1.2 AMR in India
AMR emergence in India is majorly driven by factors like the high burden of bacterial infections, poor sanitary, hygiene conditions, and the increasing proportion of intensive animal farming, and this is ramped by the unregulated access to antibiotics, including sale without prescription or with an invalid prescription. The use of antibiotics as growth promoters in animal husbandry is a common practice and this, in turn, affects human health, as antibiotic-resistant bacteria can be transmitted between humans and animals through contact, food products, and from the environment . In 2010 it was estimated that India was the fifth-largest consumer of antibiotics in food animals (poultry, pigs, and cattle), after China, the United States, Brazil, and Germany based on livestock density .
Fig 1: Number of formulation companies manufacturing various antibiotics for animal use. This shows sulfonamides are one amongst the highly produced antibiotics in India .
|Study||Year(s) data collection and state||Specimen||Organism||Findings|
|Brower et al. 2017||2014 Punjab||Cloacal swab samples Broilers (n=270) Layers (n=260)||Not applicable||ESBL producing strains (%) Broilers: 87% of cloacal swabs Layers: 42% of cloacal swabs|
|Shrivastav et al. 2016||2015 Madhya Pradesh||Cecal swabs||E. coli (n=400)||ESBL producers (%) Broilers: 33.5%|
|Kar et al. 2015||2013-2014 Odisha||Feeal sample||E. coli (n=170)||ESBL producers (%) Poultry: 9.4%|
|Naik et al. 2015||2013-2014 Chattisgarh||Chicken meat samples (n=200)||Salmonella species (n=14)||Prevalence of Salmonella: 7% Resistance % Ciprofloxacin:o9 Erythromycin:100% Oxytetracyeline: 42.8%|
|Kaushik et al. 2014||2010-2013 Bihar||Chicken meat samples (n=228)||Salmonella species (n=54)||Prevalence of Salmonella: 23.7% 100% resistance AmpicillinGentamicin Highly sensitive Ceftriaxone Azithromycin Moderately sensitive Ciprofloxacin Tetracyeline|
|Samanta et al. 2014||Year not mentioned West Bengal||Cloacal samples, eggs and environment samples of backyard poultry flocks (n=360)||Salmonella species (n=22)||Prevalence of Salmonella: 6.1% Resistance % Ciprofloxacin: 100% Gentamicin: 100% Tetracycline:1009 Ceftriaxone:|
|Singh et al. 2013||Year not mentioned Uttar Pradesh||Cloacal samples, eggs and environment samples (n=720)||Salmonella species (n=26)||Prevalence of Salmonella- 3.3% Resistance% Ampicillin: 0% Ciprofloxacin: 11.5% Gentamicin: 7.7% Tetracycline:23.1%|
Table 1: Antibiotic resistance in poultry in various studies in India 
In the studies conducted involving farms, it was observed that there was high resistance to the commonly used antibiotics including sulfonamides, ciprofloxacin, β-lactams, and tetracycline . However, the data available for India is still quite inadequate and there is a lot of information gap that needs to be bridged with the help of surveillance and studies.
From the data available from other nations it was noted that agricultural waste contains high levels of antibiotics. This is because of high consumption and incomplete metabolism in the animal bodies .
Fig 2: The graph above depicts the detection of antibiotics in poultry (“Poultry Litter”), swine (“Swine Manure”), and beef cattle (“Cattle Manure”) manure. Antibiotic class codes on the y-axis are as follows: MC macrolide, LM lincosamide, TM trimethoprim, TC tetracycline, SA sulfonamide, PP polypeptide, FQ fluoroquinolone, COC coccidiostat, BL beta-lactam .
From Table 2, fluoroquinolones, sulfonamides, and tetracyclines were found consistently in all the litters (poultry, swine, cattle) across different countries. All of these have been listed by WHO as critically important for human health. The relatively low concentrations of beta-lactams and polypeptides were due to their ability to get readily metabolized. This shows that the previously mentioned classes of antibiotics are of greater concern and there is a need to design and test treatment technologies that ensure degradation of antimicrobials in animal waste before use as fertilizers and soil amendments .
|Sample type||Source of Sample||Antiblotic class||Maximum Detected Range||Remarks|
|Poultry Litter||China, Egypt, and Austria||Enrofloxacin (fluoroquinolone)||1421mg/kg. 31mg/kg and 8mg/kg|| |
|Poultry litter||China||Sulfonamides and sulfadiazine||6mg/kg and 51mg/kg|| |
|Poultry Litter||USA||Tetracyclines||66 mg/kg||Also, in Austria, China and Egypt tetracycline residues were detected|
|Swine Litter||USA||sulfamethoxazole and trimethoprim||400 ug/L and 2.5 ug/L|| |
|Swine Litter||USA||Macrolides (i.e., erythromycin and tylosin)||0.001 to 10 mg/L|| |
|Swine litter||Austria China, Germany, Switzerland and the USA||All classes (fluoroquinolone sulfonamide and tetracycline)||0.01 and 100 mg/kg (or mg/L).||Tetracycline antibiotics and key metabolic products. have been widely reported in swine manure with detection frequencies as high as 73 % in Austria|
|Cattle Litter||USA||All classes (fluoroquinolone sulfonamide and tetracycline)||The range observed for fluoroquinolones and tetracyclines was 0.1 to 100 mg/kg. but sulfonamide levels were lower.|| |
|Cattle litter||China||Oxytetracycline, enrofloxacin, ciprofloxacin and chlortetracycline||59.59mg/kg. 46.70 mg/kg. 29.59 mg/kg and 27.59 mg/kg|