PDF(Pubmed)
Abstract：
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.
摘要：
抗生素耐药性是威胁人类和动物生命的全球性健康挑战。特别是在欠发达国家的低收入和弱势群体中。它的多因素性质需要对人类的抗生素和耐药细菌进行综合研究，动物,和环境。全面了解抗生素使用和环境传播的情况和管理,本文介绍了一项研究方案，以记录人类暴露于主要直接和间接来源的抗生素，及其潜在的健康结果。我们的混合方法方法解决了微生物和病原体基因组学，和流行病学，地理空间,人类学,和社会学方面。在中国东部两个省的两个农村居民点实施，相关子研究通过家庭调查评估人群中的抗生素暴露，医学日记,和生物采样；确定人类和食畜中抗生素抗性基因的类型和频率；量化水生环境中抗生素残留和抗生素抗性基因的存在，包括废水；调查与人类和牲畜抗生素使用相关的驱动因素和行为；并分析国家和地方政策背景，提出优化和监测抗生素使用的策略和系统测量。作为英国和中国机构之间的多学科合作，本研究将深入了解影响因素，全面了解中国东部农村地区AMR和抗生素使用的复杂性。
