JPIAMR has coordinated 13 transnational joint calls till date supporting 99 projects and 38 networks with over 1300 researchers by investing 125 million Euros within the six priority areas of the shared JPIAMR Strategic Research and Innovation Agenda (SRIA) with a One Health approach.
Explore the JPIAMR project database that presents interactive data on projects and networks supported under the various calls coordinated by the JPIAMR.
Click on the titles below for more information on the research activities and outcomes of the projects and the networks supported under the JPIAMR framework.
Filter among 137 projects
Antimicrobial Stewardship in Hospitals, Resistance Selection and Transfer in a One Health Context (STRESST)
The transfer of antibiotic residues and antibiotic resistant bacteria into the environment and subsequently into animal drinking water may have an effect on the transmission of resistant bacteria and their resistance genes back into the human population. This holistic One Health view of antibiotic resistance is at the heart of our project. We want to […]
Specific Targeting of Antimicrobial Resistant Strains in situ using Targeted-Antibacterial-Plasmids (STARS-TAP)
The global spread of antimicrobial resistance (AMR) among pathogenic bacteria is recognized as one of the biggest concerns in public health and a research priority in microbiology. Drug-resistance increases exponentially for certain bacterial organisms and is becoming the main threat to human health worldwide. As a consequence, national and international authorities have emphasized the need […]
Strengthening implementation of National Action Plans through a One Health AMR full economic costing exercise (SNAP ONE)
Antibiotic resistance costs lives and money. Yet if we don’t have a good grasp of the numbers we will never know where it lies in terms of our other national priorities. In Africa we have especially little evidence on how people, animals, and the environment are affected by it. So those who make decisions do […]
Selecting Efficient Farm-level Antimicrobial Stewardship Interventions from a one health perspective (SEFASI)
Antimicrobial resistance (AMR) links together people, plants, animals and their environments under the One Health umbrella. In this work we will similarly link interventions aimed at AMR by considering their impact not only in terms of impact on hospitals, communities or farmers, but across all of these groups. This is key to informing optimal intervention […]
Phage Therapy to Reduce AMR Enterobacteria Spread from a One Health Perspective (Phage-Stop-AMR)
The spread of multi-drug resistant (MDR) bacteria in food-producing animals including broilers is a global public health concern. Controlling growth of MDR bacteria and limiting the transmission of antimicrobial resistance genes in broilers could be an effective mitigation strategy. To counteract the spread of MDR bacteria among zoonotic pathogens in food-producing animals and reduce the […]
Phage treatment and wetland technology as intervention strategy to prevent dissemination of antibiotic resistance in surface waters (PhageLand)
PhageLand is aimed to develop a novel intervention strategy combining the low-cost and eco-friendly capacity of constructed wetlands with the specificity of bacteriophages (i.e., viruses killing bacteria) to prevent the dissemination of antibiotic resistance from wastewater into surface waters. PhageLand will investigate the prevalence of antibiotic resistant bacterial pathogens (ARB) in low-middle income countries (LMICs) […]
Interventions to decrease CRE colonization and transmission between hospitals, households, communities and domesticated animals (I-CRECT)
In middle-income countries antibiotic resistance is increasing causing suffering and high mortality. In 12 Vietnamese hospitals half of patients were colonised with “superbugs” called carbapenem resistant Enterobacteriaceae, for short CRE , at admission 13% and after 2 weeks in hospital 89%. CRE colonization cause hospital infections and high mortality. As many patients are CRE colonized […]
Use of phage applications to combat MRSA at the sow-piglet interface to reduce exposure of staff and contamination of the environment (PHAGE-EX)
This project addresses the issue of occupational and environmental exposure to livestock-associated MRSA in pig farms. Using bacterial phages, we will try to reduce the transmission of MRSA from sows to their piglets during the nursing phase. Specific phage cocktails will be designed using several phages to control MRSA on the skin of sows and […]
Novel interventions for eliminating one-health mobile antimicrobial resistance genes from human and animal microbiomes (MOB-TARGET)
Many of the most important one-health AMR genes are carried on mobile genetic elements that move between bacterial strains through the process of conjugation. The genetic mobility of these AMR genes allows them to become widely disseminated across species of bacteria, including harmless commensal strains and dangerous pathogen strains, and ecological niches, including humans, farms […]
Microbiota Intervention Strategies Limiting Selection and Transmission of Antibiotic Resistance burden in the One Health domain (MISTAR)
