Drivers_of_antimicrobial_resistance_in_Uganda_and_Malawi_DRUM_

The mechanisms that support the emergence, movement, and persistence of antimicrobials within communities are poorly understood both qualitatively and quantitatively. This makes it difficult to identify or predict the impact of intervention strategies. DRUM will characterise the emergence and spread of AMR within complex social settings in Malawi and Uganda using an agent-based modelling approach informed by DNA sqeuence data. Specifically, for this partcular part of the study we will answer the following three questions: What is the overall diversity in ESBL-E and ESBL-K across the different sample sources? How does the ESBL-E/ESBL-K diversity link to units of AMR transmission? Methods: Human and animal stool and environmental samples have been longitudinally collected from 400 households in urban, peri-urban and rural settings in Malawi and Uganda. We will sequence mixtures of colonies harvested from an enrichment culture by sweeping whole plates of randomly selected samples. Expected findings The study will help to quantify within and between samples diversity and transmission bottle necks. These findings will inform an agent based model, which will be devloped to model transmission dynamics of ESBL producing E. Coli and K. pnuemoniae in Uganda and Malawi communities.

抗菌药物在社区内的出现、传播与持续存续相关机制，在定性与定量层面均尚未得到充分阐明。这使得识别或预测各类干预策略的实际效果变得极具挑战性。
DRUM项目将借助基于DNA测序数据构建的智能体建模方法，对马拉维与乌干达复杂社会环境下抗生素耐药性（Antimicrobial Resistance, AMR）的出现与传播特征进行系统刻画。具体而言，本研究的该部分将聚焦解答以下两个核心问题：不同样本来源中产超广谱β-内酰胺酶大肠杆菌（ESBL-E）与产超广谱β-内酰胺酶肺炎克雷伯菌（ESBL-K）的整体多样性水平如何？ESBL-E/ESBL-K的多样性与抗生素耐药性传播单元之间存在何种关联？
研究方法：研究团队已从马拉维与乌干达的城市、城郊及农村地区的400户家庭中，纵向收集了人类与动物粪便及环境样本。我们将对随机选取样本的富集培养平板上刮取的菌落混合物进行测序。
预期研究成果：本研究将量化样本内部及样本间的多样性与传播瓶颈。相关研究结果将为基于智能体的建模工作提供依据，该模型将用于模拟马拉维与乌干达社区内产超广谱β-内酰胺酶大肠杆菌与肺炎克雷伯菌的传播动态。