Chicken or Egg: Drivers for Antimicrobial Resistance in Poultry in India (DARPI)

本研究的目的是首先绘制出在印度从农场到餐桌的整个禽肉供应链中，由于不当使用而导致的抗菌素使用（AMU）和抗菌素耐药性（AMR）。该研究为[1]提供了一个独特的机会来绘制AMU，[2]为了解AMR发展的切入点，[3]为不适当的AMU在家禽中的贡献提供了机会，[4]为解决印度巨大的AMR负担提供了潜在的解决方案。抗菌素耐药性是一个主要的全球健康风险，特别是在发展中国家，威胁着人类和动物的健康。造成这一问题的原因是在人和牲畜生产中不适当使用抗微生物药物。印度的传染病负担很高，来自人类临床感染的细菌越来越难以治疗，可用的治疗选择越来越少。研究表明，牲畜的肠道通常可能携带耐药细菌，家禽和禽肉也被确定为此类细菌的来源。然而，关于问题的严重程度，或者在禽肉生产中使用了哪些抗菌素，如何使用，以及这如何促进可能对人类和动物健康构成威胁的抗菌素耐药性细菌的传播，完全缺乏数据。禽肉是印度主要的蛋白质来源之一，也是增长最快的畜牧业。在印度，越来越多的禽肉是通过更集约化的综合或半综合养殖系统生产的，其中抗菌剂用于各种目的，包括促进生长、预防和治疗疾病。迄今为止，还没有通过禽肉供应链对抗生素耐药性或抗生素耐药性进行全面研究。我们的跨学科项目旨在通过研究整个禽肉食品供应来解决这些数据缺口，以确定：驱动AMU的行为以及这些行为如何促进AMR的选择和传播，从而为更好地利用提供信息；与农民和其他利益相关者一起设计具有成本效益和易于实施的干预措施，以减少抗菌素/抗菌素耐药性；确定改变AMU实践或使用替代方法的经济影响。该项目将涉及与家禽业、决策者和其他利益相关者密切合作，以确保研究结果产生影响。该项目及时地为抗菌药物管理提供了关键数据：印度家禽业的发展轨迹正在转向集约化养殖，预计抗生素单位将大幅增加。因此，这是一个机会，通过与利益相关者密切合作，为可持续的AMU提供替代战略。该项目还提供了其他好处，强大的社会科学组件为驱动AMU的行为提供了独特的见解，以及实现AMU和AMR可视化的服务设计，以及协同设计策略。印度的研究人员将接受这些方法的培训，在印度农业和兽医研究中建立社会科学的能力，这将在这个项目结束后很长一段时间内具有价值。这项研究将是第一个在印度从农场到餐桌的整个禽肉供应链中绘制AMU和AMR的研究。该研究提供了一个独特的机会来绘制抗菌素耐药性图谱，了解抗菌素耐药性发展的切入点以及不适当的抗菌素在家禽中的作用，并提出解决印度巨大的抗菌素耐药性负担的潜在解决方案。

The aim of this study is to first to map antimicrobial use (AMU) and the antimicrobial resistance (AMR) that is driven by inappropriate use, across the entire poultry meat supply chain from farm to table in India. The study provides [1] a unique opportunity to map AMU, [2] to understand entry points for development of AMR and [3] the contribution by inappropriate AMU in poultry, and [4] suggests potential solutions to address the huge AMR burden in India.AMR is a major global health risk, particularly in developing countries, threatening human and animal health. Contributing to this problem is the inappropriate use of antimicrobials in people and livestock production. India has a high burden of infectious disease, and bacteria from human clinical infections are becoming increasingly difficult to treat, with fewer treatment options available. Studies suggest that livestock may commonly carry resistant bacteria in their gut, with poultry and poultry meat also identified as a source of such bacteria. However, there is a complete lack of data on the scale of the problem, or on what antimicrobials are being used in poultry meat production, how they are used, and how this contributes to the carriage of AMR bacteria that may be a threat to human and animal health.Poultry meat is one of the main protein sources in Indian and is the fastest growing livestock sector. Increasingly, poultry meat in India is produced through more intensive integrated or semi-integrated farming systems where antimicrobials are used for various purposes, including for growth promotion, to prevent and treat disease. To date there have been no comprehensive studies on AMU or AMR through the poultry meat supply chain. Our interdisciplinary project aims to address these data gaps by studying the poultry meat food supply in its entirety to determine: behaviours that drive AMU and how these contribute to the selection and transmission of AMR, to inform better use; to design with farmers and other stakeholders interventions to reduce AMU/AMR, which are cost-effective and easy to implement; determine the economic impact from changing AMU practices, or using alternatives. The project will involve working closely with the poultry industry, policy makers and other stakeholders throughout to ensure the findings have impact.This project is timely in providing crucial data to inform antimicrobial stewardship: the trajectory of the Indian poultry industry is shifting towards intensive farming and AMU is predicted to rise substantially. Therefore, this is an opportunity to intervene through working closely with stakeholders to provide alternative strategies for sustainable AMU. The project also offers other benefits, with a strong social science component providing unique insights into behaviours driving AMU, as well as service design enabling visualization of AMU and AMR, and co-design strategies. Indian researchers will be trained in these methods, building capacity for social science in Indian agricultural and veterinary research that will have value long after the conclusion of this project. The study will be the first to map AMU and AMR in the entire poultry meat supply chain from farm to table in India. The study provides a unique opportunity to map AMU, understand entry points for development of AMR and the contribution by inappropriate AMU in poultry, and suggest potential solutions to address the huge AMR burden in India.