STARCS: Selection and transfer of antimicrobial resistance in complex systems.

Selection and transmission are key determinants for the dissemination of antimicrobial resistance(AMR) across the planet. These determinants of AMR are frequently studied in laboratory settingswhile in reality they occur in complex systems, e.g. in microbial communities that colonize human andanimal guts or in environmental ecosystems. The central aim of STARCS (Selection and Transmissionof Antimicrobial Resistance in Complex Systems) is to characterize and quantify the processes ofselection and transmission of AMR genes and drug-resistant bacteria in complex (eco)systems from a'One Health' perspective and to integrate these elements into predictive mathematical models, whichwill be used to inform policy development.To reach this goal, the consortium will (i) develop and implement innovative metagenomicmethodologies to map the expression of AMR genes and their linkage to bacterial hosts and mobilegenetic elements in human, animal and environmental samples, (ii) use relevant animal models (usingmice and ducks) and observational studies (in hospitals and in dogs and their owners) to analyse andquantify the processes of selection and transmission of drug-resistant Enterobacteriaceae (specificallyExtended Spectrum Beta-Lactamase producing Escherichia coli) and (iii) implement state-of-the-artepidemiological modelling to quantify the spread of ESBL-producing E. coli between humans andanimals.STARCS will develop technological breakthroughs to assess selection and transmission dynamics onthe level of the resistance gene, the mobile genetic element, the bacterium, the human-animalenvironmentinterface and in clinical settings. This project will deliver important knowledge intoselection and transmission of AMR, will provide the scientific community with novel tools to studyselection and transfer of AMR in complex systems and will result in much-needed guidance towardspolicy decisions by international and national institutions. Ultimately the results from STARCS will forman evidence-based foundation for the development of new regulations, aimed at curbing the spread ofAMR.

Keywords:ANTIMICROBIAL RESISTANCE

Disciplines:Microbiology, Systems biology, Laboratory medicine