Antimicrobial Resistance Transmission Associated With Small-scale Food-animal Production in Peri-urban Communities of Quito, Ecuador

Project Summary/AbstractThe increased prevalence of antimicrobial resistance (AMR) among Enterobacteriaceae has had major clinicaland economic impacts in human medicine. Many of the multi-drug resistant (MDR) Enterobacteriaceae foundin humans are community-acquired and linked to food-animals (i.e. livestock raised for meat and dairyproducts). The objective of this research project is to apply epidemiologic methods and next-generation DNAsequencing to quantify the exchange of MDR strains of E. coli and mobile genetic elements (e.g. plasmids,transposons, etc.) between food-animals and children living in peri-urban parishes east of Quito, Ecuadorwhere small-scale food-animal production is widespread. The study will include households with youngchildren in three neighborhood types: 1) neighborhoods with no food-animal production; 2) neighborhoods withsmall-scale food-animal production only; and 3) neighborhoods with small-scale and commercial-scale food-animal production. Approach: In Aim 1, we will examine whether young children and food-animals share E. coliclones [assessed by whole genome multi-locus sequence typing (wgMLST)] that also have the samephenotypic multi-drug resistance pattern. In Aim 2, we will identify MDR E. coli strains in young children andanimals that are not clones (identified by wgMLST) but share the same phenotypic multi-drug resistancepattern. We will then analyze the mobile genetic elements associated with the observed phenotypic resistancepatterns and characterize the phylogenetic relationship of the mobile genetic elements responsible forresistance gene transfer. In Aim 3a, we will examine whether food-animal production poses a significant riskfor transmission of AMR to children, controlling for other known risk factors, and in Aim 3b, we will applyqualitative research methods to characterize the drivers of antimicrobial use in small-scale food-animalproduction. Expected Outcomes: To our knowledge, the proposed study will be one of the first of its kind andwill likely set a precedent for future studies that aim to better understand community transmission of AMR. Thisstudy will likely make major contributions to our understanding of: i) mechanistic questions of AMRtransmission (i.e. clonal spread versus horizontal gene transfer); ii) exposure-related questions of AMRtransmission (i.e. risk factors associated with colonization with MDR/ESBL-E. coli); and iii) an understanding ofthe driving factors for use of antimicrobials in small-scale food-animal production.