The central aim of MISTAR is to implement and quantify the effect of novel intervention strategies based on the preservation of the “healthy microbiota” to eradicate and control the spread of antimicrobial resistance (AMR). We will do this using a One Health approach that involves hospitalized patients, healthy humans, pets, farm animals and the environment. […]
Targeted removal of ARGs and facultative pathogenic bacteria (FPB) in wastewater from AMR hotspots using modular advanced treatment solutions (HOTMATS)
The objective of the project HOTMATS is to design and demonstrate effective and compact solutions for the source-treatment of wastewater emitted from AMR hotspots. The goal is to stop the spreading of antimicrobial resistant bacteria (ARB), antibiotic resistance genes (ARG), and other health-critical microorganisms from hotspots to the public sewage network, which currently is one […]
Ionophore coccidiostats: risk of CO-selectioN of antImicrobial resistance – Clinical impact and intervention strategies (ICONIC)
Today’s intensive broiler production is highly dependent on in-feed ionophore coccidiostats. Because these ionophores are not used in humans, it is widely assumed that their use in poultry is not a risk for human health. Recent evidence, however, suggests that they may cause co-selection of medically important antimicrobial resistance. This means that the use of […]
FARM interventions to Control Antimicrobial ResistancE (FARM-CARE)
The aim of FARM-CARE is to control development and spread of antibiotic resistance in pig farming through four complementary interventions that reduce antibiotic use in pigs and prevent transfer of resistant bacteria to people. The four interventions include a farm practice that reduces stress and antibiotic use in pigs (intervention A); a strategy based on […]
Interventions to control the dynamics of antimicrobial resistance from chickens through the environment (ENVIRE)
The overall objective of the project ENVIRE is to contribute to the reduction of antimicrobial resistance in broiler chickens and of the spread from chicken farms to the environment, and ultimately to humans. We will carry out intervention studies, either as an experiment or in chicken farms. We will test, which interventions are most effective […]
Designing One Health Governance for Antimicrobial Stewardship Interventions (DESIGN)
AMR is a problem of the global commons, whose resolution depends on coordination of collective global strategy. Addressing the challenges posed by AMR through a One Health approach relies on inter-sectoral policy coordination – across public health, agricultural, and environmental sectors – internationally, making stewardship complex, necessitating new approaches to policy development. Our research seeks […]
COMplex Biofilms and AMR Transmission (COMBAT)
Antimicrobial resistant microorganisms are difficult to treat and lead to increased death and treatment costs. Antibiotic resistance is recognised as a critical threat in both human and animal medicine. Addressing this threat can be challenging when bacteria exist in complicated communities called biofilms. Biofilms form naturally and allow bacteria to survive and persist in diverse […]
Optimising community antibiotic use and environmental infection control with behavioural interventions in rural Burkina Faso and DR Congo (CABU-EICO)
Incorrect use of antibiotics is a major cause of antibiotic resistance. In rural Africa, people often receive antibiotics without prescription from local pharmacy shops, increasing the risk of resistance. Substandard sanitation and hygiene practices result in frequent exchange of bacteria between humans’ guts, and their environment. How important these different sources are for the acquisition […]
Combating Antibiotic Resistance in Philippine Lakes: One Health upstream interventions to reduce the burden (ARPHILAKE)
Antimicrobial resistance (AMR) may lead to more deaths than cancer by 2050. Action is required now to avert this disaster. This study aims to implement key interventions in Greater Manila, The Philippines to reduce AMR. Interventions will focus on hospitals, small farms, and the Laguna Lake, one of the largest freshwater lakes in Asia. Better […]
Impact of reducing colistin use on colistin resistance in humans and poultry in Indonesia (COINCIDE)
Antimicrobials are drugs that help cure people and animals from infections with bacteria. The slogan: ‘the more you use, the faster you lose’ is definitely applicable for antimicrobials. When you use antimicrobials, more bacteria become resistant, meaning that an infection can no longer be treated. This is a worldwide challenge for the treatment of diseases […]
Knowledge transfer strategies, networking and public engagement for a successful mitigation of risks induced by aquatic pollutants (AquaticPollutantsTransNet)
This transfer project is part of the AquaticPollutants projects’ family and accompany its research and innovation projects. It will support the funded projects in scientific communication and in the uptake of research results with the aim to increase their impact.
Marine Plasmids Driving the Spread of Antibiotic Resistances (MAPMAR)
Antibiotic resistance genes (ARGs) are one of the most challenging contaminants of emerging concern (CECs). Instead of being directly produced by human activity, ARGs emerge as consequence of antibiotic use in clinical settings, and residual antibiotic contamination.
