Improving the TRIcycle protocol: upscaling to national Monitoring, detection of CPE and WGS pipelines for One Health Surveillance

Antimicrobial resistance is a “One Health” problem and affects humans, animals, and the environment. The WHO has created a protocol for detection of ESBL-producing bacteria (the Tricycle protocol), to learn more about resistant bacteria in all 3 areas. In the TRIuMPH project, this was expanded to include carbapenemase-producing Enterobacteriaceae (CPE), which are especially important resistant bacteria. These protocols were applied in Madagascar, Malaysia, and Pakistan.

Resultaten

The CPE bacteria were indeed found in all 3 reservoirs, with differences between the countries. It was also found that these resistant bacteria can be measured using existing systems for monitoring wastewater. This provides an idea of how CPE spreads in countries where these bacteria are likely common, and makes methods for CPE analysis available that can be used internationally.