Abstract:
Introduction. Antimicrobial resistance is a widespread and tough challenge, if
not impossible, to limit by biological, physical or geographical barriers. This is the
reason behind the "One Health" approach, which guides all rules and research
plans on antimicrobial resistance worldwide. The abusive and excessive use of
antimicrobials in human medicine, veterinary practices, agriculture and aquaculture
has traditionally been considered the main reason for the global spread of
antimicrobial resistance. The purpose was to assess the epidemiological risk of
wastewater as a source of antimicrobial-resistant bacteria concerning public
health, focusing on low - and middle-income Eastern European countries.
Material and methods. To achieve this goal, the development of a secure, cost effective
and sustainable technology has been planned, which could easily be introduced
in low- and middle-income countries. There have been outlined the following
steps: mapping the consumption of antimicrobial emulsions at the national
level (primary, cross-sectional study, complete sampling, based on imported
data and centralized public acquirement of medicines); research regarding the
knowledge, attitudes and practices of the population on antimicrobial resistance
(primary, cross-sectional, descriptive study); qualitative and descriptive evaluation
of barriers to reduce the phenomenon of antimicrobial resistance by the
healthcare services; research regarding the knowledge, attitudes and practices in
human and veterinary healthcare on antimicrobial resistance (primary, cross sectional,
descriptive study); screening and investigation of the microbial resistance
mechanisms to the strains isolated from patients with infectious pathological
processes (preclinical study); analysis of the specific features and sampling
of the Constructed Wetlands in Orhei (preclinical study). The Ethics Committee of
Ministry of Health of RM positively approved the Research PhageLand.
Results. The obtained results of this research will contribute to a better
understanding of the involved factors that are generating the broadening of
antimicrobial resistance and how they influence the transmission among different
hosts (bacteria, animals and humans). Moreover, it can also have a major impact
to the engineering field and wastewater management companies by expanding
the range of tools with sophisticated technologies, designed to reduce the risk of
transmitting antimicrobial resistance in wastewater and improve sewerage
practices.
Conclusions. The effective use of knowledge and practices in the worldwide fight
against antimicrobial resistance, providing useful data, applicable knowledge,
efficient, environmentally friendly and cost-effective protocols and technologies,
which can be scaled, implemented and used at the European and international
levels with no economic or geographical obstacles.
Acknowledgment. The research was conducted in the Republic of Moldova within
the JPIAMR projects (PhageLand), project number – 22.80013.8007.1
