[FG] Bielicki Julia Anna

Research Project  | 4 Project Members

We will develop and validate approaches for sentinel One Health AMR surveillance in rural sub-Saharan Africa. Building on previous novel work showing that metagenomic profiling of pooled faecal material can accurately predict AMR prevalence in clinical isolates of Enterobacterales, we aim to extend this work to other bacterial species and One Health compartments. We will conduct metagenomic profiling on pooled DNA extracts from human stool samples (hospital and community-level) and from household environments in Burkina Faso and Kenya. We will assemble existing local data from hospital-based microbiology diagnostic laboratories. We will perform community-level surveys and use randomly selected households within village clusters. We will sample suspected environmental AMR exposure sites in and around households and collect data on community-level human and animal antibiotic use, hygiene practices, contact with domestic animals, and sanitary facilities. Data analysis will seek to quantify community-level exposure risks and evaluate the accuracy of predicting resistance in clinical isolates using metagenomic data. A cost-utility analysis will determine under what circumstances the use of pooled metagenomic data to inform empirical antibiotic policies would represent an efficient use of resources.The proposed work will establish how this approach could provide a viable, low-cost and convenient approach for AMR sentinel surveillance in settings which - like many in rural sub-Saharan Africa - lack systematic microbiological diagnostics and where sewage systems are non-existing.

Research Project  | 4 Project Members

Nearly 1 in 10 newborns in Europe is admitted to a neonatal intensive care unit (NICU) in the first days of life, around 400,000 admissions every year. While care in a neonatal unit results in a greater chance of survival in newborns with serious illness, it also increases the risk of exposure to bacteria from the hospital environment. These can cause serious infections in babies, which are commonly resistant to many routinely used antibiotics.

Premature babies are a particularly vulnerable population, because their immune system is immature, and their skin and mucosa are not yet effective barriers against infections. Those who are seriously ill need life saving devices and prolonged antibiotic treatments. All of these factors increase the risk of being colonized with antibiotic-resistant organisms. Colonisation with resistant bacteria is a major problem for several reasons: the colonised babies are at higher risk of severe infection, but they are also a source of resistant bacteria being introduced to the hospital environment, which can potentially infect other babies in the unit.

NeoIPC is establishing innovative approaches for optimal infection prevention of resistant bacteria in NICUs by integrating clinical research, implementation science and surveillance.