Consequences of antimicrobials and antiparasitics administration in fish farming for aquatic ecosystems (CONTACT)
Aquaculture is an important source for food, nutrition, income and livelihoods for millions of people around the globe. Intensive fish farming is often associated with pathogen outbreaks and therefore high amounts of veterinary drugs are used worldwide.
CECs and AMR bacteria pre-concentration by ultra-nano filtration and Abatement by ThermoCatalytic Nano-powders implementing circular economy solution. (NanoTheC-Aba)
This project will deliver an energy efficient new integrated prototype system for water purification, composed of three different components.
Potential of decentralized wastewater treatment for preventing the spread of antibiotic resistance, organic micropollutants, pathogens and viruses (PRESAGE)
New approaches are needed to reduce the emission of contaminants of emerging concern (CECs). Some sources contribute strongly to suchemissions, which has driven the focus of PRESAGE on innovative decentralized wastewater treatment (WWT), based on anaerobic andaerobic compact systems.
Development a smart forewarning system to assess the occurrence, fate and behaviour of contaminants of emerging concern and pathogens, in waters (FOREWARN)
This project will assess the occurrence, fate and behaviour of contaminants of emerging concern (CECs) and pathogens, and develop machine-learning methods to model their transfer and behaviour and build a decision support system (DSS) for predicting risks and propose mitigation strategies.
Sustainable Electrochemical Reduction of contaminants of emerging concern and Pathogens in WWTP effluent for Irrigation of Crops (SERPIC)
This project will develop an integral technology, based on a multi-barrier approach, to treat the effluents of wastewater treatment plants(WWTPs) to maximise the reduction of contaminants of emerging concern (CECs).
Probing Antibiotic Residues and Resistance Transfer in Aquatic Environments (PARRTAE)
The project aims to study bacteria, antibiotic resistance genes (ARGs) and antibiotic residues in groundwater, surface water, wastewater, marine water environments in the North Sea and the Atlantic including ports, and aquaculture facilities.
Presence, behavior and risk assessment of pharmaceuticals in marine ecosystems (PHARMASEA)
PHARMASEA integrates international expertise to answer key research questions on fate and biological effects of active pharmaceutical ingredients (APIs), well recognized contaminants of emerging concern (CECs) for marine ecosystems.
Green Ultrafiltration Water Cleaning Technologies (GreenWaterTech)
Clean water is a key challenge in the 21th century, identified in the UN sustainable development goals. In close collaboration with industry and stakeholders, this project aims at developing new types of sustainable water treatment techniques that is, cheap, easy tomaintain and can be applied in settings/countries where clean water is a challenge.
Surveillance of Emerging Pathogens and Antibiotic Resistances in Aquatic Ecosystems (SARA)
Appropriate methods for wastewater-based epidemiology (WBE) and a better understanding of the fate of pathogenic viruses and antibioticresistant bacteria from the sources to river basins and estuaries are urgently required.
Reduction and assessment of antimicrobial resistance and emerging pollutants in natural-based water treatment systems (REWA)
The main goal of the REWA project is the strategic development and implementation of sustainable and cost-effective technologies for theremoval of contaminants of emerging concern (CECs), metals, pathogens including antimicrobial resistant bacteria and antibiotic resistancegenes (ARGs) from water.
Nanoenabled strategies to reduce the presence of contaminants of emerging concern in aquatic environment (AMROCE)
Contaminant of emerging concern (CECs) such as antibiotics, pathogens and antimicrobial resistant (AMR) bacteria in water bodiesassociated to intensive fish and inland animal farming, represent a great threat to the environment and human health.
Antibacterial biocides in the water cycle – an integrated approach to assess and manage risks for antibiotic resistance development (BIOCIDE)
The overall aim of BIOCIDE is to determine how antibacterial biocides contribute to the development and spread of antibiotic resistant bacteria in different aquatic/marine ecosystems, and to inform and enable measures that ultimately protects human health and safe water resources for both humans and wildlife.
Network T&CM alternatives for antibiotics worldwide: Global Initiative for Traditional Solutions to Antimicrobial Resistance (GIFTS-AMR)
Traditional and Complementary Medicine (T&CM) is often used in both animal and human healthcare and may contribute to reducing inappropriate antibiotic use (e.g. as part of delayed prescription strategies (human healthcare) or as alternative prevention or treatment (e.g. for uncomplicated acute infections in both human and animal healthcare).
