Antimicrobial Drug Resistance

Antimicrobial Drug Resistance; a World-wide Concern

The WHO Director-General’s Global Report on Antimicrobial Resistance released in April, 2014 demonstrates a dangerous new epidemiological era characterized by the world-wide increasing prevalence of drug-resistant microbes. According to a CDC report released last year, antibiotic resistance annually causes more than 2 million illnesses and over 23,000 deaths in the United States. Widespread use of antibiotics, not only in hospital settings but also in the general population, agricultural and animal feed practices has increased the rates of bacterial population resistant to multiple drugs. Increasing antibiotic treatment failures is a global public health concern. Dr. Dinesh Chandel and other CGHAD faculty members utilizing laboratory facilities at UNMC and overseas are engaged in tracking antibiotics resistance in different populations.

The developing world, where antibiotic are available without a prescription is now experiencing an acute problem of antimicrobial resistance in populations starting from neonates to adults and the elderly. The frequency and spectrum of antimicrobial-resistant infections has increased in both hospital and the community settings. In an Indo-US collaborative study, CGHAD scientists reported increased rates of neonatal sepsis mainly due to drug-resistant ESBL-positive infections in an Indian setting. Although nosocomial drug-resistance is a burgeoning problem globally, appearance of ESBLs even in the rural population, and so early in life, raises serious concerns. Following these studies, CGHAD faculty in collaboration with major Indian medical institutions and the Asian Institute of Public Health conducted a PCR-based survey of ESBL-gene fecal carriage among infants and found equally high rates of carriage (in stool) of bacteria with ESBL-encoding genes.

In an ongoing research study involving high-throughput DNA sequencing based metagenomics protocols, we are examining the possible impact of early probiotics intervention in changing the gut flora in the developing infants and subsequent change in the acquisition of antibiotic-resistant organisms.

Research on Multidrug Resistant TB in India:

CGHAD collaborators at the Asian Institute of Public Health in India have been funded by TB Reach (Stop TB Partnership with a WHO secretariat) to examine MDR TB in a population of over 500,000 that includes migrant and mining workers in Jajpur and Bhubaneswar area. In this innovative initiative, non-formal health care providers including pharmacies that dispense drugs (for fever, cough, and weakness) without a prescription have been brought into the partnership for referral and GenXpert sputum testing. Household contacts of the positive cases, especially the pediatric age group are targeted to provide insights into latent TB