#1Health-PREVENT

Antibiotics are essential to effectively treat bacterial infections in both veterinary and human medicine. Therefore, the research consortium #1Health-PREVENT investigates the occurrence of multidrug-resistant microorganisms and evaluates the effectiveness of measures to contain their spread in a “One Health” initiative.

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Prevention of antibiotic-resistant bacteria

The aims of the research consortium #1Health-PREVENT are to perform investigations into the epidemiology of zoonotic antibiotic multidrug-resistant microorganisms (MDRO) as well as to study interventions that could reduce selection pressure and prevent transmission of MDRO between humans and animals. In two main work packages, the consortium investigates the following topics that are highly relevant for Public Health:

  • #1Health-Epidemiology: Studies answering questions about the epidemiology of MDRO in livestock and exposed humans. The focus of this work package is on assessing the (molecular) epidemiology of carbapenem- und colistin-resistant enterobacteria, multi-resistant coagulase-negative staphylococci and enterococci, methicillin-resistant Staphylococcus aureus (MRSA), and biocide-non-susceptible bacteria occurring on pig and poultry farms, companion animals and among humans with (occupational) contact to the respective animals.
  • #1Health-Interventions: Interventions to prevent MDRO in livestock, companion animals, pets and humans. The focus of this work package is on assessing innovative approaches in the fields of antibiotic use (antibiotic stewardship) in veterinary hospitals, targeted dispersal of physiological bacteria in the environment, alternative husbandry conditions and vaccination strategies, barrier precautions for occupationally exposed humans and protocols on biocide susceptibility testing and –use.

#1Health-PREVENT research questions and individual projects

In the two work packages #1Health-Epidemiology and #1Health-Interventions the consortium has the following hypotheses and aims to answer the following research questions in three epidemiological studies (#epi1-3) and six intervention studies (#intervention1-6):

  • Work package #1Health-Epidemiology (#epi1-3):

The main research question is: “What is the (molecular) epidemiology of defined multidrug-resistant microorganisms (MDRO) on livestock farms (pigs, poultry) and among persons with direct contact to livestock?”

To answer this question, the consortium will assess the occurrence of defined MDRO and biocide-non-susceptible isolates in livestock environments and among directly exposed persons. This information is needed for risk assessment and is a prerequisite for efforts to reduce MDRO transmission from the livestock environment to humans with (in)direct exposure.

The basic hypothesis in these studies is that current data do not adequately reflect the occurrence of CRE, colistin-resistant enterobacteria, multidrug-resistant coagulase-negative staphylococci (including daptomycin- and linezolid-resistant strains), enterococci (including linezolid-resistant strains), and methicillin-resistant Staphylococcus aureus (MRSA) among livestock, exposed humans, and the farm-to-fork food chains.

  • Work package #1Health-Interventions (#intervention1-6):

The main research questions in this work package are: “Can we reduce MDRO in livestock and among humans exposed to livestock by innovative approaches and improved conventional approaches? Can we improve the use of antibiotics and other agents selecting MDRO by implementing antibiotic stewardship interventions in the One Health context?”

To answer these questions, the consortium will perform interventional studies in human and veterinary medicine to reduce the burden and spread of zoonotic MDRO, and to implement antibiotic stewardship programs in order to improve the rationale use of antibiotics and biocides.

We hypothesize that in a One Health consortium, collaborative antibiotic stewardship efforts between veterinarians, physicians and public health authorities can improve the rationale use of antibiotics. Moreover, we assume that antimicrobial resistance and the occurrence of MDRO in livestock holdings can be reduced by the targeted use of physiological, non-pathogenic, non-resistant bacteria, alternative farming conditions, barrier precautions or other interventions (e.g. vaccination). We also hypothesize that these interventions have an impact on the spread to and colonization of humans with MDRO.

 

Overall, the research consortium will have the following results relevant for application in clinical routine and for risk assessment by Public Health authorities:

  1. Epidemiological data about the occurrence and prevalence of carbapenemase-producing (incl. OXA-carbapenemases) and colistin-resistant enterobacteria on pig and poultry farms, multi-resistant coagulase-negative staphylococci (oxazoldinones, daptomycin) and MRSA in dairy herds.
  2. Evaluation of interventions on the occurrence of multidrug-resistant microorganisms (MDRO) and biocide-non-susceptible microorganisms:
  • Effects of the dispersal of non-pathogenic microorganisms in the environment of farms
  • Effects of alternative bedding material
  • Antibiotic Stewardship programs in veterinary clinics
  • Improvement of mastitis prophylaxis
  • Barrier precautions for humans occupationally exposed to animals carrying MDRO
  • Recommendations and protocols for biocide susceptibility testing

Coordination

Priv. Doz. Dr. med. Robin Köck
Institut für Hygiene
Universitätsklinikum Münster
Münster
Email: kockr(at)uni-muenster.de

Cooperation

The following project partners are involved in the interdisciplinary epidemiological and interventional studies within the consortium #1Health-PREVENT.

  • Universitätsklinikum Münster

Leadpartner in studies: #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: h uman medicine

  • Fachhochschule Südwestfalen - Universtity of Applied Sciences

Leadpartner in study: #intervention1

Prof. Dr. med. vet. Marc Boelhauve,

Fachhochschule Südwestfalen, Fachbereich Agrarwirtschaftboelhauve.marc(at)fh-swf.de

boelhauve.marc(at)fh-swf.de

Expertise: agriculture and  veterinary medicine

  •  Bundesinstitut für Risikobewertung

Leadpartner in study: #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,  veterinary medicine

  • Freie Universität Berlin

Leadpartner in studies: #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: veterinary medicine

  • Julius-Maximilians-Universität Würzburg

Leadpartner in studies: #epi1, #intervention2

PD Dr. med. Wilma Ziebuhr,

Universität Würzburg, Institut für Molekulare Infektionsbiologie

w.ziebuhr(at)mail.uni-wurzburg.de

Expertise: human medicine

Leadpartner in studies: #intervention2,3,5

Dr. med. vet. Christiane Cuny, Dr. med. vet. Birgit Walther, Prof. Dr. rer. nat. Wolfgang Witte

Robert Koch-Institut

cunyc(at)rki.de; waltherb(at)rki.de

Expertise: Public Health, human medicine / veterinary medicine

Other cooperation

The research consortium #1Health-PREVENT closely cooperates with Public Health institutions such as the Lower Saxony public health office (NLGA) and the Lower Saxony State Office for Consumer Protection and Food Safety (LAVES). In addition, there is a close cooperation with the Dutch-German Interreg V project EurHealth-1Health funded by the European Union, the Dutch Ministry of Health, Welfare and Sports and the German federal states of North Rhine-Westphalia and Lower-Saxony. Moreover, the consortium seeks cooperation with several other veterinary and human public health institutions on local and regional level.