Wastewater treatment plants as critical reservoirs for resistance genes (Gene-gas)
Multiresistant bacteria are a severe problem to modern healthcare. The problem is increasing and development of novel technologies to cope with this critical situation is a necessity. Solutions include novel antibiotic drugs as well as reducing the spread of resistance genes in the environment.
Sharing Research on AMR Network (SHARENET)
The threat of AMR is rising in low and middle income countries (LMIC). The French Alliance of Health Sciences Research Institution (AVIESAN) has recently established a small network for AMR research in partnership with LMIC scientists to strengthen local research expertise. The aim is to assist in the collection of relevant evidence to advise stakeholders and policymakers on suitable control strategies for AMR reduction that are tailored to the local situation and founded on local problematics. Countries initially involved are Cambodia, Madagascar, Ivory Coast and France.
Convergence in evaluation frameworks for integrated surveillance of AMR, CoEval-AMR PHASE 2
An integrated approach to surveillance spanning different sectors has been promoted by international organisations for more than a decade and constitutes a central recommendation of the WHO action plan on AMR. The objective of the CoEval-AMR Network is to develop consolidated guidance for evaluation that addresses the specific needs of integrated One Health surveillance systems for AMR and AMU.
Alliance for the Exploration of Pipelines for Inhibitors of Carbapenemases (EPIC Alliance)
EPIC Alliance is composed of 11 members from 7 countries, bringing together experts from the fields of clinical and basic microbiology, infectious diseases, computational biology & chemistry, bioinformatics, biochemistry, translational biology, biophysics, pharmacology, toxicology, veterinary sciences, and epidemiology.
JPIAMR Network for Integrating Microbial Sequencing and Platforms for Antimicrobial Resistance (Seq4AMR)
Main Questions/Approach: How can we best identify and promote collaboration and implementation between AMR NGS stakeholders that link the individual fields of (new) NGS technologies, algorithms, quality standards, teaching/training and sequence databanks?
The JPIAMR Primary Care Antibiotic Audit and Feedback Network (PAAN): An international collaboration on best practices for the delivery of antibiotic prescribing feedback to community clinicians using behavioural science
Antibiotic overuse is contributing to rising rates of antimicrobial resistance. Audit and feedback (A&F) can be an effective tool to modify prescribing behaviour. Jurisdictions are, or will be, implementing community antibiotic A&F, as part of broader antimicrobial stewardship programs, which will benefit from tools and resources to optimize their effectiveness.
Establishing a Monitoring Baseline for Antibiotic Resistance in Key environments (EMBARK)
There is a growing recognition that interventions within the healthcare sector are not enough to curb antibiotic resistance development. Instead, a one-health perspective incorporating animal husbandry and external environments is needed. This calls for monitoring antibiotic resistance outside of the healthcare setting.
Yeast-based biosensors for the specific and accessible detection of pathogens and antimicrobial resistance (AntiRYB)
Early and specific detection of microbial infections is crucial for the containment of diseases and for reducing the dependence on the use of antibiotics. There is however a lack of reliable, cheap and easy to use detection methods for day-to-day monitoring of infection and antimicrobial resistances in samples from patients, animals and the environment. This deficinecy is critical for the abuse of antibiotics and the diffusion of antimicrobial resistance.
Concomitant IDentification and Antibiotic REsistance profile of bacteria in one hour with an adaptive targeted single Mass Spectrometry analysis (IDAREMS)
Blood stream infection (BSI) is annually responsible of hundred thousand estimated deaths worlwide. The time frame for identification and antimicrobial susceptibility testing of the causative agent(s) of BSI directly impact the delay in the administration of appropriate antimicrobial therapy and, consequently, the clinical outcome of patients.
IDx: An exploration of regulatory, corporate, relational, and technical barriers to uptake of diagnostics in the fight against AMR (IDx)
Greater availability of fast and accurate diagnostics for infections would greatly reduce the over-prescription of antibiotics and slow the growth of antibiotic resistance which limits treatment options. It would also help prescribe the right drug at the right time, thus reducing suffering and increasing survival.
Prevention of antibiotic resistance by TARGEted Treatment of pneumonia in children (TARGET)
Lower respiratory tract infections (LRTI), such as pneumonia, are a leading cause of death especially in children below the age of 5 years. Low and middle-income countries (LMIC) suffer the highest burden of childhood pneumonia.
