Airway and Resistome Microbiology - Markus Hilty

One Health project of the resistome in Thailand

Southeast Asia (SEA) is considered to be a hotspot for infectious diseases and antimicrobial resistance (AMR). The alarming prevalence of extended-spectrum beta -lactamases producing enterobacteria (ESBL-E) and the emergence and the rapid dissemination of plasmids carrying the mcr-1 gene conferring resistance to colistin (polymixin E) in Thailand is therefore a global health concern. The abuse of antibiotic in human is suggested to be the cause of this very high prevalence in community. However, other factors could also be responsible, in particular, occupational or direct contact with farm’s animals could be a risk factor of acquiring genes of resistance from zoonotic bacteria. For example, colistin has been extensively used in animal production, often as growth promoters and clonal transmission of colistin-resistant E. coli from a domesticated pig to a human was demonstrated in Laos. Colistin is re-introduced as the last resort antibiotics to cure multidrug resistant Gram-negative infection in human setting and therefore resistance to colistin is worldwide, one of the most worried concern. Therefore it is urgent to elucidate the role of farm animals in the spread of AMR in the community and to assess the risk factors for animals and humans to be colonized with AMR. Therefore, the main objective of this proposal is to assess, with a One Health approach, the occupational risk for pig and poultry farmers to be colonised with animal-associated ESBL-E and colistin-resistant Gram-negative bacteria. The second objective is to look at the association between farm parameters and prevalence of AMR. In particular: a) the type of animal production (extensive vs intensive), b) the antimicrobial usage (type and quantity) and c) the role of the other animals present on the farm with a special focus on rodents. The third objective is to study the influence of faecal carriage of ESBL-E or colistin resistant bacteria on the faecal microbiota of farmers. Finally, the fourth objective is to transfer the analytical methods (microbiota analysis) to a Thai PhD student and to propose efficient preventive measure to reduce the prevalence of resistance in animal farms and to avoid the transmission to the farmers.

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