Given that the Government of India is heavily supporting the setting of traditional surveillance networks and systems through several vertical programs, the call focused on innovations in new data sources, analytical methods and new biomarkers for surveillance.
Another area where research is particularly important, especially for India, given its high rates of infectious disease, is innovative low-cost products and technologies that can be used to break the cycle of infections especially in healthcare settings.
The effect of antibiotics in the environment is still not well understood, but what is known is that there is a large outflow of antibiotics/antimicrobials from various sources such as industries that produce active pharmaceutical ingredients (APIs) for antimicrobials, the community, farms, industrial agricultural set ups among others. It is therefore important to arrest this flow of antibiotics into the environment through new technologies and products.
In line with the call mandate the shortlisted ten projects are broadly aimed at addressing big gaps in the surveillance and response system for infectious diseases threats.
The details of supported projects are as follows:
- A blood-based host biomarker for discriminating viral and bacterial infections: A clinical decision support tool.
Organization/Institute: Indian Institute of Science (IISc), Bangalore
The project proposes to develop a biomarker-based blood test to rapidly discriminate between viral and bacterial infections. The test will aid stewardship efforts by reducing the indiscriminate use of antibiotics for all suspected infections. As preliminary work, the study team has identified a panel of host genes capable of robustly discriminating viral from bacterial infections. The expression profiles of these genes were quantified in independent datasets available publicly which demonstrated a significant separation between viral and bacterial infections. Effective utilization of this information will optimize the appropriate use of antibiotics in the clinical setup.
- High Resolution Genome Based Tracing of Antimicrobial Resistant Escherichia coli in the Pork production chain to identify the Critical Control Points: A One Health Systems Study.
Organization: Indian Council of Agricultural Research, North Eastern Hill Region (ICAR-NEH)
Collaborators: Tamil Nadu Veterinary and Animal Sciences University, Karnataka Veterinary, Animal and Fisheries Sciences University, Institute for Social and Economic Change, Hassan Institute of Medical Sciences
The project intends to quantitatively assess the dynamics of antimicrobial resistant AMR E.coli across the pork-value-chain in three different states, Tamil Nadu, Karnataka and Meghalaya to identify critical control points of entry and exit of AMR E.coli to design a relevant Hazard Analysis and Critical Control Points (HACCP).
- Low cost Ferroelectric Material based technology to combat microbial resistance and prevention.
Organization: Indian Institute of Technology (IIT), Mandi
The idea is to develop new low-cost technology based on ferroelectric materials bulk, powder coating/thick film to impair the life of microbial cells commonly found in drinking tap water, water storage tanks and nosocomial infections. Organic pollutants like pharmaceutical waste would be another target area.
- Biomarkers for bacteremia, antimicrobial resistance and hospital acquired infections by NMR and Mass Spectrometry among febrile neutropenic patients.
Organization: All India Institute of Medical Sciences (AIIMS), New Delhi
The project proposes use of metabolomics including High throughput Nuclear Magnetic Resonance (NMR) spectroscopy and Liquid-chromatography mass spectrometry (LC-MS) as a powerful tool for the discovery of biomarkers for differentiating bacteremic cases and non-bacteremic cases among febrile neutropenic Cancer patients to decrease antibiotic consumption, differentiating antimicrobial resistance extended spectrum beta-lactamase (ESBL) present or not based on metabolites and differentiating community acquired bloodstream infections and hospital acquired bloodstream infections including Central line associated bloodstream infections (CLABSI) based on metabolomics. This will greatly reduce antibiotic consumption, selection of drug-resistant strains, antibiotic associated complications, hospital acquired infections.
- Development of low cost Sericin coated industrial capacity filters to remove antibiotics and associated chemicals from effluents
Organization: Indian Institute of Technology (IIT), Guwahati
Principal Investigator: Dr. Senthilmurugan S
Collaborator: Eureka Forbes Ltd.
In the current situation, both conventional and advanced wastewater treatment technologies are either inefficient or costly for removal of micro-pollutants, drug particles, heavy metals etc. from water. While, existing membranes have been reported to be not compatible for reuse and recycle. These gaps demonstrate that there is still an apparent requirement of a cost-effective simpler solution for providing people with quality water. In this project, the lab developed Sericin coated UF membrane will be optimized at industrial level and scaled up for commercial production of Sericin coated membranes. Further, this project will include pilot demonstration of membrane fabrication process, cost-effective post-treatment method and life-cycle study with procedure appropriate maintenance activities. This project will also provide a novel collection method for used UF membrane, its recoating and recirculation.
- Development of Raman spectroscopy as a surveillance technology for antimicrobial resistance
Organization: Indian Institute of Sciences (IISC), Bangalore
The project intends to create a Raman database by collecting and recording Raman spectra at every step of various bacterial strains that are sensitive, intermediate or resistant to antimicrobial agents. The focus is to understand the progression/emergence of AMR to work as a supportive surveillance technology. The spectral database will also aid in prediction of possible resistance in bacterial strains. The study team aims to evaluate how bio spectroscopy, in particular Raman spectroscopy, can be utilised to fingerprint microbiomes and study the progression of AMR resistance in bacteria.
- Harmonized One health Trans-species and community Surveillance for Tackling Antibacterial Resistance in India HOT-STAR-India
Organization: The INCLEN Trust International, New Delhi
Collaborators: All India Institute of Medical Sciences, Bhubaneswar; Kalinga Institute of Medical Sciences, Bhubaneswar; IMS-SUM Hospital, Bhubaneswar; Hi-Tech Medical College, Bhubaneswar; OUAT Veterinary College, Bhubaneswar; Central Institute of Freshwater Aquaculture, Bhubaneswar
The study intends to implement an ecological multi-host surveillance to document the bacterial infections and antibacterial resistance (ABR) among humans, animals, birds and fishes sharing the environment and linkage with antibiotics and disinfectant exposures at individual, household/habitation and community levels from different sources. The application of geospatial epidemiology technology shall allow integrating data from multiple sources. The evidence base generated shall address the gap to transform the public health action across sectors and trigger advanced molecular and genetic epidemiology.
- Impact of AMR burden on the health Index of poultry farm workers
Organization: CSIR-Institute of Microbial Technology (IMTech), Chandigarh
Principal Investigator: Dr. Manoj Raje
Collaborator: Post Graduate Institute of Microbial Technology (PGIMER), Chandigarh
The study focuses on the transmission dynamics of resistance in poultry farm workers to estimate the possibility of zoonotic transfer of pathogens. The study will be looking at humans, animals, air and water as well.
- Community and Hospital Acquired Invasive Carbepenem Resistant Enterobacteriaceae: Longitudinal Study of the Gut Microbiome in Infected and Non-Infected Children and their Families
Organization: Christian Medical College, Vellore
Collaborator: University of Colorado, Denver
The study plans to collect stool samples from children admitted to the ICU to identify invasive MDR Enterobacteriaceae. Serial sampling of these children and subsequently their family members in the community will allow for longitudinal study of the microbiome and the presence of carbapenemase bacterial genes in their faecal samples. This will allow assessment of the risk of secondary transmission of hospital acquired resistant strains to household contacts
- Understanding the transmission of antibiotic resistance between hospitals and the environment
Organization: National Centre for Cell Sciences (NCCS), Pune
The project proposes to monitor AMR at metagenomic level by focussing on unique microbial antibiotic resistance genes (ARG) signatures and tracking the resistance from the “source” to the “sink”. The approach intends to provide direct information about AMR and its implications on vulnerable populations. This information is lacking in Indian context and a reliable catalogue would help in proper visualization of the network involved in AMR and to develop strategies to mitigate it