Modelling Approaches to Guide Intelligent surveillance for the sustainable Introduction of novel ANtibiotics (MAGIcIAN)
Antimicrobial resistance (AMR) is increasing worldwide, and surveillance activities play a key role in informing policies to contain AMR. Moreover, resistance to new antibiotics is emerging ever quicker after their introduction onto the market, rapidly reducing the effectiveness of even last-resort antibiotics.
A Smart Surveillance Strategy for Carbapenem-resistant Pseudomonas aeruginosa (SAMPAN)
Pseudomonas aeruginosa causes severe infections in hospitalized patients. The worldwide emergence of carbapenem-resistant P. aeruginosa (CR-PA) makes infections by these pathogens almost untreatable. The World Health Organization now ranks CR-PA highest in the list of ‘urgent threats’.
One Health AMR Surveillance through Innovative Sampling (OASIS)
OASIS aims to develop an antimicrobial resistance (AMR) surveillance strategy in a One Health context, and applicable in high-, middle-, and low-income countries. The proposed strategy challenges the strong reliance on laboratory-based AMR surveillance for meeting objectives of the Global Action Plan on AMR.
A K-mer Based Approach for Institutional AMR Surveillance, Transmission Monitoring, and Rapid Diagnostics (K-STaR)
Antibiotic resistant organisms (AROs) have become increasingly difficult to treat, with rising morbidity and mortality worldwide. Healthcare institutions are often the epicenter for outbreaks of these antibiotic resistant organisms, and are also windows into their circulation within the broader community.
Improving the TRIcycle protocol: upscaling to national Monitoring, detection of CPE and WGS pipelines for One Health Surveillance (TRIuMPH)
Since 2015, under the auspices of WHO, a basic protocol for One Health Surveillance of AMR has been established. This “Tricycle” protocol integrates human, animal and environmental surveillance and focuses on a single indicator for AMR: ESBL-producing E. coli. To our knowledge, this is the first One Health AMR surveillance protocol that has consistently been piloted across six different countries across the world.
Management of animal diseases and antimicrobial use by information and communication technology to control AMR in East Africa (MAD-tech-AMR)
In low-income countries (LICs), patterns of livestock diseases and antimicrobial use (AMU) are largely unknown, and there are few high-quality laboratory facilities. Robust and actor-centred surveillance systems are needed and surveillance of the dynamics leading to antimicrobial resistance (AMR) should precede more advanced systems.
Fighting antibiotic-resistant superbugs with anti-persister compounds targeting the stringent response (Anti-Persistence)
Pathogenic antibiotic-resistant “superbugs” are increasing at an alarming pace. Persistence to antibiotics favours the emergence of resistance as mutations increasing antibiotic tolerance favour selection of resistance mutations.
Design, synthesis and lead generation of novel siderophore conjugates for the detection and treatment of infections by Gram-negative pathogens (SCAN)
There is a strong need for novel, innovative therapeutic solutions for infections caused by Gramnegative pathogens. In addition, there is a lack of tools to diagnose bacterial infections at deep body sites, e.g. on implant surfaces.
Restoring E. coli Sensitivity for Antibiotics by blocking TolC-Mediated Efflux (RESET-ME)
Overexpression of efflux pumps is a major factor for drug resistance in Gram-negative bacteria. In E. coli, the AcrAB-TolC efflux pump complex transports antibiotics from the periplasm or cytoplasm into the external medium. As TolC deletion has been shown to result in increased susceptibilities of E. coli to several antibiotics, it may represent an attractive drug target.
Development of novel Mycobacterial Tolerance Inhibitors (MTIs) against MDR/XDR tuberculosis (MTI4MDR-TB)
In 2017, WHO published the Global Priority Pathogen lists with the aim to promote research and development of new treatments that are effective against microbes resistant to multiple antibiotics. Among them, multi- and extensively drug resistant Mycobacterium tuberculosis caused 48% of new tuberculosis (TB) cases in some countries in 2016.
Flavodoxin inhibitors to kill resistant bacteria (FLAV4AMR)
This transnational collaboration gathers the expertise and resources required to address lead improvement to the point of producing novel antibiotics ready for clinical trials, and to clarify the overall importance of flavodoxin as a novel drug target.
Fighting antimicrobial resistant infections by high-throughput discovery of biofilm-disrupting agents and mechanisms (DISRUPT)
Many bacterial infections are associated with biofilms. Biofilm-related infections, particularly those caused by drug resistant bacteria, are difficult to handle with current antibiotic strategies. These includes wound-infections (e.g. caused by Pseudomonas aeruginosa or Staphylococcus aureus), urinary tract infections (e.g. Escherichia coli), chronic airway infections (e.g. P. aeruginosa) and preinfection colonisation by Streptococcus pneumoniae.
