INTerrupting prolifERation of Carbapenem resistance in Indonesia: clinical and genomic Evaluation of Pathways of Transmission (INTERCEPT) : a Study Protocol
- 1Universitas Diponegoro Fakultas Kedokteran
Abstract
BackgroundCarbapenem-resistant bacteria are a major global public health threat, classified as critical priority pathogens by the WHO. In Indonesia, despite a national antimicrobial resistance control programme established by the Ministry of Health in 2015, resistance rates continue to rise, including increasing carbapenem resistance among clinically important bacteria. Strengthening approaches to directly interrupt transmission is essential, yet transmission pathways remain poorly understood with limited research and policy guidance within the Indonesian context.
Methods and analysisThe INTERCEPT study is a UK-Indonesia multidisciplinary collaboration aiming to identify transmission routes of carbapenem-resistant bacteria across healthcare and community settings, and the mechanisms of resistance gene transfer between bacteria and mobile genetic elements. We will conduct genomic surveillance of hospital inpatients, healthcare workers, hospital environments, and surrounding communities, including wastewater systems, combined with genomic analyses and mathematical transmission modelling. A cohort of patients with bloodstream infections will be recruited to evaluate resistant bacteria, treatment practices, and clinical outcomes. Qualitative research will explore behavioural and system-level factors influencing transmission and intervention implementation. Findings will inform stakeholder workshops to co-design context-specific interventions, with pilot intervention over 9 months with pre-and post-intervention assessment to guide scalable strategies to reduce AMR transmission.
DiscussionThe INTERCEPT study addresses carbapenem resistance in Indonesia using an integrated approach combining microbiological surveillance, genomics, modelling, and qualitative methods. Strengths include cross-sectoral analysis (patients, workers, environment) and participatory intervention design. Limitations include geographic scope restricted to Central Java, Indonesia.
Trial/study registrationThe INTERCEPT study has been prospectively registered in the ISRCTN registry, a WHO-recognised primary clinical study registry (ISRCTN36830327)
Related
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- Wastewater is Not a Reliable Proxy for Clinical Carbapenem Resistance Prevalence in E. coli
- Carbapenem Resistance Among Gram-Negative Bacteria in Bioaerosols at Biomedical Waste Disposal Site in Ahmedabad, India
BibTeX
@misc{farida2026interrupting,
title = {{INTerrupting prolifERation of Carbapenem resistance in Indonesia: clinical and genomic Evaluation of Pathways of Transmission (INTERCEPT) : a Study Protocol}},
author = {H. Farida and R. Hapsari and E. S. Lestari and N. Farhanah and A. P. Roberts and F. E. Graf and R. E. Dacombe and M. E. Moore and J. M. Lewis},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.28.26361608},
url = {https://www.medrxiv.org/content/10.64898/2026.08.28.26361608v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - INTerrupting prolifERation of Carbapenem resistance in Indonesia: clinical and genomic Evaluation of Pathways of Transmission (INTERCEPT) : a Study Protocol
AU - H. Farida
AU - R. Hapsari
AU - E. S. Lestari
AU - N. Farhanah
AU - A. P. Roberts
AU - F. E. Graf
AU - R. E. Dacombe
AU - M. E. Moore
AU - J. M. Lewis
PY - 2026
DA - 2026/08/28
PB - medRxiv
DO - 10.64898/2026.08.28.26361608
UR - https://www.medrxiv.org/content/10.64898/2026.08.28.26361608v1
AB - BackgroundCarbapenem-resistant bacteria are a major global public health threat, classified as critical priority pathogens by the WHO. In Indonesia, despite a national antimicrobial resistance control programme established by the Ministry of Health in 2015, resistance rates continue to rise, including increasing carbapenem resistance among clinically important bacteria. Strengthening approaches to directly interrupt transmission is essential, yet transmission pathways remain poorly understood with limited research and policy guidance within the Indonesian context. Methods and analysisThe INTERCEPT study is a UK-Indonesia multidisciplinary collaboration aiming to identify transmission routes of carbapenem-resistant bacteria across healthcare and community settings, and the mechanisms of resistance gene transfer between bacteria and mobile genetic elements. We will conduct genomic surveillance of hospital inpatients, healthcare workers, hospital environments, and surrounding communities, including wastewater systems, combined with genomic analyses and mathematical transmission modelling. A cohort of patients with bloodstream infections will be recruited to evaluate resistant bacteria, treatment practices, and clinical outcomes. Qualitative research will explore behavioural and system-level factors influencing transmission and intervention implementation. Findings will inform stakeholder workshops to co-design context-specific interventions, with pilot intervention over 9 months with pre-and post-intervention assessment to guide scalable strategies to reduce AMR transmission. DiscussionThe INTERCEPT study addresses carbapenem resistance in Indonesia using an integrated approach combining microbiological surveillance, genomics, modelling, and qualitative methods. Strengths include cross-sectoral analysis (patients, workers, environment) and participatory intervention design. Limitations include geographic scope restricted to Central Java, Indonesia. Trial/study registrationThe INTERCEPT study has been prospectively registered in the ISRCTN registry, a WHO-recognised primary clinical study registry (ISRCTN36830327)
ER -