Annual Review 2015/16

Driving the global fight against antimicrobial resistance

Researchers are joining forces to improve the diagnosis of infectious diseases and tackle the rise of the untreatable superbug.

 

Today, 88 years after former University of Edinburgh Rector Alexander Fleming discovered penicillin, it is difficult to imagine a world without antibiotics. The life-saving medicines are so widespread, it is estimated they add an average of 20 years to all of our lives. Yet bacteria are increasingly becoming resistant to the drugs used against them and untreatable superbugs are emerging at an alarming rate. 

Fresh thinking

Till Bachmann Annual Review 2015_16
Dr Till Bachmann

University researchers are developing an international competition to spark innovations in diagnosing infectious diseases to help tackle the rise of antimicrobial resistance.

At least part of the problem arises because antibiotics are overused or prescribed inappropriately. Doctors often don’t have enough information about an infection to make an accurate diagnosis and prescribe broad spectrum antibiotics as a catch-all.

Senior academics are now turning to early-career researchers in the hope that they will bring fresh insights in the quest to improve diagnosis and aid antibiotic choice. Dr Till Bachmann of the University’s Division of Infection and Pathway Medicine explains: “We need to use antibiotics more wisely and for this we need better, faster diagnostics. Ideally we need to diagnose whether or not an infection is caused by bacteria at the point of care. We also need to know what type of bacteria it is and what its characteristics are. This would allow us to use drugs that we know have the most chance of being effective, which would reduce the risk of building resistance.”

In 2016 Dr Bachmann and his colleagues have been developing an innovation competition in antimicrobial diagnostics open to PhD students from the UK and India. Their aim is to connect and inspire the next generation of scientific talent as well as to spark international, interdisciplinary and innovative research and development (R&D) efforts.

“We are focusing the competition on early career researchers to get an unbiased view on the problem,” explains Dr Bachmann. “Early career researchers can bring fresh ideas, and at the same time, we’re connecting them with leading global experts across a range of disciplines so they have access to advice and guidance that will maximise their chances of success.”

Dr Bachman believes antimicrobial resistance is a global problem, and that specific challenges are faced by individual countries. “We want to empower people around the world to find solutions that are relevant to them,” he says. “What works in India, for example, may not be so useful in Africa because the environment is different.”

The competition was borne out of an Autumn School held in late 2015, which was attended by 20 students from the UK and India.  

“We hope to take the competition global and involve undergraduate students too,” says Dr Bachmann. “Our ultimate aim is to establish a global network of next-generation researchers and a gateway for them to interact with leading experts.”

A meeting of minds

While improved diagnostics can help prevent overuse of antibiotics, experts are agreed that tackling the problem will require a multi-level approach. The good news is that the threat of antimicrobial resistance is rising to the top of the agenda for policy makers. Ahead of a United Nations General Assembly meeting, Edinburgh Professors Mark Woolhouse and Devi Sridhar – alongside colleagues New York University and Fudan University – outlined recommendations for tackling the problem.

Early career researchers can bring fresh ideas, and at the same time, we’re connecting them with leading global experts across a range of disciplines so they have access to advice and guidance that will maximise their chances of success.

Dr Till Bachmann

The meeting – bringing together global heads of state – is only the fourth of its kind in history to be convened in response to a health issue.

Professor Sridhar, of the University’s Usher Institute of Population Health Sciences and Informatics, believes that no single nation can resolve the problem in isolation because these infections know no borders. “We now have a window of opportunity for making global policies in this area that could prevent a serious public health crisis,” he says.

Setting out credible evidence to underline these policy changes will be crucial, believes Professor Mark Woolhouse: “As researchers, we have a duty to collate, evaluate, interpret and communicate the evidence clearly over the next few years.”

Professor Woolhouse cites an example from his own research to address the impact of curbing the use of antibiotics in agriculture – where they are often used to promote animal growth – on stemming the rise of drug-resistant infections. 

“It would be reassuring to have an assessment of what the magnitude of benefits of such a measure would be for public health, given that it would have obvious downsides for food production and sustainability, which are themselves important contributors to public health,” comments Professor Woolhouse. 

Drawing on our expertise

Experts are agreed that tackling antimicrobial resistance will require an interdisciplinary response. As home to world-leading medical and veterinary schools, as well as internationally recognised expertise in global policy, social sciences and physical sciences, Edinburgh is well placed to make a major contribution. 

The University is creating a local network of expertise in antimicrobial resistance to coordinate these efforts at a strategic level. The Edinburgh AMR Forum has been convened by Dr Bachmann in collaboration with Edinburgh Infectious Diseases, a research network that extends across the city.

Director of Edinburgh Infectious Diseases, Professor Ross Fitzgerald says: “We have identified four core strengths where researchers in Edinburgh can make the most impact – tracking the dynamics and spread of antimicrobial resistance around the world, improving diagnostics, understanding mechanisms of resistance and developing alternative therapies.”

Professor Woolhouse adds: “There is no single magic bullet that will solve this problem. It will require a lot of separate measures that have to be coordinated. But we believe the University is in a strong position to drive research that will make a significant impact.”

 

Photo © Tricia Malley Ross Gillespie www.broaddaylightltd.co.uk