Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community

Gupta, Madhu; Didwal, Gunjan; Bansal, Shruti; Kaushal, Kanica; Batra, Nitya; Gautam, Vikas; Ray, Pallab

doi:10.4103/ijmr.ijmr_207_18

Cited by 13 publications

(8 citation statements)

References 17 publications

(20 reference statements)

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“… 31 Indiscriminate use of beta-lactam antibiotics in both the community setting and hospitals has given rise to the presence of antibiotic-resistant Enterobacteriaceae in healthy human fecal samples in North India. 32 Our fecal resistome data have corroborated recent shotgun metagenomics data indicating the widespread presence of AMR genes in virtually all subjects irrespective of geographic location and is consistent with that reported in Chinese, Hazda hunter-gatherer and resource-limited Latin American fecal microbiotas. 2 , 3 , 7 However, although genes conferring resistance to beta-lactam antibiotics, tetracyclines, and macrolides, lincosamides and streptogramins (MLS) appeared to be common throughput Nagpur district and Melghat habitats, rural subjects from the Korku tribe generally reported lower exposure to antibiotics and thus displayed a lower abundance of other AMR genes compared with the urban Nagpur participants.…”

Section: Discussionsupporting

confidence: 90%

Metagenomics reveals impact of geography and acute diarrheal disease on the Central Indian human gut microbiome

et al. 2020

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Background: The Central Indian gut microbiome remains grossly understudied. Herein, we sought to investigate the burden of antimicrobial resistance and diarrheal diseases, particularly Clostridioides difficile, in rural-agricultural and urban populations in Central India, where there is widespread unregulated antibiotic use. We utilized shotgun metagenomics to comprehensively characterize the bacterial and viral fractions of the gut microbiome and their encoded functions in 105 participants. Results: We observed distinct rural-urban differences in bacterial and viral populations, with geography exhibiting a greater influence than diarrheal status. Clostridioides difficile disease was more commonly observed in urban subjects, and their microbiomes were enriched in metabolic pathways relating to the metabolism of industrial compounds and genes encoding resistance to 3 rd generation cephalosporins and carbapenems. By linking phages present in the microbiome to their bacterial hosts through CRISPR spacers, phage variation could be directly related to shifts in bacterial populations, with the auxiliary metabolic potential of rural-associated phages enriched for carbon and amino acid energy metabolism. Conclusions: We report distinct differences in antimicrobial resistance gene profiles, enrichment of metabolic pathways and phage composition between rural and urban populations, as well as a higher burden of Clostridioides difficile disease in the urban population. Our results reveal that geography is the key driver of variation in urban and rural Indian microbiomes, with acute diarrheal disease, including C. difficile disease exerting a lesser impact. Future studies will be required to understand the potential role of dietary, cultural, and genetic factors in contributing to microbiome differences between rural and urban populations.

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Section: Discussionsupporting

confidence: 90%

Metagenomics reveals impact of geography and acute diarrheal disease on the Central Indian human gut microbiome

et al. 2020

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“…Another factor of industrialization that is common in India is the overuse of antibiotics. India has one of the highest threats for antimicrobial resistance, 67 as was reflective in our cohorts with enriched KEGG identities in Indians and Indo-Immigrants that contain signatures for antibiotic resistance genes, a pattern previously documented in the Indian gut 26 68 The widespread use of antibiotics in India not only increases the prevalence of antibiotic resistance, but also accelerates microbiome turnover, which was indicative in the pathways enriched in our Indian cohort including peptidoglycan synthesis, microbial growth/metabolism, and DNA synthesis/repair. While common usage of antibiotics is a likely catalyst for cell turnover, the higher risk for infectious disease via water contamination and inadequate sanitation in India may also serve as environmental triggers.…”

Section: Discussionsupporting

confidence: 64%

The transition from a non-westernized to westernized gut microbiome in Indian-Immigrants and Indo-Canadians is associated with dietary acculturation

