Antimicrobial resistance in Shigella--rapid increase & widening of spectrum in Andaman Islands, India.

BACKGROUND & OBJECTIVES: Shigellosis is known to be a major cause of acute childhood diarrhoea in Andaman & Nicobar Islands, India. Rapid emergence of antibiotic resistance warrants continuous monitoring of sensitivity pattern of bacterial isolates. We report here the salient findings of an ongoing study on shigellosis in Andaman Islands, India, with regards to change in drug resistance pattern during the past one decade. METHOD: During 2006-2009, stools samples from 412 paediatric diarrhoea patients were collected and processed for isolation and identification of Shigella spp. Susceptibility to 22 antimicrobial drugs was tested and MICs were determined for 3 rd generation cephalosporins, quinolones, amoxicillin-clavulanic acid combination and gentamicin. Drug susceptibility pattern of these isolates were compared with that of 33 isolates obtained during 2000-2002. RESULTS: Shigella isolates were recovered from 50 of 412 stool samples processed. Resistance to ampicillin, nalidixic acid, tetracycline and ciprofloxacin was observed in 100, 96, 94 and 82 per cent of the isolates, respectively. The frequency of resistance to these drugs was significantly (P<0.001) higher than that observed during 2000-2002. Resistance to seven drugs was observed in 2000-2002, whereas resistance to 21 drugs was seen during 2006-2009. The number of drug resistance pattern increased from 13 in 2000-2002 to 43 in 2006-2009. Resistance to newer generation fluoroquinolones, 3 rd generation cephalosporins and augmentin, which was not observed during 2000-2002, appeared during 2006-2009. INTERPRETATION & CONCLUSIONS: The frequency of resistance among Shigella isolates has increased substantially between 2000-2002 and 2006-2009 and the spectrum of resistance has widened. At present, the option for antimicrobial therapy in shigellosis in Andaman is limited to a small number of drugs. Continuous local monitoring of resistance patterns is necessary for the appropriate selection of empirical antimicrobial therapy.

Comparison of the performance of two indices of trophic status for depicting the status of Pulicat lagoon ecosystem.

In the recent years, several indices of trophic status of coastal ecosytems are being used worldwide. However, not all of them can be applied successfully to depict the true trophic status of shallow coastal ecosystems due to their inherent complexities in nutrient circulation and interactions between biotic organisms. The most widely used index is Carlson's Trophic State Index (TSI), while more recently, several environmental indices have been constructed using soft computing techniques such as fuzzy logic. In the present investigation, a comparison of the performances of a conventional trophic state index and a newly developed fuzzy-based trophic state index has been presented in detail. The aim of the work was to highlight the advantages of the newer technique over the existing techniques in light of the inherent variability of both data as well as the sampling procedures undertaken for studying a coastal lagoon ecosystem called Pulicat lagoon in the southeast coast of India. The results of the study have shown that while there are discrepancies in depicting the trophic status of the lagoon using Carlson's index, the newer logic-based index predicted the trophic status accurately which was verified by field assessments. Thus the successful application of a more reliable index to estimate trophic status has been presented.

Tooth element levels indicating exposure profiles in diabetic and hypertensive subjects from Mysore, India.

Element contents of teeth elucidate exposure nature, but less is known about association of tooth element concentrations of diabetics and hypertensives with exposure profile. Present study aims to estimate copper, chromium, iron, zinc, nickel, and lead concentrations in the permanent teeth of control, diabetic, and hypertensive subjects from Mysore. The results show that lead levels of teeth (Pb-T) are higher in the hypertensives and diabetics, whereas copper levels of teeth (Cu-T) are lower in the hypertensives and users of stainless steel utensils than that of controls and users of mixed utensils. The elevated Cu-T levels found in the users of mixed utensils that being made of several metals are ascribed to leaching effect of sour and spicy food of Indian cuisine. The element levels were influenced by diet (Zn-T), place of living, sex and income (Pb-T) of the subjects, but not by age, drinking water from different sources, and certain habits viz., smoking, alcohol consumption, chewing betel, and nut. Thus, it is evident that high Pb-T and low Cu-T levels may be related with diabetes and hypertension and high Pb-T and Cu-T levels, respectively, in the urbanites, and the users of mixed utensils may show different exposure profiles from environment and utensils.

Distribution of Shigella enterotoxin genes and secreted autotransporter toxin gene among diverse species and serotypes of shigella isolated from Andaman Islands, India.

