One Health Surveillance of Antimicrobial Use and Resistance: Challenges and Successes of Implementing Surveillance Programs in Sri Lanka

Abstract

Background: Sri Lanka is a low-income country, as defined by the World Bank. The country suffered further economic downturn during the COVID-19 pandemic. This situation adversely affected the prioritization of policies and programs around healthcare and public health. In particular, inflation, fuel prices, and shortage of food supplies increased struggles to implement antimicrobial resistance (AMR) programs. However, in the long run, it is crucial to gather data and evidence to plan AMR policies and track interventions. (1) Aim: To establish and reiterate the importance of prioritizing AMR programs in the One Health framework, the Fleming Fellows collected and studied antimicrobial use/consumption (AMU/AMC) and resistance (AMR) in humans, food-producing animals, and the environment. (2) Methods: A systematic and cross-sectional study was conducted between 2019 and 2021. By way of coordinating an AMU/AMC and AMR prevalence study across six agencies from human health and food-producing animal sectors, the authors established a field epidemiology study, laboratory testing, and data processing at their institutions. AMU/AMC patterns were surveyed using questionnaires and interviews, while AMR samples were collected for antibiotic susceptibility tests and genomic tests. Samples were tested for phenotypic and genotypic resistance. (3) Results: In human samples, resistance was highest to beta-lactam antibiotics. In non-human samples, resistance was highest to erythromycin, a highest-priority, critically important antibiotic defined by the World Health Organization. From government records, tylosin was sold the most in the food-producing animal sector. (4) Conclusions: Sri Lanka AMU and AMR trends in human and non-human sectors can be ascertained by a One Health framework. Further coordinated, consistent, and sustainable planning is feasible, and can help implement an AMU/AMR surveillance system in Sri Lanka.

Global Strategies to Combat Antimicrobial Resistance: A One Health Perspective

“…Additionally, the surveillance of AMR food-producing animals must be integrated into the national AMR surveillance systems, including the human AMR surveillance system [202]. Therefore, it is recommended to use a One Health approach to effectively conduct AMR surveillance globally [189] [190] [192].…”

Glimpse into the biosecurity, antimicrobial usage, and antimicrobial resistance of fecal <em>Escherichia coli</em> associated with commercial chicken layer farms in a poultry dense area in Sri Lanka

“…Other than that, very recently published data on antimicrobial usage in poultry sector in Sri Lanka reports tylosin (37%) as the mostly used antimicrobial drug and usage of sulfonamide and sulfa-trimethoprim, amoxicillin, neomycin, tetracycline and enrofloxacin were recorded as 15%, 14%, 10%, 9%, and 6% during the study period respectively. Further the same study reports, based on antimicrobial classes sulfonamides, beta-lactams, macrolids, fluroquinolones, and pleuromutilin as the mostly used antimicrobials in Kuliyapitiya and Paduwasnuwara divisional secretariat areas in Sri Lanka (Ariyawansa, et al, 2023).…”

The role of veterinary research in human health promotion in South Asia

“…Citrobacter spp., Enterobacter spp., Proteus spp., Enterococcus spp., and Pseudomonas aeruginosa, were found to exhibit high degree of resistance in Bangladesh (Nobel et al 2022). AMR is a very important public health challenge in Sri Lanka (Ariyawansa et al 2023). Methicillin-resistant Staphylococcus aureus, Extended Spectrum Beta-lactamase producing E. coli, and Klebsiella spp., were reported in Sri Lanka (Munasinghe et al 2021).…”