Colonisation dynamics of antimicrobial resistance in schistosomiasis-endemic regions of Malawi: a One Health approach

T1 -基础研究T2 -人类/临床研究目的、目标和具体研究问题：[i]目的：本项目旨在研究人类和动物肠道以及环境中AMR细菌的定殖，并探索马拉维淡水源附近社区与血吸虫病的关系。[ii]目的：-估计产ESBL肠球菌肠道定植在血吸虫病流行的淡水源附近社区的患病率。强调AMR肠道定植，血吸虫病和淡水之间的关联，以提出基于证据的传播途径。描述来自终末宿主（人类和动物）和中间宿主（淡水蜗牛）粪便样本中AMR的基因组流行病学。从人类、动物和环境来源中鉴定新的AMR基因。[iii]具体研究问题：-是S。mansoni和S.与粪便耐药基因组变化和人体产ESBL肠球菌肠道定殖率相关的单一和合并感染？是否接近和/或经常接触淡水与改变产ESBL肠球菌肠道定植率相关？中间宿主（即，小泡螺属和双脐螺属物种蜗牛）在淡水中充当AMR细菌和基因的储存库？预期结果和产出：本研究的结果预计将提供马拉维的AMR监测数据，并强调AMR与血吸虫病之间的关联。除了博士论文的生成，结果将在会议上提出，并提交出版物，目的是在微生物学和热带医学领域的高影响力期刊上发表。结果还将与马拉维的政策制定者分享和讨论（例如，卫生部和控制方案管理人员）。

T1 - Basic Research T2 - Human/Clinical ResearchAims, objectives and specific research questions:[i] Aims:This project aims to characterise colonisation of AMR bacteria in the guts of human and animals, and in the environment, and to explore associations with schistosomiasis in communities living near freshwater sources in Malawi.[ii] Objectives:- To estimate the prevalence of ESBL-producing Enterobacterales gut colonisation in communities living near freshwater sources where schistosomiasis is endemic.- To highlight associations between AMR gut colonisation, schistosomiasis, and freshwater, in order to propose evidence-based transmission pathways.- To describe the genomic epidemiology of AMR in faecal samples from definitive schistosome hosts (human and animal) and intermediate schistosome hosts (freshwater snails).- To identify novel AMR genes from human, animal, and environmental sources.[iii] Specific research questions:- Are S. mansoni and S. haematobium mono- and co-infections associated with changes in the faecal resistome and the rates of ESBL-producing Enterobacterales gut colonisation in humans?- Is proximity to and/or regularity of contact with freshwater associated with altered ESBL-producing Enterobacterales gut colonisation rates?- Do intermediate schistosome hosts (i.e., Bulinus and Biomphalaria species snails) act as reservoirs for AMR bacteria and genes in freshwater?Expected findings and outputs:The findings of this study are expected to provide AMR surveillance data in Malawi and highlight associations between AMR and schistosomiasis. Alongside the generation of a PhD thesis, results will be presented at conferences, and submitted for publications, with the aim of publishing in high-impact journals in the fields of microbiology and tropical medicine. Results will also be shared and discussed with policy makers in Malawi (e.g., the Ministry for Health and control programme managers).