A One Health Review of Community-Acquired Antimicrobial-Resistant Escherichia coli in India

Abstract

Antimicrobial resistance (AMR) threatens to undermine nearly a century of progress since the first use of antimicrobial compounds. There is an increasing recognition of the links between antimicrobial use and AMR in humans, animals, and the environment (i.e., One Health) and the spread of AMR between these domains and around the globe. This systematic review applies a One Health approach—including humans, animals, and the environment—to characterize AMR in Escherichia coli in India. E. coli is an ideal species because it is readily shared between humans and animals, its transmission can be tracked more easily than anaerobes, it can survive and grow outside of the host environment, and it can mobilize AMR genes more easily than other intestinal bacteria. This review synthesized evidence from 38 studies examining antimicrobial-resistant E. coli (AR-E) across India. Studies of AR-E came from 18 states, isolated from different sample sources: Humans (n = 7), animals (n = 7), the environment (n = 20), and combinations of these categories, defined as interdisciplinary (n = 4). Several studies measured the prevalence of AMR in relation to last-line antimicrobials, including carbapenems (n = 11), third-generation cephalosporins (n = 18), and colistin (n = 4). Most studies included only one dimension of the One Health framework, highlighting the need for more studies that aim to characterize the relationship of AMR across different reservoirs of E. coli.

One Health activities to reinforce intersectoral coordination at local levels in India

“…Intersectoral collaboration happens primarily between human health and animal health scientists, though AMR studies may also involve environmental sampling and/or participation from the environmental sector. In a systematic review of studies from 18 states examining antimicrobial-resistant E. coli across India, only 10% (4 out of 38) conducted interdisciplinary sampling—defined as sampling from a combination of human, animal, or environmental sources ( 19 ). The research studies often feature a multidisciplinary approach, combining social/epidemiological surveys with laboratory-based and/or economic investigations ( Table 1 ).…”

Isolation and Phenotypic Characterization of Virulent Bacteriophages Against Multidrug-Resistant Escherichia coli and Its Phage-Resistant Variant from Sewage Sources

“…Globally, antimicrobial resistance has reached an alarming stage leading to a declaration by the World Health Organization (WHO) as one of the most critical threats confronting human health. 1 Recently, the spread of resistance genes has become a public health concern particularly among members of Enterobacteriaceae, with most of the cases reported are due to Escherichia coli, as causes of both community and hospital acquired infections 2 such as gastrointestinal tract infection, wound infection, sepsis, neonatal meningitis, and mainly urinary tract infections (UTI). 3 Besides its causation of multiple infections, E. coli is becoming an increasingly antimicrobial resistant.…”

Surveillance of Escherichia coli in different types of chicken and duck hatcheries: one health outlook

“…On the other side, many E. coli strains have different virulence genes that allow such strains to induce intestinal and extraintestinal infections, both community- and hospital-acquired ( Rajagopal et al, 2021 ). Research has shown that APEC (O1, O2, and O18 serogroups) could be zoonotic pathogens that spread from animals to humans through food and result in extraintestinal infections ( Mellata, 2013 ; Markland et al, 2015 ).…”