@article{260b73f2f0a2485fa96ac6e6d5f2b326,
title = "Gut carriage of antimicrobial resistance genes in women exposed to small-scale poultry farms in rural Uganda: A feasibility study",
abstract = "Background Antibiotic use for livestock is presumed to be a contributor to the acquisition of antimicrobial resistance (AMR) genes in humans, yet studies do not capture AMR data before and after livestock introduction. Methods We performed a feasibility study by recruiting a subset of women in a delayed-start randomized controlled trial of small-scale chicken farming to examine the prevalence of clinically-relevant AMR genes. Stool samples were obtained at baseline and one year post-randomization from five intervention women who received chickens at the start of the study, six control women who did not receive chickens until the end of the study, and from chickens provided to the control group at the end of the study. Stool was screened for 87 clinically significant AMR genes using a commercially available qPCR array (Qiagen). Results Chickens harbored 23 AMR genes from classes found in humans as well as additional vancomycin and β-lactamase resistance genes. AMR patterns between intervention and control women appeared more similar at baseline than one year post randomization (PERMANOVA R2 = 0.081, p = 0.61 at baseline, R2 = 0.186, p = 0.09 at 12 months) Women in the control group who had direct contact with the chickens sampled in the study had greater similarities in AMR gene patterns to chickens than those in the intervention group who did not have direct contact with chickens sampled (p = 0.01). However, at one year there was a trend towards increased similarity in AMR patterns between humans in both groups and the chickens sampled (p = 0.06). Conclusions Studies designed to evaluate human AMR genes in the setting of animal exposure should account for high baseline AMR rates. Concomitant collection of animal, human, and environmental samples over time is recommended to determine the directionality and source of AMR genes. Trial registration ClinicalTrials.gov Identifier NCT02619227.",
author = "Weil, {Ana A.} and Debela, {Meti D.} and Muyanja, {Daniel M.} and Bernard Kakuhikire and Charles Baguma and Bangsberg, {David R.} and Tsai, {Alexander C.} and Lai, {Peggy S.}",
note = "Funding Information: Funding was provided by National Institutes of Health grants K23 ES023700 (PSL), P30 00002, and K23 MH096620 (ACT), and K08AI123494 (AAW) (https://www.nih.gov/), Harvard School of Public Health-National Institute of Environmental Health Sciences and Center for Environmental Health (P30ES000002) Pilot Project Grant (PSL) (https://www.hsph.harvard.edu/niehs/), American Lung Association Biomedical Research Grant RG-346990 (PSL) (https://www.lung.org/), Harvard Catalyst (UL1 TR001102) Early Clinical Data Support Pilot Grant (PSL) (https://catalyst.harvard.edu/), and Friends of a Healthy Uganda (DRB, ACT) (https://attackpoverty.org/locations/friends-of-Uganda/). The funders had no role in study design, data collection, analysis, decision to submit the work for publication, or preparation of the manuscript. The authors thank the participants in this study. In addition to the named study authors, HopeNet Study team members who contributed to data collection and/or study administration during all or any part of the study were as follows: Phiona Ahereza, Owen Alleluya, Gwendoline Atuhiere, Patience Ayebare, Dickson Beinomugisha, Bridget Burns, Augustine Byamugisha, Patrick Gumisiriza, Clare Kamagara, Allen Kiconco, Noel Kansiime Kiza, Viola Kyokunda, Moran Mbabazi, Amy McDonough, Juliet Mercy, Patrick Lukwago Muleke, Elijah Musinguzi, Moran Owembabazi, Sarah Nabachwa, Elizabeth Betty Namara, Immaculate Ninsiima, Mellon Tayebwa, Specioza Twinamasiko, and Dagmar Vo?echovsk?. Clean Air Study team members who contributed to data collection and/or study administration during all or any part of the study were as follows: Solome Kobugyenyi, Alex Mutungi, John Bosco Tumuhimbise, Joy Namara Karakire, Collins Agaba. A preliminary analysis of these data was presented at IDWeek, San Francisco, California, USA, October 5, 2018. Publisher Copyright: {\textcopyright} 2020 Weil et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",
year = "2020",
month = jun,
doi = "10.1371/journal.pone.0229699",
language = "English (US)",
volume = "15",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "6",
}