In 2024, the Global One Health Academy offered Seed Grants to support NC State faculty and EHRA professionals for seed funding for novel, interdisciplinary One Health research projects. Ayse Ercumen (CNR), was a recipient of the 2024 Seed Grant Awards for a project on antimicrobial resistance (AMR) surveillance in rural Bangladesh. Learn more about Ercumen and how the Global One Health Academy helped support her research to investigate and help reduce the drivers of child exposure to AMR through her spotlight below.
What is your lab’s research focus?
My group’s research is focused on infectious disease epidemiology, environmental and zoonotic disease transmission, antimicrobial resistance and health impact evaluations of environmental interventions to improve child health in low-income countries. I also work on waterborne infections and drinking and recreational water quality, both domestically and globally.
How does your research relate to the One Health framework?
Infectious disease research sits at the very crossroads of the One Health pillars. Humans and animals share pathogens. For many infectious diseases, controlling infection among humans necessitates also considering animal reservoirs. Environmental matrices are often the conduit for how zoonotic pathogens move between humans and animals. My work investigates environmental and zoonotic pathways that mediate enteric disease transmission among young children in low-income countries. Most of my projects involve extensive environmental sampling to identify the reservoirs that harbor pathogens and drive infections. This evidence can inform the design and implementation of interventions to interrupt transmission pathways, such as water, sanitation and hygiene (WaSH) improvements but also safe animal husbandry practices to prevent the spread of zoonotic pathogens. My research portfolio includes health impact evaluations of such interventions to assess if they deliver the intended environmental and health benefits.
You received funding from GOHA for a project on antimicrobial resistance surveillance in rural Bangladesh. Tell us about this work.
Children in Bangladesh are colonized with antimicrobial-resistant bacteria at an alarmingly early age. We hypothesize this is partly due to child exposure to these organisms in the home environment, such as via contaminated drinking water, food or hands. In our earlier work in rural Bangladesh, we found that soils in the domestic environment (e.g. yards, indoor soil floors) harbor particularly high levels of microbial contamination, especially if households raise domestic animals. This is problematic because many homes in low-income countries have floors made of soil, and many child activities, such as eating, playing, and sleeping, take place on soil floors, creating opportunities for exposure. The GOHA-funded project has two aims. The first aim is to quantify antimicrobial-resistant bacteria in a diverse range of samples from the home environment to investigate the drivers of child exposure to AMR. The second aim is to understand whether replacing soil floors with concrete can reduce soilborne exposure to antimicrobial-resistant bacteria for young children.
This research involves robust international collaboration with both scientists affiliated with the Environmental Health Laboratory International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) and Bangladeshi community members who are enrolled in the NIH-funded randomized controlled trial that your project is nested under. What have been the most challenging and the most rewarding aspects of doing international research like this?
I have worked with the icddr,b for more than 15 years. Having a strong field partner is a make-or-break in my line of work, and my icddr,b colleagues are amazing. They bring a solid scientific foundation to research projects. The organization has a strong track record of pioneering public health solutions in Bangladesh, and their support is critical for building trust with the communities we work in. The rewards of productive international collaborations are too many to list! I deeply enjoy the cross-cultural immersion and working on real-world problems with field partners who can deliver real-world solutions. International fieldwork can also be demanding with long work hours and unpredictable roadblocks — it’s important to remain flexible and keep a good attitude!
What do you view as a critical challenge for your field, and how can One Health perspectives and approaches help meet this challenge?
A lingering challenge in my field is how to implement what we know works well to reduce infectious disease (e.g. centralized water and sanitation infrastructure) in settings where one size does not fit all. Centralized water and wastewater treatment starting in the early 1900s transformed public health in the US. My field has been grappling with how to achieve similar health improvements in settings where these types of centralized systems remain out of reach for the time being. Many efforts have tried to implement household-level improvements, such as treating drinking water in the home or constructing latrines; these efforts put the burden on the user and are hard to sustain and scale up. Even when such improvements are implemented successfully, their health benefits have been smaller than anticipated in rigorous health trials, in part because they do not address the full One Health spectrum. We hypothesize that, in settings where humans and animals share living spaces, ongoing pathogen transmission from domestic animals and their waste can undermine the health benefits of efforts that solely focus on containing and handling human waste. A One Health perspective that connects the dots between humans, animals and environmental reservoirs is essential to achieve meaningful health benefits.
Is there a recent or upcoming publication where we can read more about your One Health research?
In this recent paper, we measured antimicrobial-resistant bacteria on household floors in rural Bangladesh and saw some remarkably clear trends. Almost all floors showed fecal contamination, and more than two thirds of floors harbored antimicrobial-resistant bacteria. Not surprisingly, soil floors were more contaminated than concrete floors. Contamination levels progressively increased with the number of animals owned, especially if animals were allowed to roam free inside the home. Our findings indicate that broader housing improvements, such as upgrading floors to improved materials (e.g. concrete), and implementing safe animal management practices have potential to reduce exposure to antimicrobial-resistant bacteria.
- Ercumen A, Hossain MS, Tabassum T, Haque A, Rahman A, Rahman MH, Anderson C, Tazin S, Hanif S, Heitmann GB, Miah MR, Yeamin A, Jahan F, Shoab AK, Mahmud ZH, Rahman M, Benjamin-Chung J. Dirt Floors and Domestic Animals Are Associated with Soilborne Exposure to Antimicrobial-Resistant E. coli in Rural Bangladeshi Households. Environ Sci Technol. 2025 Dec 2;59(47):25173-25185. doi: 10.1021/acs.est.5c10329.
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