Tackling antimicrobial resistance in dairy production: smartphone microfluidics for parallel resistance gene detection alongside functional antibiotic

细菌中的抗菌素耐药性(AMR)是人类和动物健康以及食品生产/安全的主要威胁。在食用动物中使用抗菌剂有助于抗菌素耐药细菌(ARB)的出现和传播，这种细菌可以通过各种途径从动物传播到人类，包括进入人类食物链的受污染的牛奶和乳制品。关于英国消费者在牛奶和其他乳制品(如生奶奶酪)中可能接触AMR的额外数据以及相关健康风险的评估至关重要。然而，2016年食品标准局的一份报告证实，关于英国牛奶和乳制品中AMR的科学证据和监测数据仍然有限。该项目旨在利用智能手机和微流控技术，开发用于AMR检测和分析的微型下一代工具，为了解和控制这一公共卫生风险提供新的数据。在我们最近对牛奶样本进行的小规模可行性研究中，我们发现了抗药性细菌的例子，包括致病和非致病物种(即共生体/健康牛奶微生物群)。此外，一些细菌对多种抗生素(&gt；3种不同类别)具有抗药性，包括“最优先、最重要”的抗生素。我们在健康奶牛和患有乳房炎的牛奶中都发现了这些。携带AMR基因的ARB的存在引发了人们对原料奶和由原料奶制成的奶酪的安全性的担忧。ARB引起的乳房炎感染也使维持动物的健康和福利变得具有挑战性，因为治疗乳房炎(甚至其他感染)变得更具挑战性，治疗失败也更常见。目前的AMR检测方法仍然太慢(&gt；2D)，对于监测和AMR检测来指导治疗乳房炎时的抗生素选择来说，都太慢了，这需要在中央实验室中的专业技术人员。微流体可以进行快速测试，当与最新的智能手机和数字成像技术相结合时，这些实验室技术可以被转移到现场。我们将开发尖端、快速和便携的技术，用于AMR基因和功能性抗生素敏感性的并行检测。这些将专门为应对乳制品生产中的AMR挑战而开发，通过使我们能够了解和防止AMR在牛奶和奶酪生产中出现并传播到人类，从而促进粮食安全。

Antimicrobial resistance (AMR) in bacteria is a major threat to human and animal health, and to food production/security. Antimicrobial use in food animals contributes to the emergence and spread of antimicrobial resistant bacteria (ARB), which can spread from animals to humans via various pathways, including contaminated milk and dairy products entering the human food chain. Additional data regarding the potential exposure of British consumers to AMR in milk and other dairy products (e.g. raw milk cheeses) and assessment of associated health risk is vital. However, scientific evidence and surveillance data regarding AMR in milk and dairy products in the UK remains limited, confirmed in a 2016 Food Standards Agency report. This project aims to develop miniaturised, next-generation tools for the detection and analysis of AMR, exploiting smartphone and microfluidic technology, to provide new data for understanding and controlling this public health risk. In our recent small-scale feasibility study of milk samples, we found examples of antibiotic resistant bacteria, both pathogenic and non-pathogenic species (i.e. commensals/healthy milk microbiota). Furthermore, some bacteria were resistant to multiple antibiotics (>3 different classes) including 'Highest Priority Critically Important' antibiotics. We found these in milk from both healthy cows and suffering from mastitis. The presence of ARB carrying AMR genes raises concerns about the safety of raw milk as well as cheese made from raw milk. ARB causing mastitis infection also makes it challenging to maintain animal health and welfare, because treating mastitis (and indeed other infections) becomes more challenging and treatment failure more common. Current AMR detection methods remain far too slow (>2d) and laborious for both surveillance, and for AMR detection to guide antibiotic selection when treating mastitis, requiring expert technicians in centralised labs. Microfluidics can perform rapid tests and when combined with the latest smartphone and digital imaging technology, these laboratory techniques can be transported into the field. We will develop cutting-edge rapid and portable technology for parallel detection of both AMR genes, and of functional antibiotic susceptibility. These will be developed specifically for addressing AMR challenges in dairy production, contributing to food security by allowing us to understand and prevent AMR arising in milk and cheese production and spreading to humans.