THE ROLE OF ENVIRONMENTAL AND CLINICAL MICROBIOLOGY IN UNDERSTANDING INFECTIOUS DISEASE DYNAMICS

Аннотация

The emergence of Antimicrobial Resistance (AMR) and antimicrobial resistance making infectious diseases a major public health issue - population growth, urbanisation, climate change, international travel, environmental degradation and AmR continue to pose a significant global public health challenge. Clinical microbiology is important for the diagnosis of infection and for the identification of antimicrobial susceptibility profiles, whereas environmental microbiology is important to shed light on pathogen reservoirs and transmission routes found in water, wastewater, soil, air and healthcare settings. Although environmental and clinical surveillance are interdependent the systems frequently stand alone, which decreases the understanding of infectious disease dynamics.

The objectives of this study are to: (1) examine the association of environmental microbial contamination and human infectious diseases; (2) examine the role of environmental reservoirs in the persistence and transmission of pathogens; and (3) develop an integrated framework for disease surveillance and outbreak prediction. A sequential explanatory design, using mixed methods, was used. Environmental samples, clinical data of infections, microbiological data and statistical modeling were used to get quantitative information, and expert interviews were conducted with microbiology, ID and public health specialists to get qualitative information. Results indicated that the clinical infection occurrence was significantly positively correlated with environmental contamination indicators and that wastewater and hospital environments are key surveillance locations. The study also found that there were significant associations between environmental contamination and the spread of antimicrobial resistance.

The study adds to the expanding literature on One Health by showing the benefits of combining environmental and clinical microbiological data in a single surveillance approach. The recommended method facilitates the detection of outbreaks, the understanding of the modes of transmission, and the monitoring of antimicrobial resistance, and enhances knowledge-based public health decision-making. The study proposes creating integrated environmental-clinical surveillance systems and supports the development of wastewater-based monitoring programs, while enhancing intersectoral cooperation and providing a boost for adopting a One Health approach to tackle infectious diseases and support disease prevention, control, and response. The novelty of the study is its integration of all these aspects of environmental microbiology with clinical infection data, to improve understanding and prediction of the dynamics of infectious disease.