Barriers and pathways to environmental surveillance of antibiotic resistance in middle- and low-income settings: a qualitative exploratory key expert study.

Autor:	Peters AC; Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Gothenburg, Sweden.; Centre for Antibiotic Resistance Research in Gothenburg (CARe), Gothenburg, Sweden., Larsson DGJ; Centre for Antibiotic Resistance Research in Gothenburg (CARe), Gothenburg, Sweden.; Department of Infectious Diseases, Institute for Biomedicine, University of Gothenburg, Gothenburg, Sweden., Laxminarayan R; One Health Trust, Washington, DC, USA.; One Health Trust, Bangalore, India.; High Meadows Environmental Institute, Princeton University, Princeton, NJ, USA., Munthe C; Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg, Gothenburg, Sweden.; Centre for Antibiotic Resistance Research in Gothenburg (CARe), Gothenburg, Sweden.
Jazyk:	angličtina
Zdroj:	Global health action [Glob Health Action] 2024 Dec 31; Vol. 17 (1), pp. 2343318. Date of Electronic Publication: 2024 May 30.
DOI:	10.1080/16549716.2024.2343318
Abstrakt:	Background: Local and global surveillance of antibiotic resistance (ABR) has proven a challenge to implement effectively in low- and middleincome (LMI) settings. Environmental surveillance solutions are increasingly highlighted as a strategy to help overcome such problems, and thus to promote global health as well as the local management of ABR in LMI countries. While technical and scientific aspects of such solutions are being probed continuously, no study has investigated their practical feasibility. Objective: Explore practical barriers for environmental surveillance of ABR in LMI countries, and pathways for surveillance experts to manage these. Methods: To start charting this unknown territory, we conducted an explorative, qualitative interview study with key informants, applying a constructivist grounded theory approach to analyze the results. Results: Barriers were identified across infrastructural, institutional and social dimensions, and pathways to manage them were mostly counterproductive from an ABR management perspective, including avoiding entire regions, applying substandard methods and failing to include local collaborators. Conclusion: The research community as well as international agencies, organizations and states have key roles and responsibilities for improving the prospects of feasible environmental ABR surveillance in LMI-settings.
Databáze:	MEDLINE
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