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Int. J. Environ. Res. Public Health 2017, 14(6), 574; doi:10.3390/ijerph14060574

A Three-Year Follow-Up Study of Antibiotic and Metal Residues, Antibiotic Resistance and Resistance Genes, Focusing on Kshipra—A River Associated with Holy Religious Mass-Bathing in India: Protocol Paper

1
Department of Public Health and Environment, R.D. Gardi Medical College, Ujjain 456006, India
2
Department of Public Health Sciences, Global Health, Health Systems and Policy (HSP): Medicines focusing on antibiotics, Karolinska Institutet, Stockholm 17177, Sweden
3
International Centre for Health Research, Ujjain Charitable Trust Hospital and Research Centre, Ujjain 456001, India
4
Department of Pathology, R.D. Gardi Medical College, Ujjain 456006, India
5
Department of Microbiology, R.D. Gardi Medical College, Ujjain 456003, India
6
R.D. Gardi Medical College, Ujjain 456006, India
7
Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Ujjain 456006, India
*
Author to whom correspondence should be addressed.
Received: 19 April 2017 / Revised: 24 May 2017 / Accepted: 26 May 2017 / Published: 29 May 2017
(This article belongs to the Section Environmental Health)
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Abstract

Background: Antibiotic resistance (ABR) is one of the major health emergencies for global society. Little is known about the ABR of environmental bacteria and therefore it is important to understand ABR reservoirs in the environment and their potential impact on health. Method/Design: Quantitative and qualitative data will be collected during a 3-year follow-up study of a river associated with religious mass-bathing in Central India. Surface-water and sediment samples will be collected from seven locations at regular intervals for 3 years during religious mass-bathing and in absence of it to monitor water-quality, antibiotic residues, resistant bacteria, antibiotic resistance genes and metals. Approval has been obtained from the Ethics Committee of R.D. Gardi Medical College, Ujjain, India (No. 2013/07/17-311). Results: The results will address the issue of antibiotic residues and antibiotic resistance with a focus on a river environment in India within a typical socio-behavioural context of religious mass-bathing. It will enhance our understanding about the relationship between antibiotic residue levels, water-quality, heavy metals and antibiotic resistance patterns in Escherichia coli isolated from river-water and sediment, and seasonal differences that are associated with religious mass-bathing. We will also document, identify and clarify the genetic differences/similarities relating to phenotypic antibiotic resistance in bacteria in rivers during religious mass-bathing or during periods when there is no mass-bathing. View Full-Text
Keywords: Escherichia coli; mass-bathing; antibiotic resistance; antibiotic resistance genes; water-quality; India; river; metals; seasons Escherichia coli; mass-bathing; antibiotic resistance; antibiotic resistance genes; water-quality; India; river; metals; seasons
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Diwan, V.; Purohit, M.; Chandran, S.; Parashar, V.; Shah, H.; Mahadik, V.K.; Stålsby Lundborg, C.; Tamhankar, A.J. A Three-Year Follow-Up Study of Antibiotic and Metal Residues, Antibiotic Resistance and Resistance Genes, Focusing on Kshipra—A River Associated with Holy Religious Mass-Bathing in India: Protocol Paper. Int. J. Environ. Res. Public Health 2017, 14, 574.

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