Antibiotics are essential to effectively treat bacterial infections in both human and veterinary medicine. In the spirit of the "One Health" concept, pathogens that have become insensitive (multi-resistant) to many clinically important antibiotics are therefore jointly researched in the #1Health-PREVENT research network and interventions for their prevention are developed.
Prevention of antibiotic-resistant pathogens
The objectives of the research network #1Health-PREVENT include the conduct of epidemiological studies on the zoonotic spread of multi-resistant bacterial pathogens (MRE), and the validation of interventions that prevent the selection of MRE or prevent the transmission of MRE between animals and humans. The following topics of particular relevance to public health are being researched in two work packages (WP):
AP 1: #1Health-Epidemiology:
Studies that address open, epidemiological questions about the occurrence of MRE in farm animals and humans
The focus is on the (molecular) epidemiology of carbapenem and colistin-resistant enterobacteria, multi-resistant coagulase-negative staphylococci and enterococci, methicillin-resistant Staphylococcus aureus (MRSA), and biocide-insensitive pathogens that occur in pig and poultry farming, but also in companion animals and directly exposed humans.
AP 2: #1Health-Interventions:
Interventions to control MRE in farm animals, pets, hobby animals and humans
Investigations will focus on research into innovative interventions or the improvement of existing procedures in the areas of antibiotic stewardship in animal hospitals, targeted application of physiological bacteria in the environment, alternative housing conditions or vaccinations for animals, establishment of barrier measures for humans or protocols for biocide sensitivity testing and biocide use.
#1Health-PREVENT Research questions & individual projects
In the two work packages #1Health Epidemiology and #1Health Interventions, the consortium is working on the following main research questions and hypotheses in three epidemiological studies (#epi1-3) and six intervention studies (#intervention1-6)
Work package #1Health Epidemiology (#epi1-3): Implementation of studies on open epidemiological questions on the occurrence of multi-resistant pathogens (MRE) in livestock and humans
The main question in this work package is: "How can the (molecular epidemiology) of certain MRE in farm animals (pigs, poultry) and in humans with direct contact to these farm animals be described?
The occurrence of these MRE (e.g. colistin-resistant enterobacteria, carbapenem-resistant enterobacteria, multi-resistant coagulase-negative staphylococci) and biocide-insensitive bacteria in the vicinity of livestock farms and in exposed individuals will be investigated to generate data for risk assessment and for the development of prevention approaches.
The hypothesis in this work package is: "Currently available data only insufficiently describe the occurrence of carbapenemic (especially ertapenemic) and colistin-resistant enterobacteria, multi-resistant coagulase-negative staphylococci and enterococci (including linezolide and daptomycin-resistant variants), and MRSA.
- Work package #1Health interventions (#intervention1-6): Interventions to control MRE in farm animals, companion animals (e.g. horses) and humans will be validated. The main questions in this work package are: "Is it possible to reduce the occurrence of MRE in farm animals, companion animals (e.g. horses) and exposed humans by innovative interventions or by improving existing procedures? "Can the occurrence of MRE in animal hospitals and exposed humans be influenced by improving the quality of antibiotic use (antibiotic stewardship)?
To this end, intervention studies in human and veterinary medicine are to be conducted.
The hypothesis in this work package is: "It is possible to develop joint strategies in a One Health network of veterinary and human medicine specialists and the public health service to improve the rational use of antibiotics or to reduce the occurrence of MRE in animal husbandry by targeted application of physiological pathogens in the environment, by alternative husbandry conditions or vaccination of animals, by establishing barrier measures for humans or by improved protocols for biocide sensitivity testing and biocide use.
Overall, the network will achieve the following results, which are relevant for the clinic and the risk assessment by the public health service:
- Generation of epidemiological data on the occurrence and prevalence of carbapenemase-forming (incl. OXA carbapenemases) and colistin-resistant enterobacteria in pig and poultry farms, multi-resistant coagulase-negative staphylococci in animal exposed persons (oxazoldinone resistance (linezolide/tedizolide) and daptomycin resistance), and MRSA in dairy herds.
