That is why, as part of the SORT IT research and training initiative, led by Special Programme for Research and Training in Tropical Diseases of WHO, UNICEF, UNDP and the World Bank, with support from the Pan American Health Organization (PAHO), Amancha embarked on an investigation to measure antimicrobial-resistance in bacteria found in chicken meat in her country.

On poultry farms, antibiotics are administered in feed given to animals to prevent or treat infections, as well as to promote growth. However, when misused and overused, they can lead to the emergence of drug-resistant bacteria that can be transmitted to people when they consume the meat, putting their health at risk. Drug-resistant bacteria infections can be more serious and difficult to treat.

“In Ecuador, surveillance for antimicrobial resistance in livestock production has been evolving since 2019, and we had no experience in doing this, so the SORT IT programme strengthened capacities to use scientific evidence to promote mitigation measures,” the food engineer says.

Amancha works at the Food Safety Directorate of Ecuador’s Agency for Regulation and Phytosanitary and Zoosanitary Control (Agrocalidad) and is the antimicrobial resistance (AMR) focal point for the Ministry of Agriculture in her country.

The national pilot research lead by Amancha monitored AMR in chicken carcass samples from 199 slaughterhouses in Ecuador. Results showed high levels of resistance to critically important antibiotics in Escherichia coli and Salmonella spp bacteria isolated from the poultry sample. In total, 90% of the isolates were resistant to at least one critically important antimicrobial used in human medicine.

Such antibiotics are of often one of the few or the only treatment available for severe bacterial infections in humans. Escherichia coli and Salmonella spp can be serious in humans and cause diarrhea, urinary tract infections, fever and stomach cramps, among other symptoms.

The surveillance study of antimicrobial resistance in poultry production in Ecuador was the first of its kind in the country. Based on its results, recommendations included the implementation of AMR surveillance programmes and better use of antimicrobials in the livestock sector, as well as the elimination of antibiotics use as growth promoters, which was considered by the authorities.

Last June, Agrocalidad issued a resolution banning the use of antimicrobials as growth promoters in the manufacture of animal feed. In addition, the country started to implement good agricultural practices as mitigation measures in case of antimicrobial resistance and multi-resistance in agricultural production units.

SORT IT, research for action

Amancha’s research is one of eleven studies in Ecuador and Colombia that received grants from the Special Programme for Research and Training in Tropical Diseases of WHO, UNICEF, UNDP and the World Bank as part of the SORT IT initiative. The funds supported their participation in a virtual course on operational research that took place between July 2021 and September 2022, and to conduct the investigation to expand knowledge of antimicrobial resistance.

As a result, participants developed operational research protocols to address national AMR priorities in their countries and formulated recommendations for translating the results into public policy. Their research was also published in a special issue of PAHO’s Pan American Journal of Public Health.

“This research presents new evidence to guide AMR policies and interventions in Latin American and Caribbean countries,” says Dr Pilar Ramón Pardo, head of PAHO’s Special Programme on Antimicrobial Resistance. “Having quality research can contribute to the overall goal of preserving the antibiotics we have to save lives.”

About AMR

Antimicrobial resistance (AMR) is a threat to public health, driven by the inappropriate and unnecessary use of antibiotics in human health, animal health (treatment of infections, prophylaxis, and growth promotion in livestock production), agriculture, and by dissemination in the environment.

In 2019, almost 5 million deaths worldwide were related to multidrug-resistant bacteria, of which 1.27 million were directly attributable to AMR. A total of 338.000 deaths were related to AMR in Latin America and the Caribbean, with 84.300 attributable to AMR in the region. It is estimated that the economic losses generated by this problem will amount to 100 billion dollars by 2050.

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