Farmers in rural Northeast India are using antibiotics on their livestock, and researchers want to know whether the resistant bacteria that emerge on those farms are ending up in local hospital patients. The problem is a critical blind spot in the global fight against antimicrobial resistance. While it is known that antibiotic use in animals selects for resistant bacteria, the actual chain of transmission from farm to human remains poorly documented, especially in settings like Northeast India where small-scale livestock operations are common. Without hard evidence, policies to restrict agricultural antibiotic use risk being either too lax or unnecessarily damaging to livelihoods. This project will collect bacteria from animals, people, retail meat, and the environment on farms, then sequence their DNA to compare resistance genes and bacterial strains with those found in hospital patients. Alongside this, social scientists will interview farmers and veterinarians to understand why antibiotics are used—covering economic pressures, knowledge gaps, and social hierarchies. If the research confirms that farm-origin bacteria are causing human disease, it will provide the evidence needed to design antibiotic stewardship programmes tailored to rural India. If it does not, it will prevent wasteful restrictions and focus efforts elsewhere. Either way, the project builds local capacity in DNA sequencing and social science methods, strengthening India’s ability to monitor resistance long-term.
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Considerable amounts of antibiotics are used in the rearing of livestock and the use of these antibiotics leads to the selection of bacteria that are resistant. There is some evidence that these bacteria may contribute to resistance levels in bacteria that cause human disease. This research aims to investigate if antibiotic resistant strains of bacteria found in farms are also found in cases of human disease in a region of North East India. This project will also record the use of antibiotics on farms, and to investigate the human behavioural and animal health factors that influence antibiotic use. The study combines microbiological and social science research methods. Agriculture in this area consists mainly of smaller livestock enterprises typical of many rural settings in India. The aim is to provide a comprehensive description of the distribution of resistant bacteria in humans, livestock (including aquaculture) and the environment together with a thorough study of the context which leads to the selection of these bacteria in order to understand which antibiotics (and the quantities) are used and why. The project also aims to increase the research capacity in India to continue this work through increased experience and training in the application of DNA sequencing and social science methods for research into antibiotic resistance. The specific research work that will be performed is: 1. Sampling on farms in order to bacteria from animals, people, the environment and retail meat products, together with bacteria from cases of human disease from local hospitals. 2. Collection of data from farms to record antibiotic use, how and why decisions are made to use antibiotics, which individuals are influencing these decisions, and what factors affect the decision-making process (to include how presumptive diagnoses are made, societal hierarchy, prior knowledge, education, attitudes, and economic factors) using established social science research methods . 3. DNA sequencing of the bacteria in order to characterise the mechanisms responsible for antibiotic resistance, and to compare the relatedness of agricultural and hospital bacteria. This enables us to determine if there is transmission of antibiotic resistance from farm animals to people. 4. To develop antibiotic stewardship advice, materials and programmes that are tailored to a rural Indian context in order to maximise animal health and ensure rational use of antibiotics. Good quality scientific evidence is needed to ensure that any restrictions on antibiotic use on farms are rational, and targeted appropriately. Regardless of any contribution to human antibiotic resistance better antibiotic stewardship in agriculture will reduced levels of resistance in livestock and lead to improved animal health.
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