JMIR Publications

ABSTRACT

Background:

India has the largest burden of drug‑resistant organisms globally, including the multi-and extremely drug‑resistant tuberculosis, resistant Gram‑negative and Gram‑positive bacteria. Resistant bacteria are found in all living hosts, the environment and move between hosts and ecosystems. An intricate interplay of infections, exposure to antibiotics and disinfectants at individual and community levels among the humans, animals, birds and fishes trigger evolution and spread of resistance. 'One Health' framework proposes addressing the antibiotics resistance as a complex multidisciplinary problem. But the evidence base in Indian context is limited.

Objective:

This multi-sectoral, trans-species surveillance project documents the infection and resistance patterns for seven resistant priority bacteria and the risk factors for resistance following the One Health framework and geospatial epidemiology.

Methods:

This hospital and community based surveillance adopts cross-sectional design with mixed-methodology (quantitative, qualitative and spatial) data collection. This study is being conducted at six microbiology laboratories and community in Khurda district, Odisha, India. The laboratory surveillance collects data on bacterial isolates from different hosts and their resistance pattern. For the eligible patients/animals/birds/fishes, the detailed data from their households/farms on health care seeking, antibiotics usage, disinfection practices and neighborhood exposure to infection risks shall be collected. The antibiotics prescription and usage pattern at hospitals/clinics and therapeutic/non-therapeutic antibiotics/disinfectant usage at farms shall be collected. Interviews with key informants from animal breeding, agriculture and food processing shall explore the perceptions, attitude and practices related to antibiotics usage.

Results:

The data analysis shall follow quantitative (descriptive and analytical), qualitative and geospatial epidemiology principles.

Conclusions:

This study will inform about the bacterial infection and resistance epidemiology among different hosts, the risk factors for infection and resistance transmission and identifying the potential triggers and levers for further exploration and action. Clinical Trial: Not applicable