The third annual meeting of the ASPIC Clubs network was held on 25th March 2021, virtually. The meeting was attended by participants from the 16 constituent colleges of the network involving student and faculty members of the ASPIC Clubs and speakers from major universities in India and ReAct nodes of North America and Europe. The keynote address of the event was on ‘Implications of AMR spread in waterways: Environmental presence and source hotspots’ took by Dr Devika Pillai, Director of Research, Kerala University of Fisheries and Ocean Studies and chaired by Prof. Jeen Abraham, Head of Microbiology, PGM College. The address touched upon the causes for emergence of AMR in the aquatic environment and prevalence of multi-drug resistant isolates and resistant genes from hospital effluents and aquaculture farms. The study done by Dr. Devika showed that bacterial strains isolated from direct hospital effluents and aquaculture farms in the vicinity of selected hospitals showed high resistance against all the antibiotics tested. Location of the farms with respect to its distance from the hospital was found to be a factor for the number of antibiotic resistant bacteria prevalent. The detection of different resistance genes in hospital discharge water and adjoining aquaculture farms indicated the possibility of transmission and dissemination to other bacteria through plasmid mediated horizontal transfer under selection pressure of antibiotics. The session also pointed to a deeper systemic problem for a state like Kerala having an abundance of natural water bodies, where hospitals are seen to be key hotspots for dissemination of resistant bacteria. It also pointed to the need for constant monitoring of hospital wastewater for the presence of antibiotic residues, antibiotic-resistant bacteria and the immediate need for effective wastewater treatment plants in hospitals as part of antibiotic stewardship schemes.
The next session was handled by Dr Maria Pranting, Scientific Coordinator, ReAct Europe on ‘Making sense of Antimicrobial Resistance: Communicating the Science’ and was chaired by Prof. Vidya N.P, Asst. Professor of Biotechnology, St. Mary’s College for Women. The session entailed on different aspects related to communicating ABR such as behavioural influence, selection of target groups, messaging and channels to communicate. The session also introduced the Toolbox,a repository on antibiotic resistance managed by ReAct and its major focus areas. Dr. Maria also introduced various examples of support resources for the students to use while designing and implementing activities.
The session on Addressing AMR in the global context: Access vs. Excess was delivered by Prateek Sharma, Research Associate, ReAct North America & IDEA intitative, Dept. of International Health, John Hopkins Bloomberg School of Public Health. The session was chaired by Dr Jaya Ranjalkar, Senior Research Officer, ReAct Asia Pacific, CMC Vellore. The session discussed on the different drivers of AMR, investing in stewardship efforts for tackling AMR, enabling sustainable access to antibiotics and empowering students as AMR champions. Rising antimicrobial consumption with increased consumption of antibiotics in the animals sector was seen to be a major threat in driving the AMR pandemic. Lowering demand for antimicrobials and reducing unnecessary use through public awareness, proper sanitation and hygiene, rapid diagnostics, vaccines and alternatives were discussed upon. Investing in AMR prevention efforts were seen to have high rates of return by reducing poverty and maintaining the global GDP. The session also touched upon tackling AMR & COVID 19 and looking for its cost savings, 5 As of Access, WHO-AWaRe etc. The session concluded emphasizing on the need for making change through initiatives from local to global levels. Afterwards Sachin G Swamy, Student President of ASPIC YCM chapter made a video presentation on the activities of ASPIC Club at Yuvaraja’s College, Mysore, which is the latest of the colleges to join the network.
The session on Emerging MDR infections during the COVID-19 pandemic was taken by Dr. Reba Kanungo, Dean of Research & Professor of Microbiology, Pondicherry Institute of Medical Sciences. The session was chaired by Dr. N. S Devaki, Professor of Molecular Biology, Yuvaraja’s College, University of Mysore. The session discussed on existing MDR infections across the globe and emerging concerns during Covid-19 pandemic. Conditions for rapid rise in emergence of resistant infections in India were seen to be due to poor public health infrastructure, high burden of disease, unregulated sale of antibiotics and fixed dose combinations. Increase in the incidence of antimicrobial resistance, multidrug resistant organisms, high rates of antimicrobial agent utilization in COVID-19 patients, relatively low rate of co- or secondary infection were all seen to be collateral damage of the Covid-19 pandemic. Causes of increased AMR during pandemic were seen to be due to many individuals presenting with mild disease without pneumonia or moderate disease with pneumonia receiving antibiotics. Intensive care units in 88 countries showed that although only 54% of patients had been suspected of or proven bacterial infection and 70% of them had received at least one antibiotic either for prophylaxis or treatment purposes .Other causes was attributed to increased exposure/antibiotic pressure, combination therapy, disruption of services, change in priority/personnel and containment. Exposure to low levels of biocidals in disinfectants and sanitizers used abundantly also were seen to be helping in developing cross resistance to antibiotics. Measures to contain rising AMR would include infection control and prevention, targeted training in identifying signs and symptoms of Covid-19, continuity of essential health services ,regular supply of quality assured and affordable antimicrobials including antiretroviral and tuberculosis drugs and vaccines. Further measures can be expansion of testing facilities for presumed patients to reduce the urge to initiate antibiotics, maximum caution in the use of biocides for environmental and personal disinfection, prioritizing biocidal agents without or with a low selection pressure for antibiotic resistance, addressing gaps in research, ensuring antimicrobial stewardship activities become an integral part of the pandemic response. Thus it is important to halt the emergence of untreatable drug-resistant infections and diseases that could potentially lead to another public health emergency. Two of the winning proposals from the Student Research Champions for AMR (SRC4AMR) competition organized by ReAct Asia Pacific and ASPIC Clubs were also presented for the event. The last session of the meet on nanobiomaterials and implant coatings was given by Dr. A. Joseph Nathanael, Associate Professor, CBCMT, VIT University, Vellore called for more inter-sectorial work on AMR between different allied groups. The meet received great feedback from the participants and the clubs were invigorated to further continue taking action on antibiotic resistance.