One health trans-species and community surveillance for tackling antibacterial resistance among gram negative bacilli with special emphasis on carbapenemase in Odisha, India
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Antibacterial resistance (ABR) among gram negative bacilli (GNB) poses a major threat to clinical medicine and public health. Colistin & carbapenems are considered as the last-resort options. However, resistance to carbapenems is increasing globally in the recent years not only in humans but also in livestock, fish, plants and environment sharing one eco system. An ecological surveillance model to document the resistant bacterial isolates from multiple hosts living in the same environment shall be useful to understand the ABR transmission dynamics considering the ‘One Health’ perspective. Most of the published reports on ABR are single centre based. This multicenter study used one-health framework and geospatial analysis approaches for understanding the ABR epidemiology. Objective: To conduct surveillance for 4 index GNB along with antibacterial susceptibility pattern (ABSP) and to look for carbapenem resistance genes from human, domesticated/food chain animals, birds & fishes at farming sites. Methodology: Study conducted at four medical colleges, two veterinary hospitals & one fish farm located in Khordha district of Odisha during June 2019 to May 2020.The identification & ABSP of index GNB(E.coli, Klebsiella sp.,Pseudomonas sp.& Acinetobacter sp)from different host samples performed by VITEK-2 system and genes for carbapenemase detected using XpertCarba-R assay kit. The antibiogram and locational data for index GNB from various hosts were subjected for descriptive and geospatial analysis for similarities and differences. Results: Out of 10,001 samples from humans (within 48 hours of hospitalization), one of the four GNBs were isolated in 7890 (78.89 %) patients, including Klebsiella spp. 3523 (44.65%), E.coli 2285 (28.96%), Pseudomonas spp. 1190 (15.08%), and Acinetobacter spp. 892 (11.31%).Resistance to ampicillin, cefotaxime,ceftriaxone and carbapenems was >75%, to cotrimoxazole &tetracycline 63.3 -80% & 14.3-48.3% by all index GNBs. Index GNBs were found in 50.8% out of the 118 animal specimens, predominantly from domestic/firm animals & the commonest was Klebsiella and Pseudomonas spp. Resistance to colistin was 88% by E.coli,100% by pseudomonas & Acinetobacter spp.& 50% by Klebsiella spp.None were resistant to carbapenems.Out of 1111 isolates extracted from 116 fish / pond water samples, 447 (40.2%) were index GNBs predominantly E.coli. Carbapemen and colistin resistance was observed in 100% and 13% of Acinetobacter isolates, respectively.Carbapenemase genes NDM/OXA 48 alone or co expression in 78.5% of GNB from humans & 20% from animal and 3% fish isolates. Discussion: Overall, most of the index GNBs were multidrug resistant across multihost species although the frequency was high in humans and colistin & carbapenem resistance being more prevalent in humans and nil in animals. Geospatial analysis revealed overlapping antibiotic resistance pattern for the index GNB from different hosts sharing the common geography/environment. Conclusion: This one-health framework analysis is critical for understanding the antibiotic resistance profile and transmission dynamics across the hosts.
Authors: Prof Ashoka Mahapatra, Dr. Manoj Kumar Das, Prof Basanti Pathi, Prof Rajashree Panigrahi, Prof Swetalona Pattnaik
Language: English
Subfield: Molecular Medicine
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $2,900
OpenAlex ID: W4408046898