TRAINAU is a multidisciplinary Early Stage Training site on identification, characterisation, and assessment of public health risks associated with non-human use of antimicrobials. TRAINAU brings together early-stage researchers with different backgroundsand provides them with the scientific and technological competences necessary to perform high-level research and obtain substantial progress in this field.
The Early Stage Training site builds on the experience gained in Denmark. The country has established a fully integrated surveillance program on antimicrobial usage and antimicrobial resistance in animals, food, and humans. The Early Stage Training site consists of inter-related research groups located at University of Copenhagen, Faculty of Life Sciences and Faculty of Pharmacy, Technical University of Denmark, National Food Institute and the national reference laboratory Statens Serum Institut. Faculty of Life Sciences is the co-ordinator institution.
The international dimension of TRAINAU is ensured through the strong networks of the host group with European universities, research institutions as well as with international organisations. Fellows will establish links across Europe, stimulating future international collaborations and producing positive effects on their future careers.
TRAINAU contributes to coordination of research training in the area of microbiological risk assessment and enables dissemination of principles and methods for surveillance of antimicrobial usage and resistance to other European countries. TRAINAU also contributes to reinforce the capacity of emerging research groups through enhancing the scientific capacities of the fellows.
Non-human use of antimicrobials, in particular the use in food animals, contributes to the public health problems in relation to antimicrobial resistant human infections. Control efforts should be guided by microbial risk assessment in an integrated food chain perspective.
TRAINAU's objectives are to answer the following main questions in order to assess the risks of non-human antimicrobial usage:
The project brings together young researchers with different backgrounds (veterinary and medical microbiology, epidemiology, statistics, pharmacology, and analytical chemistry) and provides them with the scientific and technological competences necessary to obtain substantial progress in this field. The fellows, which come from eight different countries, form a multidisciplinary team and collaborate in the design of their research plans as well as in the analysis of results. The supervisors have ensured that individual research plans for the fellows are in line with the overall research strategy of the team.
The research activities have generated data and developed new methods in order to answer questions that are of crucial importance for conducting risk based evaluations. The main questions that the research has been aiming to answer in order to assess the risks of non-human antimicrobial use include:
Antimicrobial resistance is a complex phenomenon involving a multitude of different drugs, bacterial species, resistance mechanisms, and resistance genes. Due to the complexity of the problem, it is impossible, within the frame of this consortium, to assess the risks associated with the use of all antimicrobials as a whole. Thus, the research activities have been focused on specific antimicrobial classes used in animals. Appropriate resistance indicators (i.e. bacterial indicator + resistance phenotype) have been chosen prior to the experimental work. Particular emphasis has been given on resistance phenotypes of clinical importance and epidemiological markers that can be used to track animal-to-human transmission. The preliminary results of the programme are very promising, and by far exceeding the expected outcome.
Descriptive and analytical epidemiological studies have investigated the association between different antimicrobial usage patterns and occurrence of antimicrobial resistance in animals at the level of the individual animal, the individual farm and the entire population. In addition to animal, human and food samples made available from the existing national surveillance programs, additional sampling has been conducted within specific settings (e.g. farms, slaughterhouses, family households, etc.). The epidemiological relationships between bacterial isolates from animals, food, and humans have been determined by molecular methods. Resistance genes and the associated mobile genetic elements have been characterised and horizontal transfer between animal and human bacterial populations have been investigated.
Experimental research activities have included laboratory experiments used to validate results from field studies and to provide quantitative data that can be used for risk assessment. The experiments have been employing the same resistance indicators used in the risk assessment framework and seek to answer important questions for which data are not available in the literature. For example, animal models have been used to study the transmission of resistant strains between individuals, the effects of antimicrobial resistance on incidence and severity of human infections, and the effects of drug metabolites and different modes of drug administration on selection of resistant bacteria in animals. At present time the fellows are collaborating on a quantitative risk assessment using their obtained results and the present literature, the outcome of this assessment looks promising but is still under further preparation. For more detailed description of the scientific outcome please see the annual scientific outcome report available on the programme homepage. A full list of publications directly related to the programme is also available on the website.
The Early Stage Training programme will strive to continue the activities in a postdoc-based EU research programme, in collaboration between the Danish consortium and the fellow's home institutes.