D’Aloisio,

Ballal,

Ghosh

et al. 2024

Preprint

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Objective: This study investigates the gut microbiome of Indians residing in India, Indian immigrants in Canada, and Canadians of Indian ancestry to understand the impact of westernization on their gut. Given the higher risk of Inflammatory Bowel Disease (IBD) among Indo-Canadians, these results provide insight into how westernization of the gut microbiome may influence incidence of IBD. Design: Stool samples were collected from healthy Indians in India, Immigrants born in India, Indo-Canadians, plus Canadian-borne individuals with European descent and Euro-Immigrants as non-Indian/westernized controls (N = 174).16S and shotgun sequencing compared microbial taxa and functional profiles across groups. Dietary and demographic data were collected to assess lifestyle patterns. Results: The microbiome of Indians and Indo-Immigrants were found to be distinct from westernized groups, with high abundances of Prevotella spp. and CAZymes known to facilitate the breakdown of plant-based foods, reflecting their traditional high complex carbohydrate diet. The Indian microbiome also showed characteristics of high bacterial cell turnover, pathogenic potential and stress tolerance, indicating their gut may be better primed to handle stressors on the gut. Indo-Canadians exhibited a transitional gut microbiome, harbouring taxa both common to Indians and westernized groups, which followed a pattern of increasing dietary acculturation. Conclusions: The transition from a non-westernized to westernized microbiome in Canadian-borne Indian migrants highlights the significant influence that the westernized lifestyle and dietary acculturation has on the gut microbiome. Considering globalization and immigration to westernized countries is occurring at a rapid rate, with 40.6% of the Canadian population made up of first- and second-generation immigrants,1 future research should investigate the health implications that such microbiome transitions have on immigrant populations and newly industrialized nations.

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“…Only ~10% (n = 4) of the studies included in this review analyzed E. coli from a combination of the three dimensions of the One Health approach (i.e., environment, animals, and humans). Refer Table A2 for specific details and a summary of each study [8,11,16,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][40][41][42][43][44][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61]. One Health is a powerful transdisciplinary tool.…”

Section: Discussionmentioning

confidence: 99%

A One Health Review of Community-Acquired Antimicrobial-Resistant Escherichia coli in India

Rajagopal¹,

Chandy

Graham³

2021

IJERPH

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Antimicrobial resistance (AMR) threatens to undermine nearly a century of progress since the first use of antimicrobial compounds. There is an increasing recognition of the links between antimicrobial use and AMR in humans, animals, and the environment (i.e., One Health) and the spread of AMR between these domains and around the globe. This systematic review applies a One Health approach—including humans, animals, and the environment—to characterize AMR in Escherichia coli in India. E. coli is an ideal species because it is readily shared between humans and animals, its transmission can be tracked more easily than anaerobes, it can survive and grow outside of the host environment, and it can mobilize AMR genes more easily than other intestinal bacteria. This review synthesized evidence from 38 studies examining antimicrobial-resistant E. coli (AR-E) across India. Studies of AR-E came from 18 states, isolated from different sample sources: Humans (n = 7), animals (n = 7), the environment (n = 20), and combinations of these categories, defined as interdisciplinary (n = 4). Several studies measured the prevalence of AMR in relation to last-line antimicrobials, including carbapenems (n = 11), third-generation cephalosporins (n = 18), and colistin (n = 4). Most studies included only one dimension of the One Health framework, highlighting the need for more studies that aim to characterize the relationship of AMR across different reservoirs of E. coli.

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Antibiotic-resistant Enterobacteriaceae in healthy gut flora: A report from north Indian semiurban community

Cited by 13 publications

References 17 publications

Metagenomics reveals impact of geography and acute diarrheal disease on the Central Indian human gut microbiome

Metagenomics reveals impact of geography and acute diarrheal disease on the Central Indian human gut microbiome

The transition from a non-westernized to westernized gut microbiome in Indian-Immigrants and Indo-Canadians is associated with dietary acculturation

A One Health Review of Community-Acquired Antimicrobial-Resistant Escherichia coli in India

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