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Cycle 7 (2018 Deadline)

Monitoring of antimicrobial resistance of bacteria for a better health of animals in Tunisia

PI: Lilia Messadi (, Ecole nationale de médecine vétérinaire de Sidi Thabet
U.S. Partner: Charlene Jackson, U.S. National Poultry Research Center
Dates: January 2019 - December 2022

Project Overview:

International organizations such as the World Health Organization, the World Organization for Animal Health, and the UN Food and Agriculture Organization consider antimicrobial resistance (AMR) as a major risk for human, animal, and environmental health. Therapeutic failures are witnessed, with an increasing risk of moving towards a "post-antibiotic era" where common infections could kill humans and animals. Scientists have predicted that by 2050, more than 10 million people could die each year because of AMR. A very recent study shows that between 2000 and 2015, Tunisia ranked as the world's second highest country for consumption of antibiotics, which is very worrying because there is a direct relationship between antibiotic consumption and AMR. Tunisia does not yet have a national strategy for monitoring the AMR of bacteria isolated from animals. Some preliminary studies have been conducted on a few bacterial species, mainly targeting commensal bacteria of healthy animals. It appears that the observed AMR is important in some animal species, especially among poultry, with a risk of transfer of resistance genes or resistant bacteria to consumers and to people in contact with pets or livestock.

The objective of this project is to survey AMR of bacteria at the animal/human/environment interface by targeting animals, food of animal origin, and pests (rats and cockroaches), according to the "One Health" concept. The epidemiological study of resistance and the identification of risk factors in husbandry practices and in veterinary use of antibiotics should results in suggested corrective measures to reduce AMR. For livestock, the team will focus primarily on smallholder farmers with limited income, to provide them with added value through health education messages in order to improve hygiene and prevent infectious diseases of animals. These livestock promotion measures are in line with USAID's development goals. They will target women as much as possible because they are often involved in small farms and are more receptive to educational messages on hygiene. The USG-supported partners will assist by developing laboratory methods for the monitoring of AMR and characterization of resistance genes, and also for training and education programs. Practical training of laboratory technicians and students will improve monitoring methods. Workshops and seminars for students and veterinarians will improve the use of antibiotics to reduce the frequency of resistant bacteria. Consequently, the trained students will be able to develop sensitization messages for breeders and in particular women, who are generally more concerned about hygiene measures. One of the main difficulties would be to convince veterinarians to change their practices regarding antibiotics. The main results of the study will be sent to the decision makers of the Ministry of Agriculture to enable the establishment of a national strategy to fight against this threat.

Summary of Recent Activities

In the first quarter of 2022, the project team continued the studies already started by interpreting the main results of antimicrobial resistance observed on antibiograms, the molecular characterization of antimicrobial genes of resistance by PCR for the main antibiotics and the study of risk factors. In particular, they focused their investigations on the major antibiotics in veterinary medicine (cyclines, sulfonamids, aminoglycosides) and antibiotics of critical importance for humans (3rd and 4th generation cephalosporins, fluoroquinolones and colistin). They also gained knowledge on the relative susceptibility of Escherichia coli in various animal species. It is thus possible to classify the animals in which resistance is most important (poultry, calves and dogs).

In the coming months, they intend to finalize the last analyses and complete the interpretation of the results with statistical analysis. In order to improve the working conditions in the laboratory, they will undertake work to modernize the premises. New laboratory benches will be installed and aluminum partitions will be put in place to optimize the space and create specific units. They hope to be able to organize a seminar on their results, involving their peers, decision-makers and certain international bodies such as the FAO and the OIE. A no-cost extension has been issued through December 2022 to allow additional time for procurement of equipment and supplies and preparation of papers for publication.

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