Impact of reducing colistin use in humans and poultry in Indonesia - JPIAMR 13

 

Colistin is considered a last-resort antimicrobial for treatment of infections with multidrug-resistant bacteria, classified by the World Health Organization (WHO) as ‘highest prioritized, critically important for human medicine’. WHO has suggested banning or highly restricting its use in animals, and in fact, the presence of colistin resistance in E. coli in poultry resulted in a ban for livestock in Indonesia in 2020. Colistin is still suspected to be routinely used in humans in multiple settings, but these practices are poorly understood. The ban on colistin use in livestock offers a unique opportunity to assess the impact of this intervention on colistin resistance in humans and animals, and how a one health, or multi-sectoral, perspective can strengthen this intervention.

This project aims to: determine phenotypic and genotypic colistin resistance in E. coli from humans and poultry in Indonesia; assess the impact of the colistin ban on resistance in E. coli in animals and humans; estimate the transmission of colistin resistance between animals and humans; study colistin use and perceptions at the community level; and expand the initial colistin ban in the animal-production sector into an integrative multi-sectorial one-health intervention, which will be designed and implemented using a community participatory approach. This project will provide a strong scientific basis for antimicrobial resistance (AMR) policies in Indonesia, with great significance across Southeast Asia.

This project is one of three which will receive funding support from IDRC through the Joint Programming Initiative on Antimicrobial Resistance (JPIAMR), an international platform that coordinates global funding to support collaborative research and action on AMR. Through the JPIAMR, IDRC has partnered with 30 other donor agencies to fund innovative research projects to understand the impact of interventions on the development and transmission of antibiotic resistance and to design, implement, evaluate and compare interventions that will have a true impact on reducing the development and transmission of AMR in and between the different one-health settings.