TRIuMPH
Type:
Research, AMR, Mother & child
Region/Countries:
Global – France, Malaysia, Pakistan, Madagascar & Netherlands
Project for monitoring antimicrobial resistance in three countries that have already implemented the WHO’s TRIcycle protocol. This project is an extension of the TRIcycle project.
Context
While many countries and international organizations underline the need for One Health surveillance of bacteria resistant to antibiotics in the implementation of national action plans for AMR (WHO, 2018), many countries do not have a surveillance system in place, particularly in the environmental and animal health sectors. Better surveillance is particularly necessary for Extended-spectrum beta-lactamase (ESBL)-producing enterobacteriaceae and Carbapenemase-producing Enterobacteriaceae (CPE), which have been declared a critical priority by the World Health Organization (WHO) (Tacconelli et al. 2018).
The TRIcycle protocol developed in line with the One Health approach by the WHO Advisory Group on Integrated Surveillance of Antimicrobial Resistance (WHO AGISAR, 2017) involves the surveillance of the healthy human population (carriage by pregnant women) and infected patients (blood infections) as well as surveillance in the animal sector (chickens) and the environmental sector (human and animal wastewater and surface water).
Objectives
The objective of the TRIuMPH project is to:
- Improve the TRIcycle protocol for AMR surveillance across the three sectors (human, animal, and environmental) by developing new protocols for:
- the detection of Carbapenemase-producing Enterobacteriaceae (CPE) easily applicable to the three sectors, using a simple and low-cost method since commercial systems are not readily available in LMICs.
- the introduction and use of open source WGS analysis pipelines.
- The extension of the current TRIcycle project:
- to new regions joining the study (new sites).
- to samples taken from other surveillance campaigns, such as the environmental surveillance campaign for polio.
Activities
- Training in detection methods and phenotypic characterization of CPE.
- Identification of new study sites on a national scale in the countries involved*.
- Sampling across the three sectors (human, animal, and environmental) and phenotypic analysis.
- Molecular characterization (analysis by Whole Genome Sequencing) of CPE strains isolated in the three sectors.
Impact of the project
- AMR diagnosis and surveillance capacities of LMICs for the human, animal, and environmental sectors.
- Data on the prevalence of coli ESBL and CPE in the various sectors, resistance indicators to measure the impact of future interventions.
- Contribution to the reporting of One Health AMR data to health authorities.
- Development of an international AMR network.
Promoter
- Joint Programming Initiative on Antimicrobial Resistance Call for Diagnostics and Surveillance (JPIAMR) Secretariat, via the national funding agency
- National Research Agency (ANR) for France
- Swedish International Development Cooperation Agency (SIDA, Sweden) for Madagascar
- International Development Research Centre (IDRC, Canada) for Pakistan and Malaysia
Partners
- National Institute for Public Health and the Environment, Netherlands
- INSERM IAME UMR1137, University Paris-Diderot Medical School, France
- Utrecht University, Netherlands
- National Institute of Health, Pakistan
- Infectious Disease Research Center of Institute for Medical Research, MOH, Malaysia
- Charles Mérieux Center for Infectious Disease (CICM), Madagascar
- Mérieux Foundation (Inserm sub-contractor), France