On 20-21 January 2016, the Joint Programming Initiative on Antimicrobial Resistance (JPIAMR), the US National Institute of Health (NIH) and the US National Institute of Allergy and Infectious Diseases (NIAID), organised a meeting which brought together scientists in the field of antibacterial resistance. The aim was to increase the trans-Atlantic dialogue and encourage scientific collaboration to enhance research addressing antibacterial resistance.
With antibacterial resistance accelerating at an alarming pace, leading to a global increase in morbidity and mortality due to resistant bacterial infections, it was crucial to take the first step towards greater collaboration globally. The talks and discussions during the two days covered cutting-edge approaches to address antibacterial resistance.
“Our goal is not to fight antibiotic resistance but morbidity and mortality of bacterial infectious disease. And to do so, you need an entire tool kit. We need to control infections, not resistance,” said Fernando Baquero, Ramón y Cajal University Hospital, Spain.
Much discussion around continuous treatment of infectious diseases, when our current antibiotics fail, have centred around the development of new antibiotics. “We cannot get out of this problem by only developing new antibiotics. The selective pressure will always find ways of becoming resistant. How do we mitigate this relationship?” asked Henry F. Chambers, University of California. He went on to say that we must meet the challenge of resistance with improved diagnostics, stewardship which is data driven, evidence-based and mandatory, smarter strategies and trial design and finally “some new AB wouldn’t hurt either.” “When new drugs emerge we need a plan to reduce the emergence of resistance,” added George Drusano, University of Florida.
The use of antibiotics is one of the risk factors in the emergence of resistance. But it’s important to be aware that emergence and spread of resistance is different. Emergence comes from usage of antibiotics. For example frequently prescribing a certain type of antibiotic against a certain type of infection will select for resistance. The spread of resistance is different. Resistance can spread from the hospital to the community and then into the environment as well as from animals into the enviroment. That’s the cycle of spread.
We have been using antibiotics for a long time and it has been used as cheap infrastructure. It’s cheaper to prescribe antibiotics than a vaccine. And it’s cheaper to dose our agricultural animals with antibiotics than for example to provide better housing allowing more space which would also keep them healthier without antibiotics.
But how do we turn the tide? What are the alternatives? Researchers are working on alternative therapies such as Ecobiotic drugs. This is a new technology for the treatment of disease where the microbiome (the natural bacteria in our bodies) is being replenished to better withstand invading bacteria.
“We have to invest more money into research to better understand the problem of resistance from all angles. This is what the Joint Programming Initiative on Antimicrobial Resistance (JPIAMR) is doing. We have recently opened a call for proposals in the field of transmission dynamics as we are dedicated to the one health approach,” said Laura Marin, coordinator of the initiative.