A Three-Year Follow-Up Study of Antibiotic and Metal Residues, Antibiotic Resistance and Resistance Genes, Focusing on Kshipra-A River Associated with Holy Religious Mass-Bathing in India: Protocol Paper.

Vishal Diwan,Cecilia Stålsby Lundborg,Vijay K Mahadik,Salesh Chandran,Vivek Parashar,Harshada Shah,Ashok J Tamhankar,Manju Purohit

doi:10.3390/ijerph14060574

Abstract

Background: Antibiotic resistance (ABR) is one of the major health emergencies for global society. Little is known about the ABR of environmental bacteria and therefore it is important to understand ABR reservoirs in the environment and their potential impact on health. Method/Design: Quantitative and qualitative data will be collected during a 3-year follow-up study of a river associated with religious mass-bathing in Central India. Surface-water and sediment samples will be collected from seven locations at regular intervals for 3 years during religious mass-bathing and in absence of it to monitor water-quality, antibiotic residues, resistant bacteria, antibiotic resistance genes and metals. Approval has been obtained from the Ethics Committee of R.D. Gardi Medical College, Ujjain, India (No. 2013/07/17-311). Results: The results will address the issue of antibiotic residues and antibiotic resistance with a focus on a river environment in India within a typical socio-behavioural context of religious mass-bathing. It will enhance our understanding about the relationship between antibiotic residue levels, water-quality, heavy metals and antibiotic resistance patterns in Escherichia coli isolated from river-water and sediment, and seasonal differences that are associated with religious mass-bathing. We will also document, identify and clarify the genetic differences/similarities relating to phenotypic antibiotic resistance in bacteria in rivers during religious mass-bathing or during periods when there is no mass-bathing.

Highlights

Antibiotic resistance (ABR) is one of the major health emergencies for global society
It is further reported that antibiotics may be present in river water and other aquatic environments at levels that could alter the ecology of the environment, and give rise to antibiotic resistant bacteria and genes that code for resistance [14,15]
Various genes coding for β-lactamase such as CTX-M, TEM and SHV; plasmid-mediated quinolone-resistance genes—qnrA, qnrB, qnrS, aac(60 )-Ib-cr and qepA—and the carbapenem-resistance coding genes, OXA-48, IMP, VIM and NDM, will be amplified and identified with previously described primers [50] for E. coli isolated from all sediment and water samples

Summary

Introduction

Antibiotic resistance (ABR) is one of the major health emergencies for global society. Surface-water and sediment samples will be collected from seven locations at regular intervals for 3 years during religious mass-bathing and in absence of it to monitor water-quality, antibiotic residues, resistant bacteria, antibiotic resistance genes and metals. The available literature has documented the presence of antibiotic residues in varying concentrations in aquatic environments, including river ecosystems [8,9,10,11,12,13]. The presence of antibiotic resistant bacteria and genes in aquatic environments has become a serious concern for global public health [16,17,18,19]. Antibiotics are produced naturally by autochthonous microbial communities, anthropogenic sources of antibiotics are considered to be a major driver of clinically important resistance phenotypes and genotypes [20]

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