We studied the prevalence and distribution of the newly described genes for Shigella enterotoxins (ShET1 and ShET2, encoded by set and sen genes) and secreted auto-transporter toxin (encoded by sat gene) in clinical isolates from the Andaman Islands, India. A total of 153 Shigella isolates obtained from hospitalized patients during 1994-2004 were analysed. These isolates included all the four species of Shigella (S. dyseteriae-29, S. flexneri-75, S. sonnei-38, S. boydii-5) that belonged to diverse serotypes (including serologically untypable-6) and each serotype included a wide variety of genotypes. Each isolate underwent polymerase chain reaction (PCR) for detection of set, sen and sat genes employing specific primers. We found the set gene in all S. flexneri 2a and 2b isolates (41 of 41, 100%) but not outside S. flexneri serotype 2. The sen gene was well distributed among all species and serotypes but its presence was apparently low at 49.1% (75 of 153), probably because of the loss of the large plasmid that harbours the gene in 76 of the 78 (97.4%) sen negative isolates. Also, all S. flexneri 2 isolates (including 2a and 2b serotypes) had the sat gene. It was present in 96% (72 of 75) of S. flexneri, in 6.9% (2 of 29) of S. dysenteriae, in 20% (1 of 5) of S. boydii, and in 33.3% (2 of 6) of untypable Shigella, but not in (0 of 38) S. sonnei. This study provides initial data on the prevalence and distribution of of the set, sen and sat genes in a wide variety of Shigella isolated over a 10-year period. Our results suggest a greater prevalence of the set and sat genes in S. flexneri 2 isolates than previously thought and might help in future pathochip designs.

Microbial diversity in hypersaline wastewater: the example of tanneries.

In contrast to conventional wastewater treatment plants and saline environments, little is known regarding the microbial diversity of hypersaline wastewater. In this study, the microbial communities of a hypersaline tannery effluent, and those of three treatment systems operating with the tannery effluent, were investigated using 16S rDNA phylogenetic markers. The comparative analysis of 377 bacterial sequences revealed the high diversity of this type of hypersaline environment, clustering within 193 phylotypes (> or = 97% similarity) and covering 14 of the 52 divisions of the bacterial domain, i.e. Proteobacteria, Bacteroidetes, Firmicutes, Actinobacteria, Chlorobi, Planctomycetes, Spirochaetes, Synergistes, Chloroflexi, Thermotogae, Verrucomicrobia, OP3, OP11 and TM7. Most of the phylotypes were related to halophilic and pollutant-degrading bacteria. Using statistical analysis, the diversity of this type of environment was compared to that of other environmental samples selected on the basis of their salinity, oxygen content and organic load.

Anaerobic digestion of tannery soak liquor with an aerobic post-treatment.

The leather industry occupies a place of prominence in the Indian economy due to its massive potential for employment, growth and exports. The potential environmental impact of tanning is significant. This study focuses on tannery soak liquor, generated by the soaking of hides and skins, which is characterised by high organic load and high salinity. For these reasons, the soak liquor should be segregated and pre-treated separately before being mixed with the composite wastewater, made of all other streams mixed together. The anaerobic digestion of tannery soak liquor was studied using a UASB. COD removal reached 78% at an OLR of 0.5 kg COD m(-3) d(-1), a HRT of 5 days and a TDS concentration of 71 gl(-1). The combination of the UASB with an aerobic post-treatment enhanced the performance of the overall wastewater treatment process and the COD removal efficiency of the combined anaerobic/aerobic treatment system reached 96%. However, for effective operation, the system had to be operated at very low OLRs, which affects the economic viability of such a process.

Halophilic biological treatment of tannery soak liquor in a sequencing batch reactor.

Hypersaline wastewater (i.e. wastewater containing more than 35 gl(-1) total dissolved solids (TDS)) is generated by various industrial activities. This wastewater, rich in both organic matter and TDS, is difficult to treat using conventional biological wastewater treatment processes. Among the industries generating hypersaline effluents, tanneries are prominent in India. In this study, tannery wastewater from soak pit was treated in a lab-scale SBR for the removal of organic matter. The characterisation of the soak liquor showed that this effluent is biodegradable, though not easily, and highly variable, depending on the origin and the nature of the hides. TDS was in the range of 21-57 gl(-1) and COD was in the range of 1.5-3.6 gl(-1). This soak liquor was biologically treated in an aerobic sequencing batch reactor seeded with halophilic bacteria, and the performance of the system was evaluated under different operating conditions with changes in hydraulic retention time, organic loading rate and salt concentration. The changes in salinity appeared to affect the removal of organic matter more than the changes in hydraulic retention time or organic loading rate. Despite the variations in the characteristics of the soak liquor, the reactor achieved proper removal of organic matter, once the acclimation of the microorganisms was achieved. Optimum removal efficiencies of 95%, 93%, 96% and 92% on COD, PO4 3-, TKN and SS, respectively, could be reached with 5 days hydraulic retention time (HRT), an organic loading rate (OLR) of 0.6 kg COD m(-3)d(-1) and 34 g NaCl l(-1). The organisms responsible for nitrogen removal appeared to be the most sensitive to the modifications of these parameters.