Microorganisms with antimicrobial resistance (AMR) are prevalent among humans and animals, and also found in the environment. Though organisms with AMR can spread to humans via food from animal sources, the burden of AMR in food-producing animals remains largely unknown. Thus, we assessed the resistance pattern among Escherichia coli isolated from chicken cecum samples and explored issues contributing to AMR in animals in the Dhulikhel Municipality of Nepal. We conducted a mixed-methods study, comprising a cross-sectional quantitative component, with collection of chicken cecal samples from slaughter houses/shops. In addition, a descriptive qualitative component was undertaken, with a focus group discussion and key informant interviews among stakeholders involved in animal husbandry. Of the 190 chicken cecum samples collected, 170 (89%) were subjected to culture and drug sensitivity testing, of which E. coli was isolated from 159 (94%) samples. Of the 159 isolates, 113 (71%) had resistance to ≥3 antimicrobial class. Resistance to tetracycline (86%) and ciprofloxacin (66%) were most prevalent. Overuse of antimicrobials, easy availability of antimicrobials, and lack of awareness among farmers about AMR were major issues contributing to AMR. The high prevalence of resistance among E. coli in chicken cecal samples calls for rational use of antimicrobials, educating farmers, and multi-sectoral coordination.

Evidence-based decision-making to combat antimicrobial resistance (AMR) mandates a well-built community-based surveillance system for assessing resistance patterns among commensals and pathogenic organisms. As there is no such surveillance system in Nepal, we attempted to describe the antimicrobial resistance pattern in E. coli isolated from the fecal samples of apparently healthy individuals in Dhulikhel municipality and also explored the local drivers of AMR. We used a mixed-method design with a cross-sectional quantitative component and a descriptive qualitative component, with focus group discussion and key informant interviews as the data collection method. Fecal samples were collected from 424 individuals randomly selected for the study. E. coli was isolated from 85.9% of human fecal samples, of which 14% were resistant to ≥3 class of antimicrobials (multidrug resistant). Of the 368 isolates, resistance to ampicillin (40.0%), tetracycline (20.7%) and cefotaxime (15.5%) were most prevalent. The major drivers of AMR were: lack of awareness of AMR, weak regulations on sales of antimicrobials, poor adherence to prescribed medications, and incomplete dosage due to financial constraints. These findings indicate the need for strict implementation of a national drug act to limit the over-the-counter sales of antimicrobials. Additionally, awareness campaigns with a multimedia mix are essential for educating people on AMR.

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Aims: To assess the waste disposal practices and perception towards solid waste management in selected areas of Bangalore. Study Design:  Descriptive cross-sectional study. Place and Duration of Study: Bangalore between November 2019- November 2020. Methodology: Multi stage sampling technique was used. Using random sampling, respondents from 100 households were selected from each of the 3 study areas. Face to face interview and focus group discussions in all 3 areas were conducted. Semi structured questionnaires were used to collect data. Results: The study revealed that only 35% of the respondents segregated their waste even though 64% of them had heard about it. 74.7% of them said waste van was available to collect their waste whereas few of them also resorted to open dumping and burning as method of waste disposal. 94% of the respondents said food waste was the commonly produced waste followed by plastics and papers. 14.3% respondents said garbage collection facility was not available in their area. About 72.6% of them were satisfied with the current solid waste management system. Availability of regular garbage collection facility was found to be significant with waste disposal practice. Conclusion: The variables such as age, education, size of household, source of income and monthly income were found to be significant with waste segregation practices. The waste segregation practices were found to be highly significant with knowledge on waste segregation, education on solid waste management, and exposure to information.