Laboratory research into antimicrobial resistance in bacteria.
The study took samples from healthy pregnant women in four cities (Antananarivo, Majunga, Tamatave, and Ambatondrazaka) in which ESBL-producing E. coli is prevalent in the general population, and from broiler chickens and surface water in the Antananarivo region, as indicators of resistance in the animal and environmental sectors.
Analysis of the samples highlighted an average prevalence of ESBL-producing E. coli of 29.8% in the pregnant women and 56.9% in the broiler chickens, while the bacterium was isolated from all the environmental samples.
These carriage rates of ESBL-producing E. coli in the human and animal sectors were particularly high during the hot and humid season.
The study also revealed significant circulation of ESBL-producing E. coli strains between the three sectors in Antananarivo. This project is one of the first to address the circulation of bacterial resistance from a “One Health” perspective in humans, broiler chickens, and the environment, by using a rigorous, standardized protocol. It is also the first analysis of the isolated strains involving complete genome sequencing, carried out under the WHO Tricycle protocol. The study was set up against a backdrop of the growing threat of antimicrobial resistance (AMR), which represents a major global public health challenge.
Its success is due to close, coordinated collaboration between several Mérieux Foundation employees, including Milen Milenkov and Emilie Westeel, operational research officers in the medical division, Laurent Raskine, a biology specialist, and Florence Komurian-Pradel, head of the AMR unit and the GABRIEL network, together with teams from CICM Antananarivo and the public hospital laboratories within the RESAMAD network in Madagascar.
More information about the Tricycle protocol
Recognizing the need for an integrated approach to tackle the problem of AMR, WHO developed the Tricycle protocol to offer an integrated, multi-sector monitoring initiative to track the prevalence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in the human, animal, and environmental sectors. The protocol was designed to provide crucial data on the circulation of resistant strains, enabling a better understanding of inter-sector transmission mechanisms and facilitating the development of appropriate coordinated responses to the public health challenge posed by AMR.