A One Health approach to assessing occupational exposure to antimicrobial resistance in Thailand: The FarmResist project.

Duangdao Sudatip,Sophie Alexandra Baron,Anamika Kritiyakan,Kittipong Chasiri,Surapee Tiengrim,Chuanphot Thinphovong,Visanu Thamlikitkul,Markus Hilty,Wantanee Phanprasit,Anne Oppliger,Serge Morand,Jean-Marc Rolain,Rim Abdallah

doi:10.1371/journal.pone.0245250

Abstract

This Southeast Asia-Europe research project will use a One Health approach to identify the major parameters responsible for the presence of animal-associated antimicrobial resistant bacteria in animal production facilities in Thailand and the risk of their transmission from animals to humans. We will focus on traditional, small, extensive pig and poultry farms where information on antibiotic use is scarce and animals live in close contact with humans. This cross-sectional study will be based on the epidemiological analysis of the antimicrobial resistance (AMR) present in fecal samples from animals and humans. Extended spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E) and Enterobacteriaceae resistant to colistin will be actively searched in the feces of farm animals (pigs and poultry), small wild rodents and farmers. Phenotypic (selective plating) and genotypic (multilocus seuquence typing and sequencing) methods will be used for the detection of AMR, the identification of antibiotic resistance genes (ARGs) and the characterization of strains carrying resistance genes. Questionnaires will be administered to investigate the effects of antibiotic use, farm characteristics and biosecurity measures on the occurrence of AMR in animals. Subsequently, the fecal carriage of AMR and ARGs in farmers will be compared to a control population with no occupational contacts with animals, thus enabling an estimation of the risk of transmission of AMR/ARGs from animals to farmers.

Highlights

One Health is a collaborative, multi-sectoral, trans-disciplinary approach working at local, regional, national, and global levels used to achieve optimal health and well-being outcomes which recognize the interconnections between people, animals, plants and their shared environment
The approach is relevant for combating antimicrobial resistance (AMR) since animals and humans are colonized by the same bacteria species and cured with the same classes of antibiotics
The objectives are: 1) to assess the occupational risk of pig and poultry farmers being colonized by animal-associated Extended spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E) and colistin-resistant Enterobacteriaceae and 2) to look at the associations between farm characteristics, included the presence of rodents carriers of AMR and the prevalence of AMR in the farm’s animals and the farmers

Summary

Introduction

One Health is a collaborative, multi-sectoral, trans-disciplinary approach working at local, regional, national, and global levels used to achieve optimal health and well-being outcomes which recognize the interconnections between people, animals, plants and their shared environment (www.onehealthcommission.org). Despite the alarming carriage of ESBL-E and colistin-resistant bacteria in the community and the significant use of antibiotics in pig and poultry farming, data concerning antimicrobial usage (AMU) and the prevalence of AMR in pig and poultry farm environments are poorly documented. To fill this gap, in 2016, the Thai cabinet endorsed a National Strategic Plan on Antimicrobial Resistance 2017–2021. The objectives are: 1) to assess the occupational risk of pig and poultry farmers being colonized by animal-associated ESBL-E and colistin-resistant Enterobacteriaceae and 2) to look at the associations between farm characteristics, included the presence of rodents carriers of AMR and the prevalence of AMR in the farm’s animals and the farmers

Methods

Findings

Conclusion and perspective