WHO has established a basic protocol for One Health Surveillance of AMR. This “Tricycle” protocol integrates human, animal and environmental surveillance. The TRIuMPH project builds on the Tricycle project by developing protocols for the detection of carbapenemase-producing Enterobacteriaceae (CPE).  

These are applied in a one year surveillance campaign, including whole genome sequencing analysis of ESBL / CPE isolates. Additional sites are included within participating countries through in-country training, and samples from existing monitoring campaigns are used for CPE monitoring, namely water samples taken within the Polio Eradication campaign.

Goal of the project

TRIuMPH serves to enable a globally-comparable CPE surveillance by providing protocols for AMR surveillance in human, animal and environmental samples, aligning sampling with existing national sampling networks, and providing tools for whole genome sequence analysis. These protocols and tools are piloted in a one year surveillance campaign and evaluated with respect to the prevalence of CPE in humans, animals and the environment in three countries.

Who is involved 

The Netherlands: Utrecht University
France: University Paris Diderot, Fondation Merieux
Madagascar: CICM, Antananarivo
Malaysia: Institute for Medical Research, Min Health, DVS, 
Pakistan: NIH


Standard operating procedures for surveillance of carbapenem producing Enterobacterales (CPE) in humans, animals and the environment were established. Training courses were held on the lab procedures and for analysis of whole genome sequencing data of E. coli. Visits are being paid to investigate lab implementation of the protocols in Madagascar, Malaysia and Pakistan.

Upcoming events 

Final project workshop presenting the results of One Health CPE surveillance (probably end of 2024 in Geneva).

RIVM role  

RIVM coordinates the project, led the development of CPE protocols for environmental matrices, and for wastewater based surveillance of CPE. 


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