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]目标：本项目旨在描述AMR细菌在人和动物肠道以及环境中的定植特征，并探索马拉维淡水水源附近社区血吸虫病与血吸虫病的关系。[ii]目标：-估计在血吸虫病流行的淡水水源附近生活的社区中产ESBL肠杆菌肠道定植的流行率。-强调AMR肠道定植、血吸虫病和淡水之间的关联，为了提出循证传播途径。-描述来自确定的血吸虫宿主(人和动物)和血吸虫中间宿主(淡水蜗牛)的粪便样本中AMR的基因组流行病学。-从人、动物和环境来源鉴定新的AMR基因。[iii]具体的研究问题：-曼氏葡萄球菌和血结核杆菌的单一和联合感染是否与人类粪便抵抗力的变化和产生ESBL的肠杆菌属肠道定殖率有关？-接触淡水是否与产生ESBL的肠道细菌定殖率改变有关？-是否与中间血吸虫宿主(即，淡水中AMR细菌和基因的储存库：预期的结果和产出：这项研究的结果预计将提供马拉维的AMR监测数据，并强调AMR与血吸虫病之间的联系。在撰写博士论文的同时，还将在会议上介绍成果，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论文。结果还将与马拉维的政策制定者(例如，卫生和控制部方案管理人员)分享和讨论。

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).