Since 2015, under the auspices of WHO, a basic protocol for One Health Surveillance of AMR has been established. This “Tricycle” protocol integrates human, animal and environmental surveillance and focuses on a single indicator for AMR: ESBL-producing E. coli. To our knowledge, this is the first One Health AMR surveillance protocol that has consistently been piloted across six different countries across the world.

The TRIuMPH project builds on the Tricycle project and on the JPI network “NETESE” by adding new research elements and protocols, thereby extending the application of the Tricycle surveillance. This will be achieved in a collaborative approach with current Tricycle and NETESE partners (PK, MY and MG) and partners that contributed to the Tricycle protocol development (Utrecht University, INSERM and RIVM National Institute for Public Health and the Environment ). New One Health protocols will be developed and applied in a one-year surveillance campaign for the detection of carbapenemase-producing Enterobacteriaceae (CPE, WP2), and for whole-genome sequencing analysis of ESBL / CPE isolates (WP3).

Within one single country, the extension of surveillance to a broader scale is needed, as analyses are currently limited to single cities. This will be brought about by two activities: Inclusion of additional sites within participating countries through in-country training (WP4), and integration with existing monitoring campaigns, such as for water samples taken within the Polio Eradication campaign (WP5). These also offer the opportunity to validate the applicability of wastewater sampling as a proxy of community prevalence of ESBL and CPE.

RIVM coordinates TRIuMPH. Partner countries involved are France, Madagascar, Malaysia, Pakistan and the Netherlands. RIVM's Heike Schmitt is the project coordinator.

Funding
The project has been awarded funding within the JPIAMR 9th transnational call: “Call on Diagnostics and Surveillance 2019.

• dr. A.L. (Aldert) Zomer
• prof. dr. J.A. (Jaap) Wagenaar

• Coordinator: Heike Schmitt - National Institute for Public Health and the Environment (RIVM) The Netherlands
• Laurence Armand-Lefevre - University Paris-Diderot Medical School INSERM IAME UMR1137 France
• Luc Samison - University of Antananarivo Centre d’Infectiologie Charles Mérieux Faculty of Medicine Madagascar
• Rohaidah Hashim - Institute for Medical Research Infectious Disease Research Centre MOH Kuala Lumpur Malaysia
• Muhammad Salman - National Institute of Health Public Health Laboratories Division Islamabad Pakistan