Advancing CRISPR antimicrobials to combat the bacterial pathogen Klebsiella pneumoniae (CRISPRattacK)
The increasing incidence of multidrug-resistant bacterial infections and the trickling pipeline of novel antibiotic classes demand a new generation of antimicrobials. One promising avenue has been the development of antimicrobials based on CRISPR-Cas immune systems.
Anti-biofilm therapies using local application of bacteriophages (ANTIBIO-LAB)
The use of medical devices has had an enormously positive impact on patient care. However, approximately 5% of patients across all medical specialities can develop an infection associated with the device, which can have disastrous consequences.
All recent reports establishing a roadmap to tackle the global, worldwide antimicrobial resistance (AMR) problem highlight the need to enlarge the current armamentarium beyond the sole “full antibiotic” model. Many efforts are being devoted to fulfil these needs both by academia and industry, as exemplified by the BEAM Alliance member portfolio (https://beam-alliance.eu/ba_pipeline). These new options include improved time-to-cure, anti-virulence, involvement of immune system, impact on flora, infection prevention, etc. both for animal and human medicine.
There is an urgent need for discovery and development of new drugs to combat multi-resistant organisms. The search for new drugs is cumbersome, particularly because the current business model for antibiotics in the pharmaceutical industry has been stalled because of the poor return on investment.
Network of European and African Researchers on Antimicrobial Resistance (NEAR-AMR)
The Network of European and African Researchers on Antimicrobial Resistance (NEAR-AMR) represents a group of experts from leading institutions throughout Europe and Africa, within multiple disciplines (clinical, pharmacy, veterinary, environmental microbiology, epidemiology, molecular biology and evolution) encompassing a One Health approach to AMR.
inCreasing cOmmunicatioN, awareNEss and data sharing in a global approaCh against resisTance (CONNECT)
The CONNECT network is based on the need for defining and implementing an integrated research strategy to facilitate the necessary studies and investigations for an innovative response to AMR. The CONNECT network output will contribute to the development of the JPIAMR-VRI by aligning stakeholders to share values on AMR with a One Health approach.
Intensive Care Airway and Lung Microbiome Network ICALM Network (ICALM)
Hospital acquired pneumonia (HAP) is the most frequent infection acquired in the Intensive Care Unit (ICU). ICU-related respiratory infections arise as a consequence of the processes of ICU care. Mechanical ventilation (MV) is potentially lifesaving, but also carries microorganisms into the lower airways, changing the native flora, and increasing the risk of Ventilator-Associated Tracheobronchitis (VAT) and Ventilator-Associated Pneumonia (VAP).
Wildlife, Agricultural soils, Water environments and antimicrobial resistance – what is known, needed and feasible for global Environmental Surveillance (WAWES)
The World Health Organisation (WHO), Food and Agriculture Organisation (FAO), and World organisation for Animal health (OIE), agree that surveillance of antibiotic/antimicrobial resistant bacteria (AMR) should be performed using a One Health multi-sectoral approach. Despite this, there is an overall lack of surveillance focusing on the environment and wildlife. Furthermore, there is unquestionably a lack of standardisation and synergy between projects and research efforts focusing on AMR in the environment and wildlife.
AMR Dx Global
AMR Dx Global is a transnational, multi-sectorial, multi-stakeholder and interdisciplinary network focussed on rapid diagnostics training and capacity building to tackle the global threat of antimicrobial resistance with a One Health approach. The network is coordinated by the University of Edinburg and brings together partners from 18 countries including international organisations like WHO, FIND, AMREF and ICAN.
Towards Developing an International Environmental AMR Surveillance Strategy
There is an urgent and increasing need to fully understand the development and transmission of AMR both into and within the wider environment. However, at present, research into environmental aspects of AMR has been largely confined to individual institutions or academic laboratories.
Convergence in evaluation frameworks for integrated surveillance of AMR (CoEval-AMR)
An integrated approach to surveillance spanning different sectors has been promoted by international organisations for more than a decade and constitutes a central recommendation of the WHO action plan on AMR. The objective of the network is to develop guidance for a harmonised evaluation framework that will address the specific needs of integrated surveillance systems for AMR.
Providing a Roadmap for Automated Infection Surveillance in Europe (PRAISE)
Surveillance of healthcare-associated infections (HAI), including surgical site infections (SSI) and central line associated bloodstream infections (CLABSI), is a key component of national surveillance programs. Identifying infections – as opposed to colonisation – allows for the quantification of the burden of infections by antimicrobial-resistant (AMR) pathogens and evaluation of the effectiveness of interventions.
National health care infrastructures, health care utilization and patient movements between hospitals: Networks working to improve surveillance (NeWIS)
There is a worldwide concern about the emergence, and widespread dissemination, of AMR “high risk” clones that carry the genomic determinants for enhanced virulence and resistance.
KlebNet: a One Health network bridging science and surveillance on antimicrobial resistant Klebsiella (KlebNet)
Klebsiella, particularly Klebsiella pneumoniae (hereafter, collectively called Kp) is an opportunistic pathogen of humans and animals that now tops the ‘urgent threat’ lists of CDC, ECDC and WHO due to high rates of multidrug resistance.
Surveillance Of mobiLome meDiated aNtibiotic rEsiStance Spread (SOLIDNESS)
Mobile genetic elements (MGEs) are DNA molecules that often carry important genes for the fitness of microorganisms, such as resistance and virulence genes, which may confer an adaptive advantage to recipient bacteria. Hence, they play a pivotal role in horizontal gene transfer.
Bridging the gap between humAn and animal suRveillance data, antibiotic poliCy, and stewardsHip (ARCH)
Surveillance is essential to all aspects of the clinical management of antimicrobial resistance. It provides necessary information to develop empiric therapy guidelines, antibiotic formularies, and stewardship programmes. However, the value of surveillance as a critical component of antimicrobial stewardship is not fully established and the majority of the guidance documents focuses either on laboratory surveillance or antibiotic guidelines.
Network for Enhancing Tricycle ESBL Surveillance Efficiency (NETESE)
The extended-spectrum beta-lactamase (ESBL)-Escherichia coli Tricycle surveillance program has been developed by WHO to obtain a global picture of antimicrobial resistance (AMR) in humans, animals and the environment in all countries, especially in those with limited surveillance capacities.
An Online Platform for Expanding Antibiotic Stewardship (OPEN Stewardship)
Antibiotic resistance is a mounting public health threat calling for action on global, national and local levels. Antibiotic use has been a major driver of increasing rates of antibiotic resistance. This has given rise to the practice of antibiotic stewardship, which seeks to reduce unnecessary antibiotic use across different care settings.
Impact of Prescription Quality, Infection Control and Antimicrobial Stewardship on Gut Microbiota Domination by Healthcare-Associated Pathogens (PILGRIM)
Vancomycin-resistant enterococci (VRE), extended-spectrum beta-lactamase producing Enterobacteriaceae (EPE), and Clostridium difficile have become an immediate threat to hospitalized patients worldwide. Although surveillance and control programmes are in place in many countries to mitigate transmission of these drug-resistant organisms in the healthcare setting, the impact of the VRE/EPE/C. difficile epidemic on individual patients entering the healthcare system is poorly understood.
Piloting on-site interventions for reducing antimicrobial use in livestock farming emerging economies (REDUCE AMU)
Increasing intensification and expansion of the livestock sector in emerging economies is a large user of antimicrobials, driving the global emergence of antimicrobial resistant bacteria in livestock, humans and the environment.
Improving rational prescribing for UTI in frail elderly (ImpresU)
Frail elderly, particularly those receiving home care or living in a care home, constitute a vulnerable and under researched population. They are frequently diagnosed with urinary tract infection (UTI) and almost 60% of the antibiotics (AB) used in this population are for UTI. However, a substantial part of these prescriptions might not be necessary, because presenting signs and symptoms (S&S) are erroneously ascribed to a UTI.
Antimicrobial Resistance Manure Intervention Strategies (ARMIS)
Manure is one of the major sources of antimicrobial resistance (AMR) in the environment, since livestock animals consume the majority of antibiotics produced globally. Antibiotics together with antibiotic resistant bacteria are excreted to the environment via manure, and may significantly contribute to the transmission of and exposure to AMR in food, water, and air as exemplified for methicillin-resistant Staphylococcus aureus (MRSA).
A digital antimicrobial stewardship smartphone application to combat AMR: the AB-assistant (AB-assistant)
Antimicrobials are an indispensable part of modern medicine. However, optimal prescription of these agents is becoming increasingly challenging because of the growing complexity of guidelines, and constantly changing epidemiology. Moreover, due to local variations in the prevalence of certain pathogens and antimicrobial resistance, antimicrobial choices need to be tailored to local epidemiology.
