Spatial and temporal dynamics of AMR transmission from the outdoor environment to humans in urban and rural Bangladesh

孟加拉国城乡从室外环境到人类的抗菌素耐药性传播的时空动态

• 批准号: NE/N019555/1
• 负责人: Emily Rousham
• 金额: $ 20.64万
• 依托单位: Loughborough University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2016
• 资助国家: 英国
• 起止时间: 2016 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=NE%2FN019555%2F1
• 关键词: Spatial; temporal; dynamics; AMR; transmission

Antibiotic resistant bacteria can be found in freshwater, soil, wastewater and among livestock. It is not yet known, however, how easily these resistant bacteria in the outdoor environment can be transmitted to humans. Research is needed on the human health risk from antimicrobial resistance (AMR) in the natural environment, and research is required in locations with high levels of AMR in the environment and where humans are at high risk of environmental exposure. Bangladesh is one such location where many factors favour the transmission of antibiotic resistance such as the widespread bacterial contamination of soil and drinking water; high human population densities; inadequate sanitation and poor treatment of wastewater alongside regular floods and natural disasters. Furthermore, inexpensive antibiotics are readily available from over-the-counter suppliers leading to widespread use in humans and animals. This study will examine whether there is a health risk to humans from being exposed to AMR in the outdoor environment in Bangladesh. The novelty of the study is that it will measure the quantity of resistant bacteria in the outdoor environment (freshwater, soil, wastewater) and relate this to the presence of resistant bacteria in livestock (poultry) and humans at the same time and in the same locations. This will also be one of the first studies to measure AMR in humans with high and low exposure to contaminated environments. The study will take place in three locations where transmission is likely to be high because of human interaction with animal and environmental reservoirs of AMR contamination. These locations are urban markets selling live poultry in Dhaka city, commercial poultry farms and rural villages where poultry and humans share living and sleeping areas. We will measure the quantity of resistant bacteria in the gut (faeces) of humans who live or work closely with poultry (such as live poultry sellers and slaughterers, commercial poultry farm workers and village women who have poultry living in the household). These rates will be compared to humans who share similar environments but have little or no exposure to poultry. We predict that the resistant bacteria from the gut of chickens will be present in poultry faeces and that this is a potential route of AMR transmission to humans through close contact. We also predict that there will be more AMR bacteria in poultry that are given antibiotics regularly in poultry feed or as medication and this will increase the risk of AMR bacteria in humans. A further aim is to study how resistant bacteria in the environment change over time by comparing the quantity of resistant genes in water, soil and waste during the dry season and wet season in Bangladesh. Understanding the seasonal changes of AMR in the outdoor environment will enable us to target interventions at times when the risks of transmission of AMR are highest.Finally, we will examine the cultural and social practices in animal husbandry and poultry keeping in relation to the use of antibiotics as medicine and in animal feed. We will observe the practices of farm workers, slaughterers and market sellers to assess which aspects of food production, selling and disposal of poultry waste contaminate the environment, and what human activities (hand washing, use of gloves, handling of poultry) increase or decrease risk of exposure to AMR. We will use this information to identify ways of reducing the spread of AMR among animals and humans. This study will provide new insight into whether AMR in the environment is a serious threat to human health. As new forms of resistant genes and bacteria are spreading rapidly in south Asia, there is an urgent need to establish how AMR can be transmitted through water, soil, waste and livestock, and identify what can be done to reduce this transmission at a global level.

