Impacts of Antibiotic Residues in the Environment on Bacterial Resistance and Human Health in Eastern China: An Interdisciplinary Mixed-Methods Study Protocol

Shenghan Cai, Na Wang, Like Xu, Fei Yan, Qingwu Jiang, Xinping Zhao, Wei Wang, Hexing Wang, Lufang Jiang, Wenjuan Cong, Samuel K. Sheppard, Jason Weeks, Barbara Kasprzyk-Hordern, Chaowei Fu and Helen Lambert
Additional contact information
Shenghan Cai: Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
Na Wang: Key Laboratory of Public Health Safety of Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Shanghai 200032, China
Like Xu: Department of Chemistry, University of Bath, Bath BA2 7AY, UK
Fei Yan: Key Laboratory of Public Health Safety of Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Shanghai 200032, China
Qingwu Jiang: Key Laboratory of Public Health Safety of Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Shanghai 200032, China
Xinping Zhao: Key Laboratory of Public Health Safety of Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Shanghai 200032, China
Wei Wang: Key Laboratory of Public Health Safety of Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Shanghai 200032, China
Hexing Wang: Key Laboratory of Public Health Safety of Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Shanghai 200032, China
Lufang Jiang: Key Laboratory of Public Health Safety of Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Shanghai 200032, China
Wenjuan Cong: Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
Samuel K. Sheppard: The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath BA2 7AY, UK
Jason Weeks: IEH Consulting, Nottingham NG2 6AU, UK
Barbara Kasprzyk-Hordern: Department of Chemistry, University of Bath, Bath BA2 7AY, UK
Chaowei Fu: Key Laboratory of Public Health Safety of Ministry of Education, NHC Key Laboratory of Health Technology Assessment, Shanghai 200032, China
Helen Lambert: Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK

IJERPH, 2022, vol. 19, issue 13, 1-14

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.

Keywords: antibiotic resistance; antibiotic exposure; antibiotic-resistant bacteria; cohort study; mixed methods; transmission; wastewater-based epidemiology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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