Does AMR in livestock contribute to AMR in people in NE India? An interdisciplinary study.

大量的抗生素用于饲养牲畜，这些抗生素的使用导致选择具有耐药性的细菌。有一些证据表明，这些细菌可能有助于导致人类疾病的细菌的耐药性水平。这项研究的目的是调查在印度东北部一个地区的人类疾病病例中是否也发现了农场中发现的抗生素耐药性细菌菌株。该项目还将记录农场抗生素的使用情况，并调查影响抗生素使用的人类行为和动物健康因素。这项研究结合了微生物和社会科学的研究方法。该地区的农业主要由印度许多农村地区典型的小型畜牧企业组成。其目的是全面描述耐药细菌在人类，牲畜（包括水产养殖）和环境中的分布，并对导致选择这些细菌的背景进行彻底研究，以了解使用哪些抗生素（和数量）以及原因。该项目还旨在提高印度的研究能力，通过在应用DNA测序和社会科学方法研究抗生素耐药性方面增加经验和培训，继续开展这项工作。在农场采样，以细菌从动物，人，环境和零售肉类产品，连同细菌从人类疾病的情况下，从当地医院。2.从农场收集数据以记录抗生素的使用，如何以及为什么做出使用抗生素的决定，哪些人影响这些决定，以及哪些因素影响决策过程（包括如何做出推定诊断，社会等级，先验知识，教育，态度和经济因素）使用既定的社会科学研究方法。对细菌进行DNA测序，以确定抗生素耐药性的机制，并比较农业和医院细菌的相关性。这使我们能够确定是否有抗生素耐药性从农场动物传播到人。4.制定针对印度农村情况的抗生素管理建议、材料和计划，以最大限度地提高动物健康并确保合理使用抗生素。需要高质量的科学证据，以确保对农场抗生素使用的任何限制都是合理的，并有针对性。无论对人类抗生素耐药性有何贡献，农业中更好的抗生素管理将降低牲畜的耐药性水平，并改善动物健康。

Considerable amounts of antibiotics are used in the rearing of livestock and the use of these antibiotics leads to the selection of bacteria that are resistant. There is some evidence that these bacteria may contribute to resistance levels in bacteria that cause human disease. This research aims to investigate if antibiotic resistant strains of bacteria found in farms are also found in cases of human disease in a region of North East India. This project will also record the use of antibiotics on farms, and to investigate the human behavioural and animal health factors that influence antibiotic use. The study combines microbiological and social science research methods. Agriculture in this area consists mainly of smaller livestock enterprises typical of many rural settings in India. The aim is to provide a comprehensive description of the distribution of resistant bacteria in humans, livestock (including aquaculture) and the environment together with a thorough study of the context which leads to the selection of these bacteria in order to understand which antibiotics (and the quantities) are used and why. The project also aims to increase the research capacity in India to continue this work through increased experience and training in the application of DNA sequencing and social science methods for research into antibiotic resistance.The specific research work that will be performed is:1. Sampling on farms in order to bacteria from animals, people, the environment and retail meat products, together with bacteria from cases of human disease from local hospitals.2. Collection of data from farms to record antibiotic use, how and why decisions are made to use antibiotics, which individuals are influencing these decisions, and what factors affect the decision-making process (to include how presumptive diagnoses are made, societal hierarchy, prior knowledge, education, attitudes, and economic factors) using established social science research methods .3. DNA sequencing of the bacteria in order to characterise the mechanisms responsible for antibiotic resistance, and to compare the relatedness of agricultural and hospital bacteria. This enables us to determine if there is transmission of antibiotic resistance from farm animals to people.4. To develop antibiotic stewardship advice, materials and programmes that are tailored to a rural Indian context in order to maximise animal health and ensure rational use of antibiotics.Good quality scientific evidence is needed to ensure that any restrictions on antibiotic use on farms are rational, and targeted appropriately. Regardless of any contribution to human antibiotic resistance better antibiotic stewardship in agriculture will reduced levels of resistance in livestock and lead to improved animal health.