SA Research in Antibiotic Resistance and One Health
The One Health approach is a global strategy that encourages interdisciplinary collaboration and communication on health at the human-animal-environmental interface. Antibiotic resistance (ABR) is a direct consequence of the selection pressure from indiscriminate antibiotic use in humans, animals and the environmental, requiring a One Health approach towards its understanding and containment. The high HIV/AIDS burden and the substantive risk factors for communicable diseases in South Africa results in a high incidence of infectious diseases, engendering extensive antibiotic use and subsequent resistance. Between 2002-4, two-thirds of the 1 538 433 kg of antimicrobials sold for animal use were used in growth promotion and included WHO-banned substances. Although the nature, extent and burden of ABR is not systematically and/or representatively quantified nationally/ provincially, available evidence indicates that ABR is escalating in humans, animals and the environment. There is also minimal little investment in antibiotic drug discovery, research and development.
There is thus a need to quantify the burden of ABR in humans, animals and the environment with a view to implementing interventions for its containment in the biomedical, clinical, socio-behavioural, drug discovery and policy domains.
The AIM of this project is to comprehensively delineate the molecular epidemiology, nature and extent of ABR in human, animal and environmental health in the “One Health” context to inform evidence-based strategies for its monitoring, prevention and containment by:
- Instituting surveillance programmes on antibiotic use and resistance in human, veterinary, agricultural and environmental health via the relevant government Ministries/Departments as appropriate,
- Demonstrating the phenotypic and genotypic mechanisms of antibiotic resistance by sensitivity testing and appropriate screening tests together with whole genome sequencing (WGS) and/or polymerase chain reaction (PCR) and DNA sequencing of resistance genes respectively,
- Delineating the genetic determinants of resistance and clonality by repetitive element palindromic (rep)-PCR/pulsed-field gel electrophoresis/multi-locus sequence typing and/or WGS respectively,
- Ascertaining bacterial virulence factors and their genetic determinants by WGS,
- Testing novel antibiotic entities against resistant bacteria and evaluating available innovator and generic antibiotics for the active antibiotic content in the context of spurious/falsely-labelled/ falsified/counterfeit (SFFC) drugs,
- Mobilizing relevant national government departments to improve capacities of their national systems to contain and decelerate the evolution and progress of ABR in the “One Health” context by application research output and evidence generated above.
The key output of this project is the creation of an electronic platform that will triangulate, in real time, phenotypic and genotypic trends in antibiotic resistance in correlation with antibiotic use/exposure within and between the human, animal and environmental health sectors from robust, representative surveillance programmes, allowing early warning of emerging resistance in any/all sectors to inform strategies for containment and prevent dissemination between and within sectors respectively.