Combating Antibiotic Resistance in Philippine Lakes: One Health upstream interventions to reduce the burden
Lakes provide essential natural resources for populations in low-middle income countries. A growing concern has been contamination with antimicrobial resistance (AMR) determinants from animal and human sources, especially beta-lactams and carbapenems that are the cornerstone of human antimicrobial therapy. A growing literature supports that beta-lactam resistance in Asian lakes and rivers is increasing. However, few interventions have been evaluated to see if environmental contamination from hospitals and agriculture can be reduced. We propose to develop interventions and evaluate their impact on AMR from humans, animals and the environment. Interventions include antimicrobial stewardship programs in hospitals and backyard farms, campaigns to educate the public on AMR, improve management practices on farms and cleaning of effluents feeding the lake. AMR in human and veterinary setting and lake water will be evaluated using conventional microbiology and molecular biology methods. The conditions in and around Laguna Lake in the Philippines resemble those of many Asian, Latin American and African countries, allowing project results to be generalizable to other LMICs and promote the UN sustainable development goals worldwide. The One Health approach is essential to tackle AMR in the human-animal-environment interface. Lower pollution loads will improve water quality and lake resources, and reduce disease outbreaks, benefiting the Laguna lakeshore communities of over 16 million people.
- Dylan Pillai, University of Calgary, Canada (Coordinator)
- Maria Pythias Espino, University of the Philippines, Philippines (Partner)
- Stefanos Giannakis, Polytechnic University of Madrid, Spain (Partner)
- Ana Pereira do Vale, University College Dublin, Ireland (Partner)
- Paul Wigley, University of Liverpool, United Kingdom (Partner)
Antimicrobial resistance (AMR) may lead to more deaths than cancer by 2050. Action is required now to avert this disaster. This study aims to implement key interventions in Greater Manila, The Philippines to reduce AMR. Interventions will focus on hospitals, small farms, and the Laguna Lake, one of the largest freshwater lakes in Asia. Better antibiotic use, point of care testing in hospitals and farms, and novel solar-powered wastewater cleaning technologies will be implemented. Their impact will be assessed by state-of-the-art molecular surveillance for antibiotic resistance genes and bacteria in the water before and after interventions. The study will be the most comprehensive and systematic interventions to be introduced in Asia to reduce AMR in lakes.
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