Epidemiological surveillance and public health risk assessment of food-mediated antimicrobial resistance in Hong Kong

Antimicrobial resistance (AMR) represents one of the major global health threats. While current research primarily focuses on clinical AMR burden, recent reports show community-acquired resistant infections outnumber hospital-acquired cases. Routine monitoring of AMR organisms in food samples in Hong Kong have detected Carbapenem-resistant E. coli (CR-E. coli) in raw meat samples. Whole-genome sequencing revealed these foodborne isolates are phylogenetically related to strains causing nosocomial outbreaks in hospitals.

This project is assessing the public health risks posed by foodborne AMR in Hong Kong through three integrated approaches: (i) wastewater surveillance with selective culture methods to measure community intestinal carriage prevalence; (ii) whole-genome sequencing and phylogenetic analysis to trace links between food, wastewater and clinical isolates; (iii) quantitative risk assessment through mathematical modelling. These methods will establish the first food-wastewater-hospital surveillance framework for AMR.

Beyond AMR, the proposed genomic, epidemiological and modelling methodologies are adaptable to other emerging infections and pandemic threats. Our approach may therefore provide a transferable platform for early detection, transmission mapping and risk assessment. Such approaches can help inform evidence-based multisectoral policies to strengthen public health preparedness.

This project is in collaboration with colleagues at Hong Kong Polytechnic University (PolyU). Lead investigators from PolyU are Gilman Siu and Franklin Chow.

The project is funded via a pump-priming collaborattive research funding call by The Pandemic Institute: Liverpool - Hong Kong partnership, supported by The Shaw Foundation.

Preprints: