One-Health approach for the assessment of antimicrobial … · One-Health approach for the...
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One-Health approach for the assessment of antimicrobial resistance dynamics across compartments through phenotypic, genetic and metagenomic methods
Stefano Pongolini - IZSLER
• AMR spreads through resistant bacteria and resistance genes
• AMR can be seen as a complex ecological issue
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Italian MoH-funded project – objectives:
• To study the contribution of humans, animals and environment
to AMR in human pathogens
• To assess the correlation between drug consumption and
AMR in human and vet compartments (strong, week, cross-
compartment, stable, unstable)
• To understand transmission dynamics across compartments
(how intense? Bidirectional? clonal vs horizontal)
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How can this be done? One-health collaborative project
• leveraging the high coverage of the study population of 4.5
millions people for AMR pathogens, zoonotic agents and
indicator bacteria along with the same isolates from the
parallel animal/food population
• collecting harmonized data on antimicrobial consumption in
animals and humans in the study population
• through metagenomics of samples representative of the
compartments and through investigation of individual isolates
from population screening (human) and farm screening
• Investigating the phenotypic and genetic features of AMR
across compartments (types and diversity)
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In the lab...
• metaresistomics of samples
from sewage of hospitals,
community, farms
• Characterization of resistant
isolates from humans and
animals
Antibiotico Concentrazione*
Ampicillina 8 mg/l
Cloramfenicolo 16 mg/l
Colistina 2 mg/l
Ciprofloxacina 0,064 mg/l
Meropenem 0,125 mg/l
Florfenicol 16 mg/l
Cofetaxime 2 mg/l
5.305 isolates tested
1) 3.865 clinical
2) 1.440 veterinary
total: 37.135
Salmonella phenotypic screening
AMR screening 2012-2015 of 5.305 isolates (4,473 for colistin)
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AMP FFN CIP CTX CHL COL MEM
%Isola
R
Human
Vet
AMP = AMPICILLIN CTX=CEFOTAXIME MEM=MEROPENEM
FFN = FLORFENICOL CHL = CLORAMFENICOL
CIP = CIPROFLOXACIN COL=COLISTIN
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Open questions:
• Is mcr-1 more prevalent in animal than human isolates
because of
o dynamic disequilibrium due to recent introduction in
animals?
o instability in the human compartment due to low selective
pressure?