Washington State University Paul G. Allen School for Global Health and Universidad del Valle de Guatemala (UVG) began partnering in 2013 to identify and describe animal illnesses and possible animal-human disease transmission in communities located on the Pacific Coast of Guatemala.
This collaboration was expanded in 2016 to address the global threat of antimicrobial resistance (AMR) beginning with work on gut bacteria (Escherichia coli). Researchers investigated the prevalence of resistance to ten antibiotics across four communities in the western highlands and lowlands of Guatemala, and related these findings to a range of socio-economic, sanitation and health variables. Antibiotic use per se was only an important predictor of antimicrobial-resistant bacteria when household sanitation and hygiene were rated as very good. When conditions were compromised, sanitation and hygiene were better predictors for detecting these bacteria. Findings published in Scientific Reports demonstrated that poor hygiene conditions likely obscure effects of individual antibiotic use, presumably due to enhanced microbial transmission. Consequently, efforts to improve antibiotic stewardship should be coupled with improving hygiene conditions.
In 2018, the Allen School, together with UVG, initiated a five-year collaborative agreement with the Centers for Disease Control (CDC) to develop an antimicrobial-resistance surveillance platform that will identify the community prevalence of extended-spectrum cephalosporin-resistant Enterobacteriaceae (ESCrE), carbapenem-resistant Enterobacteriaceae (CRE), methicillin-resistant Staphylococcus aureus (MRSA) and Group A Streptococcus. During the second phase of the project collaborators will continue with household-level surveys to better understand how childhood vaccination might limit the demand for antibiotics and the prevalence of resistant bacteria, but to also estimate the prevalence of these resistant bacteria for isolates collected in a hospital. Findings will be shared with the Guatemalan Ministry of Health to develop public health strategies to mitigate AMR.