Antibiotic resistance among Escherichia coli isolates from stool samples of children aged 3 to 14 years from Ujjain, India.

BACKGROUND: Antibiotic resistance is a major global public health concern, particularly in settings where few treatment options are available. Limited research has been done on antibiotic resistance in Escherichia coli of Indian children at community level. Therefore we studied antibiotic resistance patterns in E. coli isolates from stool samples of children aged 3-14 years from Ujjain, Central India, to investigate associations of resistance with demographic variables. METHODS: Children, 3-14 years of age, were included from 30 randomly selected villages of Palwa demographic surveillance site, Ujjain, India. Parents were interviewed using a questionnaire, and stool samples were collected from participating children. E. coli were isolated from stool samples (n = 529), and susceptibility testing to 18 different antibiotics was done using standard methods. RESULTS: The proportions of isolates resistant to various antibiotics were, nalidixic acid, (45%), tetracycline (37%), ampicillin (37%), sulfamethoxazole/trimethoprim (29%) and amoxicillin/clavulanic acid (29%). No isolates were resistant to imipenem. Overall, 72% of isolates were resistant to at least one antibiotic and 33% were multi-drug resistant. High rates of cross-resistance were seen for 15 (83%) of the antibiotics studied. E. coli isolates from children with literate mothers were more resistant to penicillins and fluoroquinolones. ESBL-producers comprised 9% of the isolates. CONCLUSION: Antibiotic resistance and cross-resistance were common in E. coli from stools of children. Resistance rates were associated with maternal literacy.

Indian medical students in public and private sector medical schools: are motivations and career aspirations different? - studies from Madhya Pradesh, India.

BACKGROUND: In recent years, there has been a massive growth in the private medical education sector in South Asia. India's large private medical education sector reflects the market driven growth in private medical education. Admission criteria to public medical schools are based on qualifying examination scores, while admission into private institutions is often dependent on relative academic merit, but also very much on the ability of the student to afford the education. This paper from Madhya Pradesh province in India aims to study and compare between first year medical students in public and private sector medical schools (i) motives for choosing a medical education (ii) career aspirations on completion of a medical degree (iii) willingness to work in a rural area in the short and long terms. METHODS: Cross sectional survey of 792 first year medical students in 5 public and 4 private medical schools in the province. RESULTS: There were no significant differences in the background characteristics of students in public and private medical schools. Reasons for entering medical education included personal ambition (23%), parental desire (23%), prestigious/secure profession (25%) or a service motive (20%). Most students wished to pursue a specialization (91%) and work in urban areas (64%) of the country. A small proportion (7%) wished to work abroad. There were no differences in motives or career aspirations between students of public or private schools. 40% were willing to work in a rural area for 2 years after graduating; public school students were more willing to do so. CONCLUSION: There was little difference in background characteristics, motives for entering medicine or career aspirations between medical students in from public and private sector institutions.