Extended spectrum beta-lactamase-producing Escherichia coli surveillance in the human, food chain, and environment sectors: Tricycle project (pilot) in Indonesia

Nelly Puspandari, Sunarno Sunarno, Tati Febrianti, Dwi Febriyana, Ratih Dian Saraswati, Indri Rooslamiati, Novi Amalia, Sundari Nursofiah, Yudi Hartoyo, Herna Herna, Mursinah Mursinah, Fauzul Muna, Nurul Aini, Yenni Risniati, Pandji Wibawa Dhewantara, Puttik Allamanda, Dwi Nawang Wicaksana, Rinto Sukoco, Efadeswarni, Erni Juwita NelwanCahyarini, Budi Haryanto, Benyamin Sihombing, Ricardo J. Soares Magalhães, Manish Kakkar, Vivi Setiawaty, Jorge Matheu

Research output: Contribution to journalArticlepeer-review

Abstract

The World Health Organization (WHO) has been implementing antimicrobial surveillance with a “One Health” approach, known as the Global Surveillance ESBL E. coli Tricycle Project. We describe the implementation of the Tricycle Project (pilot) in Indonesia, focusing on its results, challenges and recommendations. The samples were 116 patients with bloodstream infections caused by ESBL E. coli, 100 rectal swabs collected from pregnant women, 240 cecums of broiler, and 119 environmental samples, using the standardized method according to the guidelines. ESBL-producing E. coli was found in 40 (40%) of the 100 pregnant women, while the proportion of ESBL-producing E. coli was 57.7% among the total E. coli-induced bloodstream infections. ESBL-producing E. coli was isolated from 161 (67.1%) out of 240 broilers. On the other hand, the average concentration of E. coli in the water samples was 2.0 × 108 CFU/100 mL, and the ratio of ESBL-producing E. coli was 12.8% of total E. coli. Unfortunately, 56.7% of questionnaires for patients were incomplete. The Tricycle Project (pilot) identified that the proportion of ESBL-producing E. coli was very high in all types of samples, and several challenges and obstacles were encountered during the implementation of the study in Indonesia. The finding of this study have implication to health/the antimicrobial resistance (AMR) surveillance. We recommend continuing this project and extending this study to other provinces to determine the AMR burden as the baseline in planning AMR control strategies in Indonesia. We also recommend improving the protocol of this study to minimize obstacles in the field.

Original languageEnglish
Article number100331
JournalOne Health
Volume13
DOIs
Publication statusPublished - Dec 2021

Keywords

  • Antimicrobial resistance
  • ESBL-producing E. coli
  • Indonesia
  • One health

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