact on health. We have therefore undertaken a study involving Quantitative and qualitative methods for data collection for a 3-year period, of the Kshipra river that is associated with religious mass-bathing in Central India. Surface-water and sediment samples are being collected from seven locations at regular intervals for to monitor water-quality, antibiotic and metals residues, resistant bacteria and antibiotic resistance genes. The results will address the issue of antibiotic residues and antibiotic resistance with a focus on river environment in India within a typical socio-behavioural context of religious mass-bathing. It will enhance our understanding about the relationship between antibiotic and heavy metal residue levels, water-quality, and antibiotic resistance patterns in Escherichia coli isolated from river-water and sediment, that are associated with seasonal differences and religious mass-bathing. We will also document, identify and clarify the genetic differences/similarities relating to phenotypic antibiotic resistance in bacteria, the resistance genes in circulation in the river during religious mass-bathing or during periods when there is no mass-bathing.