抗生素耐药细菌可以在淡水、土壤、废水和牲畜中发现。然而，目前尚不清楚这些耐药细菌在户外环境中传播给人类的容易程度。需要对自然环境中抗菌素耐药性（AMR）对人类健康的风险进行研究，并需要在环境中AMR水平高以及人类处于环境暴露高风险的地方进行研究。孟加拉国就是这样一个地方，许多因素有利于抗生素耐药性的传播，如土壤和饮用水的广泛细菌污染;人口密度高;卫生设施不足和废水处理不善，以及经常发生洪水和自然灾害。此外，廉价的抗生素很容易从非处方药供应商获得，导致在人类和动物中广泛使用。这项研究将检查在孟加拉国的户外环境中暴露于AMR是否对人类造成健康风险。这项研究的新奇在于，它将测量室外环境（淡水、土壤、废水）中耐药细菌的数量，并将其与同一时间和同一地点牲畜（家禽）和人类中耐药细菌的存在联系起来。这也将是第一个测量人类在高和低暴露于污染环境中的AMR的研究之一。该研究将在三个地点进行，由于人类与动物和AMR污染的环境水库的相互作用，传播可能很高。这些地点是达卡市出售活禽的城市市场、商业家禽养殖场和家禽和人类共用生活和睡眠区的农村村庄。我们将测量与家禽生活或工作密切的人（如活禽销售者和屠宰者、商业家禽农场工人和家中有家禽的农村妇女）肠道（粪便）中耐药细菌的数量。这些比率将与共享相似环境但很少或没有接触家禽的人进行比较。我们预测来自鸡肠道的耐药菌将存在于家禽粪便中，这是通过密切接触向人类传播AMR的潜在途径。我们还预测，在家禽饲料中定期给予抗生素或作为药物的家禽中将有更多的AMR细菌，这将增加人类中AMR细菌的风险。另一个目的是通过比较孟加拉国旱季和雨季水、土壤和废物中的抗性基因数量，研究环境中的抗性细菌如何随时间变化。了解AMR在室外环境中的季节性变化将使我们能够在AMR传播风险最高的时候进行针对性干预。最后，我们将研究畜牧业和家禽饲养中与抗生素作为药物和动物饲料使用相关的文化和社会实践。我们将观察农场工人、屠宰者和市场销售者的做法，以评估食品生产、销售和家禽废物处置的哪些方面会污染环境，以及哪些人类活动（洗手、使用手套、处理家禽）会增加或减少AMR暴露的风险。我们将利用这些信息来确定减少AMR在动物和人类之间传播的方法。这项研究将为环境中的AMR是否对人类健康构成严重威胁提供新的见解。随着新形式的耐药基因和细菌在南亚迅速传播，迫切需要确定AMR如何通过水、土壤、废物和牲畜传播，并确定可以采取哪些措施在全球范围内减少这种传播。

项目成果

Human exposure to antimicrobial resistance from poultry production: Assessing hygiene and waste-disposal practices in Bangladesh

• DOI: 10.1016/j.ijheh.2019.07.007
• 发表时间: 2019-09-01
• 期刊: INTERNATIONAL JOURNAL OF HYGIENE AND ENVIRONMENTAL HEALTH
• 影响因子: 6
• 作者: Mahbub-Ul Alam;Rahman, Mahbubur;Unicomb, Leanne
• 通讯作者: Unicomb, Leanne

Human Colonization with Extended-Spectrum Beta-Lactamase-Producing E. coli in Relation to Animal and Environmental Exposures in Bangladesh: An Observational One Health Study.

• DOI: 10.1289/ehp7670
• 发表时间: 2021-03
• 期刊: Environmental health perspectives
• 影响因子: 10.4
• 作者: Rousham EK;Asaduzzaman M;Mozmader TIMAU;Amin MB;Rahman M;Hossain MI;Islam MR;Mahmud ZH;Unicomb L;Islam MA
• 通讯作者: Islam MA

Spatial and temporal variation in the community prevalence of antibiotic resistance in Bangladesh: an integrated surveillance study protocol.

• DOI: 10.1136/bmjopen-2018-023158
• 发表时间: 2018-04-28
• 期刊: BMJ open
• 影响因子: 2.9
• 作者: Rousham E;Unicomb L;Wood P;Smith M;Asaduzzaman M;Islam MA
• 通讯作者: Islam MA

Impact of contrasting poultry exposures on human, poultry, and wastewater antibiotic resistomes in Bangladesh.

• DOI: 10.1128/spectrum.01763-23
• 发表时间: 2023-12-12
• 期刊: MICROBIOLOGY SPECTRUM
• 影响因子: 3.7
• 作者: Williams, Alexander D.;Rousham, Emily;Neal, Andrew L.;Amin, Mohammed Badrul;Hobman, Jon L.;Stekel, Dov;Islam, Mohammad Aminul
• 通讯作者: Islam, Mohammad Aminul