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Risk Factors for Pathogenic and Antimicrobial Resistant Escherichia coli in Drinking Water based on Nationally representative Household-Level Surveys

English title Risk Factors for Pathogenic and Antimicrobial Resistant Escherichia coli in Drinking Water based on Nationally representative Household-Level Surveys
Applicant Julian Timothy
Number 192763
Funding scheme Project funding (Div. I-III)
Research institution Department Environmental Microbiology Swiss Federal Institute of Aquatic Science and Technology
Institution of higher education Swiss Federal Institute of Aquatic Science and Technology - EAWAG
Main discipline Environmental Research
Start/End 01.07.2020 - 30.06.2024
Approved amount 698'568.00
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All Disciplines (4)

Discipline
Environmental Research
Infectious Diseases
Other disciplines of Environmental Sciences
Other disciplines of Engineering Sciences

Keywords (5)

surveillance; antimicrobial resistance; Drinking water; E. coli; pathogenic E. coli

Lay Summary (German)

Lead
Risk factors for pathogenic and antimicrobial resistant E. coli in drinking water based on nationally representative household surveys
Lay summary

Die Ziele der Nachhaltigen Entwicklung (Sustainable Development Goals, SDGs) fordern bis 2030 weltweit den universellen Zugang zu sicherem und erschwinglichem Trinkwasser. Gemäss dem gemeinsamen Monitoringbericht von UNICEF und der WHO von 2017 sind 29% der Weltbevölkerung auf Trinkwasserquellen angewiesen, die anhand der Präsenz des Indikator Bakteriums E.coli, nicht als "sicher" erachtet sind.  Infolgedessen erhalten Überwachungsrahmen wie die Multiple Indicator Cluster Surveys (MICS) umfangreiche Sammlungen zu E. coli aus Trinkwasser in Ländern mit niedrigem/mittleren Einkommen (LMICs).  Die E.coli Sammlungen bieten eine Datenquelle, die auf den dringenden Bedarf an Überwachung und Monitoring von Durchfallerkrankungen und Antibiotikaresistenz reagiert. Durch Überwachung können wir eine Reihe wichtiger Wissenslücken in Bezug auf Prävalenzraten, Risikofaktoren und die Übertragung von pathogenen und antimikrobiell resistenten E. coli schließen.

 

Die Ziele dieser Studie sind die Quantifizierung von Prävalenzraten, die Identifizierung von Risikofaktoren und das Verständnis der Übertragung pathogener und antibiotikaresistenter E. coli in einem vorrangigen Land mit niedrigem/mittleren Einkommen. Dafür werden national repräsentative Trinkwassererhebungen und eine neuartigen, kostengünstigen Methode zum Screening von E. coli verwendet.

 

Zu den spezifischen Zielen gehört die Bestimmung:

- Prävalenzraten von antibiotikaresistenten und pathogenen E. coli in einem vorrangigen Land unter Verwendung von Trinkwasserproben von den MICS als Sentinel-Überwachungssystem,

- Risikofaktoren für E. coli, einschließlich antibiotikaresistenter und pathogener E. coli, im Trinkwasser durch Verknüpfung von Erhebungsdaten auf Haushaltsebene mit gesammelten mikrobiellen Daten, und

- Übertragung von E. coli-Pathotypen mittels phylogenetischer Rekonstruktion.

Direct link to Lay Summary Last update: 30.06.2020

Lay Summary (English)

Lead
Risk factors for pathogenic and antimicrobial resistant E. coli in drinking water based on nationally representative household surveys
Lay summary

The Sustainable Development Goals (SDGs) call for universal access globally to safe and affordable drinking water by 2030. As of 2017, an estimated 29% of the global population relies on drinking water sources that is not considered “safe”, based on the presence of the indicator bacteria E. coli.  As a result, monitoring frameworks, like the Multiple Indicator Cluster Surveys (MICS), obtain vast collections on E. coli from drinking water in across low/middle income countries (LMICs).  These collections offer a data source responsive to the urgent need for surveillance and monitoring of diarrheal disease and antimicrobial resistance. Through surveillance, we can address a number of key knowledge gaps on prevalence rates, risk factors, and transmission of pathogenic and antimicrobial resistant E. coli.

 

The objectives of this study are to quantify prevalence rates, identify risk factors, and understand pathogenic and antibiotic resistant E. coli transmission in a priority low/middle income country by leveraging nationally representative surveys of drinking water and a novel low-cost method for screening E. coli.

 

Specific objectives include determining:

-             Prevalence Rates of antibiotic resistant and pathogenic E. coli in a priority country using drinking water samples from MICS as a sentinel surveillance system,

-             Risk factors for E. coli, including antibiotic resistant and pathogenic E. coli, in drinking water by linking household-level survey data to collected microbial data, and

-             Transmission of E. coli pathotypes using phylogenetic reconstruction.

Direct link to Lay Summary Last update: 30.06.2020

Responsible applicant and co-applicants

Project partner

Associated projects

Number Title Start Funding scheme
157065 Growth kinetics and gene transfer of enteric and environmental E. coli in domestic settings 01.07.2015 Project funding (Div. I-III)

Abstract

Title: Risk Factors for Pathogenic and Antimicrobial Resistant Escherichia coli in Drinking Water based on Nationally representative Household-Level Surveys.Background and rationale: The Sustainable Development Goals (SDGs) call for universal access globally to safe and affordable drinking water by 2030. Currently, an estimated 29% of the global population relies on drinking water sources that are not “safe”, defined using E. coli as an indicator. As a result, monitoring frameworks, like the Multiple Indicator Cluster Surveys (MICS), obtain vast collections on E. coli from across low/middle income countries (LMICs). These collections offer a data source responsive to the urgent need for surveillance and monitoring of diarrheal disease and antimicrobial resistance. Through surveillance, we can address a number of key knowledge gaps on prevalence rates, risk factors, and transmission of pathogenic and antimicrobial resistant E. coli.Overall objective: To quantify prevalence rates, identify risk factors, and understand pathogenic and antibiotic resistant E. coli transmission in a priority low/middle income country by leveraging nationally representative surveys of drinking water and a novel low-cost method for screening E. coli.I will achieve this objective through a series of laboratory- and field-based experiments on:-Prevalence Rates of antibiotic resistant and pathogenic E. coli in a priority country using drinking water samples from MICS as a sentinel surveillance system, -Risk factors for E. coli, including antibiotic resistant and pathogenic E. coli, in drinking water by linking household-level survey data to collected microbial data, and-Transmission of E. coli pathotypes using phylogenetic reconstruction.Methods: We will collect E. coli isolates obtained within the scope of MICS surveys of microbial water quality monitoring. We will screen the isolates for virulence and antimicrobial resistance by expanding our digital Multiplex Ligation Assay (dMLA), which is a low-cost, targeted genomics detection pipeline for high throughput bacterial isolate screening. We will use statistical modeling to quantify the contributions of risk factors to total, pathogenic, and antibiotic resistant E. coli in drinking water. Finally, we will inform spatial scale of E. coli pathotype transmission via phylogeny. Results: The project will result in: 1) method development for screening E. coli for virulence and antimicrobial resistance applicable to future MICS surveys; and 2) data informing risk factors and spatial structuring underlying E. coli transmission to help inform environmental interventions.Impact: The proposal will directly inform development of environmental interventions to control pathogenic and antimicrobial resistant E. coli transmission; and provide a low-cost approach adaptable to ongoing surveillance and monitoring efforts, such as future MICS surveys, WHO Global AMR Surveillance System (GLASS) or the WHO ESBL-E Tricycle program.
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