Accepted for/Published in: JMIR Research Protocols
Date Submitted: May 2, 2019
Date Accepted: Oct 22, 2019
Quantification of air borne resistant organisms with temporal and spatial diversity: A study protocol in Bangladesh
ABSTRACT
Background:
Antimicrobial resistance (AMR) is a widespread and alarming issue for global health and a significant contributor to human death and illness specially in low and middle income countries (LMICs) like Bangladesh. Despite lots of work being conducted in environmental perspective, there is scarcity of knowledge about the presence of resistant organisms in air.
Objective:
The objective of our current protocol is to quantify and characterize the airborne resistomes in Bangladesh which will guide us to identify the high risk environment for multidrug resistant (MDR) pathogens with their spatiotemporal diversity.
Methods:
This is a cross sectional study design with environmental systematic and grid sampling strategy focused on collecting air samples from different outdoor environments during dry and wet season. The four (4) environmental compartments are mainly the frequent human exposure sites at both urban and rural settings, e.g. urban residential area (n=20) and live bird markets (n=20), rural household (n=20) and poultry farms (n=20). Therefore, we obtained air samples from 80 locations in two seasons by using active microbial air sampler. From each location, five air samples were collected in different media to yield total microbial count, Extended-Spectrum Beta-Lactamases (ESBL), Carbapenem-resistant enterobacteriaceae (CRE), Vancomycin-resistant enterococci (VRE) and Methicillin-resistant Staphylococcus aureus (MRSA).
Results:
The study started on January 2018 and the collection of air samples has been completed. We have received 800 air samples from eighty study locations in both dry and wet seasons. Currently, the laboratory analysis is ongoing and we expect to receive the preliminary results within July 2019.
Conclusions:
The existence of resistant bacteria in air like ESBL, CRE, VRE and MRSA will justify our hypothesis that the outdoor environment (air) in Bangladesh acts as a reservoir for bacteria that carry genes conferring resistance to antibiotics. So far our knowledge, this is the first study to explore the presence of superbugs in air of commonly exposed areas in Bangladesh.
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