AMR DxC Summer School India Blog

News from the Summer School in Bangalore

Blog text from Lucy Everitt. Pictures are from Till Bachmann and Beth Mills

Day 1 - Tuesday, 4 July 2017

The first day of the AMR DxC Summer School saw the arrival of delegates from both Edinburgh and India at C-CAMP, Bangalore. Following brief introductions, the morning’s presentations were centred around setting the scene for the potential use of rapid AMR diagnostic tools to be used as a cornerstone technique in the tackling of the imposing global threat of AMR. Dr Taslimarif Saiyed (C-CAMP, Bangalore) welcomed the delegates to C-CAMP and together with Dr Till Bachmann (University of Edinburgh, UK) thanked the sponsors of the AMR DxC Summer School 2017, the Edinburgh Global Innovation Fund by the University of Edinburgh and the Department of Biotechnology of India. Dr Saiyed then kicked off the day’s proceedings by presenting an informative account of the importance of scientific and international collaboration for tackling AMR, as well as exciting innovations under development by start-up companies situated at C-CAMP. Dr Bachmann followed with a presentation outlining the programme for the Summer School as well as emphasising the potential for the AMR DxC delegates to develop new and non-biased solutions to tackle the AMR threat. Mr Dominic McAllister (British High Commissioner, Bangalore) highlighted that India is an emerging giant in scientific research, and how it would be very fitting if the AMR crisis was ‘solved’ in India: one of the worst AMR-affected nations globally. Dr Mittur N. Jagadish (Government of Karnataka) swiftly followed Mr McAllister and argued in his presentation that there is a need for an “innovation buzz” across India for AMR-related start-ups regarding the development of practical and affordable rapid diagnostics. Dr T.S. Balganesh (Gangagen Biotechnologies) then followed by presenting his belief that the unmet need in the AMR crisis is lack of real progress in the field of drug discovery in recent years. The next session saw the delegates take part in an icebreaker session (led by Dr Bethany Mills, Proteus, University of Edinburgh) to establish the foundations for successful connectivity and group problem solving. Dr Bachmann wrapped up the morning’s presentations by presenting his forefront rapid diagnostic testing research undertaken by his research group, and placing this in the context of the current AMR global crisis.

            Following a short lunch break, Dr Saiyed highlighted to the delegates the urgent need for rapid diagnostics to be developed and used in India. Dr Bachmann then introduced the AMR DxC Pilot Competition (Antimicrobial Resistance Diagnostics Challenge) at which the delegates were tasked to develop an innovative project idea. At the end of the week, the delegates had to present their proposed projects to a panel of AMR DxC experts. To conclude the day’s presentations, the participants did their elevator pitches on their own background and research, which was an excellent way for the delegates to understand the level of multidisciplinary skillsets and experience within the different teams. The rest of the day saw the delegates work on their AMR DxC project proposals within their respective groups.

            In conclusion, the first day of the AMR DxC Summer School saw the introduction to AMR presented by various experts in the field in the context of both the UK and India, as well as the beginnings of group work toward the AMR DxC Project proposals. The day was greatly enjoyed by all and the bustling atmosphere of discussing innovations in rapid diagnostics and AMR began to build up.

Day 2 - Wednesday, 5 July 2017

Day two of the AMR DxC Summer School saw a change in location from day one: from C-CAMP to St John’s Hospital. The opportunity to visit a leading Indian hospital gave the delegates the chance to hear from experts and clinicians working at the ‘front-line’ in the wake of the crisis of AMR and how diagnostics are, or are not, effectively utilised to aid clinical decisions. Dr Mary Dias (St. John’s, Bangalore) welcomed the Summer School delegates and outlined the programme for the day. Dr Sriram Sampath (Professor and HoD, Critical Care Medicine, SJMCH, Bangalore) began the day’s presentations by describing his work in the treatment of adults in critical care settings, and stressed that currently available diagnostics are not proving sufficiently useful information for clinicians and thus physicians rely largely on an entrenched, empirical judgement practice for diagnosis and treatment. Dr Sanjiv Lewin (Professor and HoD, Paediatrics, SJMCH, Bangalore) presented his work as a paediatrician at St. John’s, and detailed that the cut-off period for antibiotic administration to a sick child is one hour, and that hypothesis-driven diagnosis currently determines antibiotic prescription, in the light of an absence of “clinically-relevant diagnostics”. Dr Cecil Ross (Professor and HoD, Dept. of Medicine, SJMCH, Bangalore) followed by presenting his experience in the field of AMR in immunocompromised individuals, and emphasised that a low level of detection is a necessary feature for future diagnostics. Dr Savitha Nagaraj (Professor of Microbiology and Infection Control Committee, SJMCH, Bangalore) continued the day’s presentations by providing the delegates with an overview of the problem of drug resistance in a tertiary care hospital, and detailed that clinicians are often unable to afford or to understand new technologies, and a lack of bioinformatics infrastructure prevents data understanding and collaboration. Dr George D’Souza (Professor of Pulmonology and Dean, SJMCH, Bangalore), stepped up next, and presented his experience of drug resistance in Tuberculosis patients in Bangalore. He emphasised the high prevalence of drug-resistant strains in seen tuberculosis infections and thus highlighted the pressing need for rapid diagnostics to improve patient care and prescription of appropriate antibiotics.  He was followed by Dr Oliver Koch (Regional Infectious Diseases Unit, NHS Lothian/ University of Edinburgh) who provided insight into the clinical reality of AMR in Scotland, particularly in the context of sepsis. Finally, Dr Dias concluded the session and presented her experience of the diagnostic challenge related to AMR in the laboratory and current research activities related to drug resistance in Bangalore. Dr Dias particularly emphasised the problem of scientists relaying lab results to clinicians, and that this results in a disassociation between technological progression and clinical practice.

