Recorded presentation

Amira Roess, MPH¹, Afsana Akhter, MA², Dilara Afroz, MA³, Nabeel Ali, MA³, Peter Winch, MD MPH⁴, and Abdullah H. Baqui, PhD, MPH⁵. (1) Department of International Health, The Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, E8132, Baltimore, MD 21205, 4435703324, aroess@jhsph.edu, (2) International for Diarrheal Diseases Research, Bangladesh, ICDDR,B, Dhaka, 2023633653, Bangladesh, (3) International Centre for Diarrheal Diseases Research, Bangladesh, ICDDR,B, Dhaka, 2023633653, Bangladesh, (4) Department of International Health/Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, (5) Johns Hopkins Public Health Sciences Division, 615 North Wolfe Steet, Room E8138, Baltimore, MD 21205

Background: No information is available from resource-poor settings on the extent of environmental antibiotic usage and its relationship to the prevalence of antibiotic resistant bacteria in animals. Objectives: To assess the extent of environmental and human antibiotic usage in rural Bangladesh, surrounding practices and beliefs, and the impact on antimicrobial resistant bacteria in human populations Methods: Interviews were conducted with 20 village doctors to learn about antibiotic prescription practices; and with 40 households in a remote region of Bangladesh to learn about human and animal antibiotic usage practices. A survey was developed to quantify these results and is currently in use. Concurrently, small and large-scale poultry farms and animal feed shops were visited to learn about animal husbandry and use of antibiotics. Results: Human antibiotic use was reported in every household sampled. Children were the recipients of about 50% of antibiotics in use. Animal antibiotic use was found in 60% of sampled households. Households spent on average 4 times more on animal medicine than on human medicine. Parallels emerged between care-seeking behavior, antibiotic use, and prescribor practices for both humans and animals. Conclusions: The extent of antibiotic use in rural Bangladesh is much higher than previously thought. Most surprising was the widespread use of animal antibiotic use and the anecdotal reports of “resistant” animal infections. We are currently collecting specimens from people and animals to determine the prevalence of antibiotic resistant bacteria in the populations and the relationship between environmental antibiotic use and the emergence of antibiotic resistance human pathogens.

Learning Objectives: At the conclusion of the session, the participant will be able to

• identify the main risk factors for the emergence and global spread of antibiotic resistant pathogens particulary from the environment to humans
• apply the research methods presented to assess the extent of risk for emerging antibiotic resistant pathogens due to inappropriate human and agricultural antibiotic use in resource poor settings

Keywords: Antibiotic Resistance, Environmental Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation