In order to generate scientific evidence on the prevailing trends of antimicrobial resistance in the country and at all levels including primary, secondary and tertiary health care systems, the Indian Council of Medical Research (ICMR) will soon begin research on antimicrobial resistance.
Senior officials in the ICMR said that it is extremely essential to generate scientific evidence on the prevailing trends of antimicrobial resistance in all parts of the country and at all levels i.e. primary, secondary and tertiary health care systems. It is also vital to understand the unknown mechanisms of drug resistance in various micro-organisms. On individual basis, researchers have been reporting the presence of multi-drug resistant organisms and their anti-microbial susceptibility patterns, but there is lack of a consolidated effort to bring about a change.
It is under this background that the ICMR has decided to initiate research on antimicrobial resistance, the officials said.
The research projects will be mainly in the areas like microbial factors, host factors, environmental factors, ecological factors, improved diagnosis, etc.
Under the microbial factors, the study will focus on the genetic analysis of microbes to determine sequences of genes and reveal vulnerable areas in a microbe’s genome which could be used as potential drug targets or aid in the development of better diagnostic tests. It will also focus on mechanisms of emergence and transfer of resistance genes among pathogens in vivo (in the host), and the distribution and dissemination of specific antimicrobial resistance genes over time.
Under the host factors, the research will focus on vitro studies to determine the host factors and immune modulators (e.g. cytokines) in normal flora, serving as resistance determinants to antibiotics; and in-vivo correlations between resistance determinants in normal flora and the prevalence of resistant pathogens.
In the environmental factors, the study will focus on contamination of water and soil by pesticides, heavy metals and anti-bioticresidues and its relationship to drug resistance. In the ecological factors, it will focus on the role of normal flora and probiotics in the emergence/control of drug resistance.
The ICMR also proposes to network the existing centres of excellence working on drug resistance in individual microbes so that they follow standard protocols and institute quality assurance and quality control measures so that authentic data on prevalence and time trends could be generated. They would need to be equipped, trained and supported to start genetic level studies in development of drug resistance. The study in this area will focus on developing methods for early diagnosis and detection of resistant strains and molecular applications for the rapid diagnosis of difficult to treat (MDR-TB, XDR-TB) as well as common infectious diseases related infections causing URTI and diarrhoea. In such cases, the irrational use of antibiotics remains to be highest.
The ICMR also proposes study on improvement of existing treatment modalities and development of new treatment modalities.