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

本研究的目的是首先绘制印度从农场到餐桌的整个禽肉供应链中的抗菌素使用（AMU）和由不适当使用驱动的抗菌素耐药性（AMR）。该研究提供了[1]绘制AMU图谱的独特机会，[2]了解AMR发展的切入点和[3]家禽中不适当的AMU的贡献，[4]并提出了解决印度巨大AMR负担的潜在解决方案。AMR是一个主要的全球健康风险，特别是在发展中国家，威胁人类和动物健康。造成这一问题的原因是在人和牲畜生产中不适当地使用抗菌剂。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，可用的治疗方案越来越少。研究表明，牲畜通常可能在肠道中携带耐药细菌，家禽和家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剂，它们是如何使用的，以及这如何导致可能对人类和动物健康构成威胁的AMR细菌的携带，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密集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，以预防和治疗疾病。到目前为止，还没有关于禽肉供应链中AMU或AMR的全面研究。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有助于AMR的选择和传播，以更好地使用;与农民和其他利益相关者一起设计干预措施，以减少AMU/AMR，这是具有成本效益且易于实施的;确定改变AMU做法或使用替代品的经济影响。该项目将与家禽业、政策制定者和其他利益相关者密切合作，以确保研究结果产生影响。该项目及时提供了重要数据，为抗菌剂管理提供信息：印度家禽业的轨迹正在转向集约化养殖，预计AMU将大幅上升。因此，这是一个通过与利益攸关方密切合作进行干预的机会，为可持续的AMU提供替代战略。该项目还提供了其他好处，强大的社会科学组成部分提供了对驱动AMU的行为的独特见解，以及实现AMU和AMR可视化的服务设计和协同设计策略。印度研究人员将接受这些方法的培训，建设印度农业和兽医研究方面的社会科学能力，这将在该项目结束后很长一段时间内具有价值。该研究将首次绘制印度从农场到餐桌的整个禽肉供应链中的AMU和AMR。该研究提供了一个独特的机会，可以绘制AMU地图，了解AMR发展的切入点以及家禽中不适当AMU的贡献，并提出解决印度巨大AMR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.