Purpose: Bacterial resistance to drugs is an increasing threat to the human community. In recent times the resistance of Gram negative bacteria to several classes of drug such as beta lactams, fluoroquinolones, aminoglycosides and colistin is gaining importance as it is involved in severe health complications in humans. In addition, many reports suggest the presence of silent antibiotic resistance genes with varying level of expression could also pose a severe threat to the public health.Methods & Materials: An E. coli isolate (MU2) phenotypically sensitive to quinolone/fluoroquinolone harboring qnrB resistance gene was selected in this study. To identify the silent nature of this resistance gene, plasmid sequencing was carried out. The growth kinetics of the isolate was determined and different stages were designated as Early Exponential Phase, Mid Exponential Phase (MEP), Late Exponential Phase, Early Stationary Phase and Late Stationary Phase. MU2 was subjected to various gut conditions such as bile shock, H 2 O 2 shock, anaerobic shock and NaCl shock at MEP. Further, TaqMan probe real time PCR was carried out to check the variations in the expression of qnrB in in vitro gut conditions.Results: We have earlier identified a plasmid-borne silent chloramphenicol resistance gene (catA1) in phenotypically sensitive Salmonella Weltevreden and the reason for its unexpressive nature was found to be the deletion of the promoter region. Further a fluoroquinolone sensitive E. coli isolated from UTI infection with a MIC of 0.047 mcg/ml for ciprofloxacin and 3 mcg/ml for nalidixic acid found to harbor a silent plasmid mediated quinolone resistance gene (qnrB). The promoter region and the gene itself was intact. The plasmid sequencing revealed the presence of prophage. Conclusion:The reversible nature of the silent antibiotic resistance gene can cause the emergence of fully antibiotic resistance revertants in the gut upon antibiotic challenge. Further, their presence in conjugative plasmid increases the risk of being transmitted to a susceptible strain and converting it to a resistant pathogen. However, in the present study, various in vitro gut shocks could not influence qnrB expression suggests that the mere presence of PMQR gene will not always confer fluoroquinolone resistance in bacterial pathogens.

Fluoroquinolones are the drug of choice for most of the infections caused by Escherichia coli, and their indiscriminate use has resulted in increased selective pressure for antibiotic resistance. At present, sequencing is the only reliable and direct technique to detect mutations in the quinolone resistance determining region (QRDR). In this study, a rapid and reliable mismatch amplification mutation assay (MAMA) PCR to detect mutations in the QRDR was evaluated and compared to PCR-restriction fragment length polymorphism (PCR-RFLP). One hundred one clinical isolates of E. coli were subjected to MAMA-PCR and PCR-RFLP to detect QRDR mutations. Overall, 92 (91.08%) resistant isolates harbored a point mutation of S83L in gyrA. Double mutations in gyrA were also detected in 45 (44.55%) isolates. Similarly, 41 (40.59%) isolates possessed a point mutation at parC 80, and 25 (24.75%) isolates possessed a point mutation at parC 84. Additionally, MAMA-PCR-the first of its kind-was also standardized to detect mutations in regions gyrB 447 and parE 416, although no mutations were detected in these regions. The rapid and sensitive MAMA-PCR method evaluated in this study would be helpful in exploring the underlying mechanism of fluoroquinolone resistance to enhance control strategies.

We found that involvement of the different stakeholders in planning and implementing the IDR programme offered a platform for collective learning and action. Impediments to the success of the programme need to be addressed by corrective actions at all levels for its future sustainability.

Background: Road traffic accident is one amongst the “biggest killers” across the World according to World Health Organization. Though road traffic accidents are both predictable and preventable, it is witnessed that there is an alarming increase in morbidity, mortality and disability owing to road traffic accident which has become a major public health concern in India. Hence this study aims to assess the awareness and obeyance of road traffic rules among commuters in south Mangaluru suburbs. Methods: A cross sectional study was conducted among 180 motorists in south Mangaluru suburbs during August 2015, who were selected conveniently and structured questionnaire was administered for interview schedule. The data were analyzed for mean, median, frequencies, percentages, standard deviation and appropriate statistical tests were applied by using SPSS version 16. Results: More than two-thirds (67.2%) had insufficient awareness about road traffic rules and more than three fourth of the respondents (86.1%) had bad obeyance of road traffic rules. There was relationship between awareness and practice which was statistically significant (p=0.041) and there was statistical significant difference (p<0.05) in obeyance according to marital status, profession and type of vehicles used. Conclusions: Though the respondents were aware about road traffic rules to a certain extent but they were not obeying the road traffic rules wholly. This can be addressed through the strict enforcement of road traffic rulesand behavioral change communications.