OneHealth study of health implications of environmental Antimicrobial | Institute of Public Health Bengaluru






OneHealth study of health implications of environmental Antimicrobial resistance in urban & rural settings

Accelerated evolution of antimicrobial resistance (AMR) in the environment—soil and water—is an unprecedented challenge of our times. Antibiotic pollution from veterinary use (and misuse) at the interface of humans, animals, and the environment poses serious but unknown threats to human, animal and ecosystem health and well-being. 
In this research, IPH Bengaluru will collaborate with ecologists from the Center for Ecological Sciences at Indian Institute of Science, Bangalore & with infectious diseases experts in All Indian Institute of Medical Sciences, New Delhi & Chamarajangar Institute of Medical Sciences, Chamarajanagar, Karnataka. We will lead the education (creating a course on NPTEL) & health systems translation of evidence component in this research. 
We propose to measure levels of antibiotic pollution and characterize AMR in soil and water across urban
and rural settings surrounding Delhi and Bangalore. We aim to compare AMR patterns in the environment with that seen in clinical settings to understand the intensity and prevalence of the threat originating from veterinary antibiotic pollution. We will assess AMR profiles in two paired urban/rural sites (i) Delhi (city with several embedded villages), and (ii) Bangalore (urban) and adjacent Chamarajanagar (rural), through systematic gridded sampling.
With laboratory incubations of soils and water, we will quantify the abundance and distribution of resistance and multi-resistance to important antibiotics. With statistical modeling of the resistance profiles, we will quantify the link between environmental AMR and its incidence among hospital infections. This will allow us to identify the intensity and prevalence of threats to humans. Through stakeholder workshops with health system actors and implementers, district and city administrators and affected communities, we will identify health policy and systems strategies to mitigate these effects and create an agenda for action at various levels of state, district, and city administration. Lastly, this will provide a template for surveilling environmental AMR in other cities and villages in India.