- Evaluation of the impact of specific interventions on the occurrence of MRE and biocide-insensitive pathogens
- Application of non-pathogenic and sensitive bacteria as competing flora in the animal housing environment and their effect on the occurrence of MRE
- Alternative agricultural husbandry conditions (e.g. exercise area, straw farming)
- Antibiotic stewardship in clinics for horses and small pets
- Improvement of mastitis prophylaxis in dairy herds
- Barrier measures against MRE colonization in exposed persons from the farm animal sector and the veterinary hospital sector
- Guideline for testing field isolates for biocide resistance
- Development of disinfection protocols for small animal hospitals and households
Coordination
Priv. Doz. Dr. med. Robin Köck
Institute for Hygiene
University Hospital Münster
Münster
E-Mail: kockr(at)uni-muenster.de
The following project partners are involved in the implementation of the interdisciplinary epidemiological studies and interventions in the network #1Health-PREVENT. For the description of the individual studies #epi1-3 and #intervention1-6 see figure above.
- University Hospital Münster
Leitung der Studien: #epi2, #epi3, #intervention1
PD Dr. med. Robin Köck1,2, Univ.-Prof. Dr. med. Alexander Mellmann1, Prof. Dr. med. Karsten Becker
2Universitätsklinikum Münster, 1 Institut für Hygiene und 2 Institut für Medizinische Mikrobiologie kockr@uni-muenster.de; alexander.mellmann(at)ukmuenster.de; kbecker(at)uni-muenster.de
Expertise: Humanmedizin
- Fachhochschule Südwestfalen - Universtity of Applied Sciences
Leitung der Studie: #intervention1
Prof. Dr. med. vet. Marc Boelhauve,
Fachhochschule Südwestfalen, Fachbereich Agrarwirtschaft
Expertise: Landwirtschaft und Veterinärmedizin
- Bundesinstitut für Risikobewertung
Leitung der Studie: #intervention4
Dr. med. vet. Alexandra Fetsch, PD Dr. med. vet. Bernd-Alois Tenhagen,
Bundesinstitut für Risikobewertung (BfR)
alexandra.fetsch(at)bfr.bund.de; bernd-alois.tenhagen(at)bfr.bund.de
Expertise: Public Health, Veterinärmedizin
- Freie Universität Berlin
Leitung der Studien: #intervention5,6
Univ.-Prof. Dr. med. vet. Stefan Schwarz, Dr. med. vet. Antina Lübke-Becker, Dr. med. vet. Andrea Feßler, PhD,
Freie Universität Berlin, Institut für Mikrobiologie und Tierseuchen
stefan.schwarz(at)fu-berlin.de; antina.luebke-becker(at)fu-berlin.de; andrea.fessler(at)fu-berlin.de
Expertise: Veterinärmedizin
- Julius-Maximilians-Universität Würzburg
Leitung der Studien: #epi1, #intervention2
PD Dr. med. Wilma Ziebuhr,
Universität Würzburg, Institut für Molekulare Infektionsbiologie
w.ziebuhr(at)mail.uni-wurzburg.de
Expertise: Humanmedizin
- Robert Koch-Institut
Leitung der Studien: #intervention2,3,5
Dr. med. vet. Christiane Cuny, Dr. med. vet. Birgit Walther, Prof. Dr. rer. nat. Wolfgang Witte
Robert Koch-Institut
cunych(at)rki.de; waltherb(at)rki.de
Expertise: Public Health, Humanmedizin/Veterinärmedizin
The network #1Health-PREVENT cooperates closely with the Lower Saxony State Health Authority (NLGA) and the State Office for Consumer Protection and Food Safety (LAVES) in conducting the epidemiological studies. Furthermore, there is a close cooperation with the Interreg V project EurHealth-1Health funded by the European Union, the Dutch Ministry of Health, Welfare and Sport and the federal states of North Rhine-Westphalia and Lower Saxony. In addition, there are further cooperations with institutions of the public health service at municipal and state level.
