TY - JOUR
T1 - Impacts of Antibiotic Residues in the Environment on Bacterial Resistance and Human Health in Eastern China
T2 - An Interdisciplinary Mixed-Methods Study Protocol
AU - Cai, Shenghan
AU - Wang, Na
AU - Xu, Like
AU - Yan, Fei
AU - Jiang, Qingwu
AU - Zhao, Xinping
AU - Wang, Wei
AU - Wang, Hexing
AU - Jiang, Lufang
AU - Cong, Wenjuan
AU - Sheppard, Samuel K.
AU - Weeks, Jason
AU - Kasprzyk-Hordern, Barbara
AU - Fu, Chaowei
AU - Lambert, Helen
N1 - Funding Information:
Funding: This work was supported by the Medical Research Council and Newton Fund through a UK–China AMR Partnership Hub award (MR/S013717/1), and the National Natural Science Foundation of China award (81861138050). The funders had no role in the design, collection, analysis, or interpretation of data, or in the decision to submit the manuscript for publication.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Antibiotic resistance is a global health challenge that threatens human and animal lives, especially among low-income and vulnerable populations in less-developed countries. Its multi-factorial nature requires integrated studies on antibiotics and resistant bacteria in humans, animals, and the environment. To achieve a comprehensive understanding of the situation and management of antibiotic use and environmental transmission, this paper describes a study protocol to document human exposure to antibiotics from major direct and indirect sources, and its potential health outcomes. Our mixed-methods approach addresses both microbiological and pathogen genomics, and epidemiological, geospatial, anthropological, and sociological aspects. Implemented in two rural residential areas in two provinces in Eastern China, linked sub-studies assess antibiotic exposure in population cohorts through household surveys, medicine diaries, and biological sampling; identify the types and frequencies of antibiotic resistance genes in humans and food-stock animals; quantify the presence of antibiotic residues and antibiotic resistance genes in the aquatic environment, including wastewater; investigate the drivers and behaviours associated with human and livestock antibiotic use; and analyse the national and local policy context, to propose strategies and systematic measurements for optimising and monitoring antibiotic use. As a multidisciplinary collaboration between institutions in the UK and China, this study will provide an in-depth understanding of the influencing factors and allow comprehensive awareness of the complexity of AMR and antibiotic use in rural Eastern China.
AB - Antibiotic resistance is a global health challenge that threatens human and animal lives, especially among low-income and vulnerable populations in less-developed countries. Its multi-factorial nature requires integrated studies on antibiotics and resistant bacteria in humans, animals, and the environment. To achieve a comprehensive understanding of the situation and management of antibiotic use and environmental transmission, this paper describes a study protocol to document human exposure to antibiotics from major direct and indirect sources, and its potential health outcomes. Our mixed-methods approach addresses both microbiological and pathogen genomics, and epidemiological, geospatial, anthropological, and sociological aspects. Implemented in two rural residential areas in two provinces in Eastern China, linked sub-studies assess antibiotic exposure in population cohorts through household surveys, medicine diaries, and biological sampling; identify the types and frequencies of antibiotic resistance genes in humans and food-stock animals; quantify the presence of antibiotic residues and antibiotic resistance genes in the aquatic environment, including wastewater; investigate the drivers and behaviours associated with human and livestock antibiotic use; and analyse the national and local policy context, to propose strategies and systematic measurements for optimising and monitoring antibiotic use. As a multidisciplinary collaboration between institutions in the UK and China, this study will provide an in-depth understanding of the influencing factors and allow comprehensive awareness of the complexity of AMR and antibiotic use in rural Eastern China.
KW - antibiotic exposure
KW - antibiotic resistance
KW - antibiotic-resistant bacteria
KW - cohort study
KW - mixed methods
KW - transmission
KW - wastewater-based epidemiology
UR - http://www.scopus.com/inward/record.url?scp=85133137265&partnerID=8YFLogxK
U2 - 10.3390/ijerph19138145
DO - 10.3390/ijerph19138145
M3 - Article
AN - SCOPUS:85133137265
SN - 1661-7827
VL - 19
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
IS - 13
M1 - 8145
ER -