Following the presentations and delicious lunch break, the delegates were given a tour of the microbiology labs in St. John’s. This gave the delegates a feel for how culture-based procedures are carried out to aid diagnoses and the other diagnostic technologies present in the hospital. The opportunity for the delegates to hear directly from physicians regarding the unmet need of currently available rapid diagnostics proved invaluable, and inspired the delegates to ensure that their group’s proposal for the AMR DxC Summer School would be easy to use, clinically relevant and affordable.

Day 3 - Thursday, 6 July 2017

Day three of the AMR DxC Summer School saw the delegates and speakers return to C-CAMP. The day began with further discussion of the project ideas within respective groups as well as feedback to the groups from group mentors. By the end of the morning’s session, group project ideas were finalised, ready for presentation preparation. Following this, Dr Bethany Mills presented her research group’s work in the field of optical endomicroscopy for the visualisation of bacteria in humans, and how this may improve the diagnosis and treatment of patients suffering from respiratory tract infections. The second speaker of the day was Dr Anand Anandkumar (Bugworks, C-CAMP, Bangalore), who presented his research within the start-up company, Bugworks, and emphasised the importance of a multidisciplinary approach for the development of creative solutions to combat the AMR crisis. Following Dr Anandkumar, Professor Ramaswamy S (InStem, Bangalore) presented his work in drug discovery within InStem, and detailed InStem’s approach of ‘curiosity thinking’ for the development of innovative projects. Following a short lunch break, Dr Ravi Krishnan (Indian Institute of Technology- Delhi, Bangalore) presented his work on rapid diagnostics for the diagnosis of enteric fever, and emphasised the importance of creative thinking and patience when developing diagnostic technologies. The next presentation of the day was given by Dr Ravi Banda (XCyton Diagnostics, Bangalore). Dr Banda stressed to the delegates that there is currently a disrespect for diagnostics within India, and that the only way to dispel this myth would be the creation of clinically relevant, affordable and accessible rapid diagnostic tools. Considering the presentations given thus far, the delegates returned to group work for the next hour to reflect on lessons learnt throughout the day and how these lessons could be incorporated into the improvement of their proposals.

Following a lab tour of C-CAMP, the delegates began preparations for the eagerly-anticipated event on the Longitude Prize and Discovery Award hosted by Nesta. The event, led by Daniel Berman (Longitude Prize Lead, Nesta, UK), outlined the structure and application procedure of the prestigious Longitude Prize: a £10 million UK-run prize fund for researchers to reward a diagnostic test that helps solve the problem of antibiotic resistance that wouldn’t be solved by the market. Speakers, including Dr Shridhar Narayanan (Foundation for Neglected Disease Research), a Discovery Award Winner in 2016, highlighted the urgent need for rapid diagnostic development in India and worldwide. This event greatly inspired the delegates not only to improve their AMR DxC Summer School project proposals, but to think beyond the week’s events and to aim for future funding (such as applying for the Discovery Award and eventually, the Longitude Prize) to develop potential ideas and technologies into possible realities.

Day 4 - Friday, 7 July 2017

Day four, the final day of the AMR DxC Sumer School, saw the participants presenting their group’s project proposal to a panel of AMR experts: Daniel Berman (Longitude Prize), Dr Balganesh (GangaGen), Dr Anand Anandkumar (Bugworks), Dr Balasubramanian (Bugworks) and Dr Ravi Kumar (Xcyton Diagnostics). After a short session to finalise presentation preparations, each of the five groups made a ten to fifteen-minute presentation followed by a ten-minute question and answer session with the AMR expert panel. Project proposals ranged from the development of new rapid diagnostic tools to the development of programming software to improve clinical diagnoses to prevent the unnecessary administration of antibiotics. The presentations were followed by a lunch break in which the experts congregated to review and score the presentations and decide the winning team(s) of the AMR DxC 2017 Summer School Challenge. The overall quality and innovative character of the presented ideas and proposal was exceptional and the expert panel decided to select two joint winners. The award ceremony followed after individual feedback to the groups by the expert panel and the two joint winners were announced. Both teams were awarded a small cash prize totalling 50,000 INR, presented by Ms. Prachi Sinha on behalf of the prize sponsor Axilor Ventures. Ms Sinha gave thorough feedback from an investor’s perspective and offered to discuss investment opportunities with the winning teams should they take their proposals forward.  Most excitingly, two panel members offered expert advice and mentorship to the winning teams as they progress towards commercial development of their ideas.  The resonating thoughts from the day’s events and the overall AMR DxC Summer School experience were that although there were two winning groups, every participant was a winner, leaving the week with new and extended contacts, inspiration from fellow participants and speakers and new ideas to carry forth into their own research. Again, the AMR DxC concept and training has proven to be successful to seed innovation and all participants are eagerly awaiting the next opportunities arising from taking AMR DxC forward and to the next level.

One thing was sure - see you at AMR DxC 2018 in Bangalore!!