Mahindroo Jaspreet, Narayan Chandradeo, Modgil Vinay, Kaur Harpreet, Shahi Varun, Sharma Bhawna, Jain Ruby, Thakur Siddhartha, Mohan Balvinder, Taneja Neelam
Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 1610012, India.
MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK.
One Health. 2024 Jan 12;18:100677. doi: 10.1016/j.onehlt.2024.100677. eCollection 2024 Jun.
The burden of foodborne diseases and antimicrobial resistance carried by key foodborne pathogens in India is unknown due to a lack of an integrated surveillance system at the human-animal interface.
We present data from the WHO-AGISAR (Advisory Group on Integrated Surveillance of Antimicrobial Resistance), India project. Concurrent human and animal sampling was done across a large area across north India. Community-acquired diarrhea cases ( = 1968) of all age groups were included. Cross-sectional sampling of stool/ intestinal contents ( = 487) and meat samples ( = 419) from food-producing animals was done at farms, retail shops, and slaughterhouses. Pathogens were cultured and identified, and antimicrobial susceptibility was performed.
Over 80% of diarrhoeal samples were obtained from moderate to severe diarrhea patients, which yielded EAEC (5%), ETEC (4.84%), EPEC (4.32%), and spp. (2%). A high carriage of EPEC (32.11%) and spp. (24.72%) was noted in food animals, but the prevalence of ETEC (2%) and EAEC (1%) was low. Atypical EPEC (aEPEC, 84.52%, ≤0.0001) were predominant and caused milder diarrhea. All EPEC from animal/poultry were aEPEC. Overall, a very high level of resistance was observed, and the MDR rate ranged from 29.2% in spp., 53.6% in EPEC, and 59.8% in ETEC. Resistance to piperacillin-tazobactam, cefepime, ceftriaxone, and co-trimoxazole was significantly higher in human strains. In contrast, resistance to ciprofloxacin, aminoglycosides, and tetracycline was higher in animal strains, reflecting the corresponding usage in human and animal sectors. ESBL production was commoner in animal isolates than in humans, indicating high use of third-generation cephalosporins in the animal sector. is an emerging zoonotic pathogen, first time reported from India.
In one of the most extensive studies from India, a high burden of key foodborne pathogens with MDR and ESBL phenotypes was found in livestock, poultry, and retail meat.
由于在人畜界面缺乏综合监测系统，印度主要食源性病原体所携带的食源性疾病负担和抗菌药物耐药性尚不明确。
我们展示了来自世卫组织-印度抗菌药物耐药性综合监测咨询小组（AGISAR）项目的数据。在印度北部的大片地区同时进行了人类和动物采样。纳入了所有年龄组的社区获得性腹泻病例（n = 1968）。在农场、零售店和屠宰场对来自食用动物的粪便/肠道内容物（n = 487）和肉类样本（n = 419）进行横断面采样。对病原体进行培养和鉴定，并进行抗菌药物敏感性检测。
超过80%的腹泻样本来自中度至重度腹泻患者，从中分离出肠集聚性大肠杆菌（EAEC，5%）、肠产毒性大肠杆菌（ETEC，4.84%）、肠致病性大肠杆菌（EPEC，4.32%）和沙门氏菌属（2%）。在食用动物中发现EPEC（32.11%）和沙门氏菌属（24.72%）的携带率较高，但ETEC（2%）和EAEC（1%）的流行率较低。非典型EPEC（aEPEC，84.52%，P≤0.0001）占主导，引起的腹泻症状较轻。来自动物/家禽的所有EPEC均为aEPEC。总体而言，观察到耐药水平非常高，多重耐药率在沙门氏菌属中为29.2%，在EPEC中为53.6%，在ETEC中为59.8%。人源菌株对哌拉西林-他唑巴坦、头孢吡肟、头孢曲松和复方新诺明的耐药性显著更高。相比之下，动物菌株对环丙沙星、氨基糖苷类和四环素的耐药性更高，这反映了在人类和动物领域的相应使用情况。超广谱β-内酰胺酶（ESBL）的产生在动物分离株中比在人类中更常见，表明第三代头孢菌素在动物领域的使用频率较高。沙门氏菌属是一种新兴的人畜共患病原体，首次在印度被报道。
在印度规模最大的研究之一中，在牲畜、家禽和零售肉类中发现了具有多重耐药和ESBL表型的主要食源性病原体的高负担。
