Microbiota Intervention Strategies Limiting Selection and Transmission of Antibiotic Resistance burden in the One Health domain





Research Project: 2022-01-02 - 2025-01-31
Total sum awarded: €1 596 781

Antimicrobial resistance (AMR) has become an endemic and increasing problem, partially under the radar and depriving future generations of effective therapies. A main AMR driver is antimicrobial overuse in humans, animals and environment, facilitating selection and spread of resistant bacteria and genes between the different One Health domains. The goal of MISTAR is to ameliorate the AMR pollution in “hothouses” (hospitals and farms) and thus, to curtail the selection and transmission of AMR within different One Health settings. We will develop and implement intervention strategies to promote microbiota preservation using cutting-edge omics technologies. To reach this goal we will design, implement and quantify (i) the effect of gut microbiota-based interventions (fecal microbiota transplantation and microbiota-based index at point-of-care) in hospitalized patients to reduce AMR, (ii) the effects of interventions aimed at reducing airborne dust-bound pollution and transmission of AMR and (iii) design and develop novel experimental intervention strategies to modulate the microbiota to eradicate AMR. MISTAR delivers important scientific knowledge, technical skills and new interventions to curtail AMR emergence that can be applied in both high- and low-income countries. A targeted communication plan (scientific, high-quality grey literature and social media) will make the findings of MISTAR accessible to a wide range of stakeholders. Ultimately, the deliverables of this project will guide policymakers to implement novel strategies to control this Global Health challenge.

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  • Marcel de Zoete, University Medical Centre Utrecht, Netherlands (Coordinator)
  • Teresa M. Coque, Ramón y Cajal Institute for Health Research (IRYCIS), Spain (Partner)
  • Surbhi Malhotra- Kumar, University of Antwerp, Belgium (Partner)
  • Stineke van Houte, University of Exeter, United Kingdom (Partner)
  • Willem van Schaik, University of Birmingham, United Kingdom (Partner)
  • Alex Bossers, Utrecht University, Netherlands (Partner)
  • Ilana Camargo, University of São Paulo, Brazil (Partner)

The central aim of MISTAR is to implement and quantify the effect of novel intervention strategies based on the preservation of the “healthy microbiota” to eradicate and control the spread of antimicrobial resistance (AMR). We will do this using a One Health approach that involves hospitalized patients, healthy humans, pets, farm animals and the environment. In MISTAR we will follow three main approaches to control the spread of AMR. (i) Intervene with the gut microbiota either by prioritizing potential interventions based of microbiota composition indices/diagnostic tools or by using fecal microbiota transplantation (FMT) to modulate the gut microbiota to reduce and possibly avoid the colonization of and further infections by multidrug resistance pathogens. (ii) Intervene with airborne dust-bound spread of antibiotic resistant bacteria (ARB) between pets and humans in households, farm animals and hospitalized patients by applying air purifiers to remove these microorganisms from the air. Finally, we will (iii) develop novel innovative intervention approaches aimed at specifically targeting ARB in complex microbial communities, like the intestinal tract and sewage. MISTAR will bring perspectives on novel interventions to reduce the emergence of antibiotic resistance that can readily be integrated into existing organisational structures that are also applicable in low-and-middle income countries, and innovative technologies, which needs investment.