Understanding the home as a source of infection of AMR bacteria carried by dust by exploring hygiene practices in different home environments in Ghana

“尘埃兔”项目将采用结合微生物学分析的设计方法来解决加纳的家庭感染问题，特别是那些具有抗菌素耐药性的感染问题，从而减少感染并积极提高健康结果。在自然环境和人造环境（如家庭、学校、医院等）中发现的细菌正在建立对药物的耐药性——改变以保护自己免受抗生素的侵害。这意味着，在不久的将来，像轻微的伤口感染这样简单的事情可能会危及生命。这是一个令人担忧的问题，抗菌素耐药性（AMR）现在被视为一种全球健康危机，远远超过埃博拉等疾病的爆发，与气候变化一样现实。这在非洲的发展中国家，例如在加纳，表现得更为明显和关键，那里有许多人死于传染病。细菌由病原体（坏细菌）和非病原体（好细菌）组成，通常散布在家里。家中的大多数表面都有一定程度的细菌覆盖，但与厨房工作表面和家具等固定表面不同，灰尘可以更容易地在家中的不同部位移动，因此是人类接触细菌感染的主要途径。尽管有明确的证据表明家中的微生物暴露和感染传播，但由于进行详细研究的困难，在了解家庭环境方面投入的研究工作较少。虽然家庭环境中灰尘的传播途径是众所周知的，但如何在家中预防细菌感染，从而降低耐药性，还没有得到研究。特别是在发展中国家，如加纳，社会不平等意味着一系列不同质量和类型的住房；这种情况加上受一些经济、教育和宗教因素影响的家庭卫生水平往往很差，助长了传染病的传播。虽然有预防家庭环境感染的卫生准则，但这些准则针对的是卫生专业人员，而不是加纳的普通家庭。因此，确定、理解和发展与发展中国家（如加纳）不同的家庭环境、教育和文化背景相关的家庭卫生习惯，以减少对细菌病原体的接触，从而减少对耐药形式的接触，这是一项非常需要但尚未得到满足的需求。在此背景下，“灰尘兔”项目旨在发展对家庭作为细菌感染来源的理解，这些细菌对抗生素具有耐药性，由灰尘发现和携带。这将通过探索加纳不同家庭环境中的卫生习惯来实现，最终目标是减少家庭环境中的细菌感染，从而减少抗生素耐药性。了解家庭卫生习惯以及与空气传播的抗菌素耐药性细菌的相互作用，将是为加纳各阶层人口以及非洲其他中低收入国家设计适当的教育/信息传播材料的第一步。Dust Bunny，独特地结合了设计研究和微生物学，为家庭清洁和减少家庭感染的新解决方案的社会实践提供了明智的评估。项目团队包括Imagination@Lancaster——一个国际领先的设计研究机构——和野口纪念医学研究所——一个卓越的研究中心和加纳主要的生物医学研究机构，与加纳卫生服务和卫生部合作，为政策变化提供证据。

The Dust Bunny project will apply design methods coupled with microbiological analyses to address issues of home-based infections in Ghana, particularly those carrying antimicrobial resistance, resulting in a reduction of infection and in positive increase of health outcomes.Bacteria found in the natural and built environment (e.g. homes, schools, hospitals, etc.) are building up a resistance to drugs -changing to protect themselves against antibiotics. What this means is that in the not-too-distant future, something as simple as a minor cut infection could become life-threatening. This is such a concern that antimicrobial resistance (AMR) is now considered a global health crisis, far surpassing outbreaks of diseases such as Ebola and as real as climate change. This is even more evident and critical in developing countries in Africa, such as in Ghana, where there are a great number of deaths from infectious diseases. Bacteria are made up of pathogens (bad germs) and non-pathogens (good germs) and are generally scattered across the home. Most surfaces in the home are covered to a certain degree with bacteria, but unlike fixed surfaces such as kitchen work surfaces and furniture, dust can move more easily around different parts of the home and therefore presents a major route for human exposure to bacterial infections. Despite being clear evidence for microbial exposure and infection transmission within the home, there has been less research effort invested in understanding the home environment, due to difficulty of conducting detailed studies. Although the transmission routes by dust in the home environment are well known, what has not been studied is how to prevent bacterial infection at home and thereby reduce resistance.Particularly in developing countries, such as Ghana, social inequalities mean a range of different quality and types of homes; this combined with often poor levels of domestic hygiene that is influenced by a number of economic, educational and religion factors, contributes to the spread of infectious diseases. Although there are hygiene guidelines available for preventing infection in the home environment, these are targeted at hygiene professionals and do not reach the everyday household in Ghana. There is therefore a much-required and unmet need to identify, understand and develop domestic hygiene practices that are relevant to different home environments, educational and cultural backgrounds in developing countries, such as in Ghana, in order to reduce exposure to bacteria pathogens and thereby exposure to resistance forms.Within this context, the Dust Bunny project aims at developing an understanding of the home as a source of infection of bacteria, resistant to antibiotics, found and carried by dust. This will be done by exploring hygiene practices across different home environments in Ghana, with the ultimate aim to reduce bacterial infection in the home environment thereby reducing AMR. Understanding the hygiene practices in the household and interactions with airborne AMR bacteria will serve as a first step to designing appropriate education/information dissemination materials for various sections of the Ghanaian population as well as other low- and middle-income countries in Africa. Dust Bunny, uniquely combines design research and microbiology to provide an informed assessment of societal practices in domestic cleanliness and novel solution to reduce infections in the home. The project team includes Imagination@Lancaster -an internationally leading research institution in design research- and the Noguchi Memorial Institute for Medical Research -a research centre of excellence and the prime biomedical research institution in Ghana, involved with the Ghana Health Service and Ministry of Health in providing the evidence to effect policy changes.