Bibliographic citations
Medina, M., (2024). Resistencia antimicrobiana en zonas rurales andinas en Cajamarca, Perú: estudio integrado basado en el enfoque UNA SALUD [Universidad Peruana Cayetano Heredia]. https://hdl.handle.net/20.500.12866/16336
Medina, M., Resistencia antimicrobiana en zonas rurales andinas en Cajamarca, Perú: estudio integrado basado en el enfoque UNA SALUD []. PE: Universidad Peruana Cayetano Heredia; 2024. https://hdl.handle.net/20.500.12866/16336
@phdthesis{renati/1281888,
title = "Resistencia antimicrobiana en zonas rurales andinas en Cajamarca, Perú: estudio integrado basado en el enfoque UNA SALUD",
author = "Medina Pizzali, Maria Luisa",
publisher = "Universidad Peruana Cayetano Heredia",
year = "2024"
}
Antimicrobial resistance (AMR) is increased by the use of antimicrobials in both animals and humans, and by exposure to AMR determinants in shared ecosystems; making it necessary to use the ONE HEALTH approach for the study of AMR. The objective of this work was to explore the contribution of people, farm animals and the environment to AMR in rural environments in Latin America, under the ONE HEALTH approach. With this basis, we oriented our sampling scheme and information collection to determine the prevalence of AMR in humans, animals and home environments (the three axes of ONE HEALTH) in rural areas of Cajamarca, and to characterize complete genome isolates of AMR bacteria. producers of extended spectrum β -lactamases (ESBL). The study had two phases: a scoping review based on the PRISMA-ScR guideline, and a cross-sectional field collection, applying microbiological, molecular and genomic methods to obtain human, animal and environmental samples, and their subsequent analysis. Few studies apply the ONE HEALTH approach to study AMR in rural areas of the region. The main contributing factors for the spread of AMR are farm animals carrying and/or transferring resistant genes or bacteria, human activities related to agriculture and animal production, and contaminated water, soil and agricultural environments. We identified the routes of AMR dissemination in rural Cajamarca, demonstrating the interconnection between animal, human and environmental transmission. We found a high prevalence of multidrug-resistant (MDR) AMR enterobacteria in children, animals, soil, and water in the high Andean rural áreas of Cajamarca. The AMR profiles found in animals, water samples and children are related to the most used antimicrobial treatments in animals and children. ESBL isolates from dogs and water were confirmed as potentially pathogenic ESBL E. coli, belonging to different sequence types and clonal complexes, indicating unrelated origins and lineages. Both isolates carried various virulence genes, ESBL genes, and resistance genes for other groups of antibiotics. Likewise, they were resistant to carbapenems. The presence of MDR ESBL enterobacteria is a public health risk in rural areas of Cajamarca, Peru. Anthropogenic factors, human habitable spaces shared with animals, and the use of contaminated water would explain the finding of MDR ESBL bacteria in this area. ONE HEALTH, mixed-methods studies applying microbiological, molecular and genomic approaches are needed to clarify the complex network of AMR dissemination routes and explore other factors that favor it.
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