Drivers of Resistance in Uganda and Malawi: The DRUM Consortium

抗生素的发现和发展是20世纪最伟大的科学成就之一，然而，人们很快就发现，细菌很快就会对这些救命剂产生抗药性，抗药性细菌的传播现在是一个全球关注的问题。地球上最贫穷的国家往往是严重和危及生命的感染的最大负担，这些国家可能受到无法治疗的细菌传播的最大影响。关于抗生素耐药性如何在全球传播还有很多未知之处，在撒哈拉以南非洲地区尤其如此，那里通常没有诊断实验室。“乌干达和马拉维的耐药性驱动因素”或DRUM联盟将研究人类行为和在乌干达和马拉维的城市和农村地区更广泛的环境中使用抗生素如何促进细菌中抗生素耐药性的传播。该联盟对常见的细菌大肠杆菌和肺炎克雷伯菌特别感兴趣。大肠杆菌是一种经常在社区引起感染的细菌，但也可能在医院内传播，而肺炎克雷伯菌是医院获得性感染的关键原因，特别是在早产儿等弱势群体中。我们选择一起研究这些细菌，因为它们来自同一个家庭，并且能够分享使它们对抗生素产生抗药性的特征。Drum联盟计划通过调查人类与抗生素、水、卫生设施和个人卫生有关的行为，以及调查细菌对这些刺激的反应，来调查哪些行为方面在传播抗生素耐药性方面最重要。我们计划使用尖端的数学技术来“模拟”哪些行为是最重要的，然后利用这些信息与乌干达和马拉维的政策专家合作，设计潜在的干预措施，以防止它们进一步蔓延。

The discovery and development of antibiotics is one of the great scientific achievements of the 20th Century, however it rapidly became clear that bacteria quickly become resistant to these lifesaving agents, and the spread of antibiotic-resistant bacteria is now a problem of global concern. The poorest nations on Earth frequently have the greatest burden of severe and life threatening infections, and these nations are likely to suffer most from the spread of untreatable bacteria. There is much that is unknown about how antibiotic resistance spreads globally and this is particularly true of sub-Saharan Africa, where diagnostic laboratories are not commonly available.The "Drivers of Resistance in Uganda and Malawi" or DRUM Consortium will address how human behaviour and antibacterial usage in the home, around animals and in the wider environment in urban and rural areas of Uganda and Malawi contributes to the spread of antibiotic resistance in bacteria. The consortium is especially interested in the common bacteria E. coli and K. pneumoniae. E. coli is an example of a bacteria that often causes infections in the community, but may also spread around hospitals, whereas K. pneumoniae is a key cause of hospital acquired infections, particularly amongst vulnerable groups such as premature babies. We have chosen to study these bacteria together as they are from the same family and are able to share traits that make them resistant to antibiotics. The DRUM consortium plans to investigate which aspects of behaviour are most important in spreading antibiotic resistance by surveying human behaviour in relation to antibiotics, water, sanitation and hygiene and by investigating bacterial behaviour in response to these stimuli. We plan to use cutting edge mathematical techniques to "model" which behaviours are most important and then use this information to work with policy experts in Uganda and Malawi to design potential interventions to prevent them from spreading further.