Comparative assessment of social-ecological resilience and transformability to limit AMR in one health systems (AMResilience)
Resilience captures the ability of systems to respond to surprise while maintaining vital functions and is an important attribute for health systems in the context of rising global risks such as emerging infectious diseases and growing antimicrobial resistance (AMR).
Intervention of antimicrobial resistance transfer into the food chain (INART)
Soil and water have been identified as reservoirs of antimicrobial resistance (AMR) and the food chain as the most likely mode of AMR transfer into human and animal pathogens. Manure is reused as soil fertiliser in which food plants grow and is a source of AMR.
Aligning industry incentives with AMR control goals: Exploring the feasibility of an antibiotic susceptibility bonus for drugs to treat Gram-negative infection (ASB)
High prices create incentives for industry to develop new antibiotics, but also incentivize firms to promote their products to maximize sales volume. Similarly, the Market Entry Rewards proposed by the O’Neill Commission and others will, if introduced, help to get new drugs to market but do not directly address the problem of antibiotic overuse leading to emergence and spread of antimicrobial resistance (AMR) (O’Neill 2016).
Preventing transmission of MRSA from livestock to humans through competitive exclusion (ExcludeMRSA)
Pig farms act as reservoir of Livestock-Associated Methicillin-resistant Staphylococcus aureus (LA-MRSA). Through occupational exposure to farm dust and contact with pigs, farm workers are at risk for acquiring LA-MRSA.
Understanding and modelling reservoirs, vehicles and transmission of ESBL-producing Enterobacteriaceae in the community and long term care facilities (MODERN)
The continuing spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBLPE) is among the most important problems in antimicrobial resistance. It is also a good model to investigate the epidemiological complexity of resistance in Enterobacteriaceae.
Antibiotic Resistance in Wastewater: Transmission Risks for Employees and Residents around Waste Water Treatment Plants (AWARE-WWTP)
The rise of antibiotic resistant infections is an imminent global public health threat, and mitigation measures are required to minimize the risks of transmission and human exposure.
Selection and Transmission of Antimicrobial Resistance in Complex Systems (STARCS)
Selection and transmission are key determinants for the dissemination of antimicrobial resistance (AMR) across the planet. These determinants of AMR are frequently studied in laboratory settings while in reality they occur in complex systems, e.g. in microbial communities that colonize human and animal guts or in environmental ecosystems.
The rates and routes of transmission of multidrug resistant Klebsiella clones and genes into the clinic from environmental sources (SpARK)
Klebsiella pneumoniae (Kp) is a leading cause of multidrug resistant hospital-acquired infections globally, and is responsible for an increasing public health burden in the community.
Genomic approach to transmission and compartmentalization of extended-spectrum cephalosporin resistance in Enterobacteriaceae from animals and humans (TransComp-ESC-R)
Resistance to extended-spectrum cephalosporins (ESC) in Enterobacteriaceae is a major challenge for public health worldwide. Its international presence in almost every ecological niche and biological compartment with still ongoing dynamic expansion makes it an ideal target to study the spread of AMR.
Escherichia coli ST131: a model for high-risk transmission dynamics of antimicrobial resistance (ST131TS)
This project will connect a large number of transnational academic resources to investigate the transmission success of Escherichia coli ST131 clone. E. coli is the most common cause of urinary tract and bloodstream infections worldwide. A recent WHO report states that resistance to one of the most widely used antibiotics (fluoroquinolones [FQs]) is very widespread.
Predicting the Persistence of Resistance Across Environments (PREPARE)
Antimicrobial resistance poses a serious challenge to health care worldwide. Attempts to control resistance by stopping antimicrobial use have met with mixed success. Failures of a critical assumption underlying such strategies – that resistant strains suffer a disadvantage in the absence of drug (the “cost of resistance”) – may be responsible for difficulties in controlling resistance by cessation of drug use.
Predicting cell-cell horizontal transmission of antibiotics resistance from genome and phenome (TransPred)
We propose to disclose candidate drug targets controlling the horizontal cell-cell transmission of antimicrobial resistance (AMR) and to predict AMR and its transmission dynamics from bacterial genome composition.
Effectiveness of infection control strategies against intra- and inter-hospital transmission of MultidruG-resistant Enterobacteriaceae – insights from a multi-level mathematical NeTwork model (EMerGE-NeT)
Multidrug-resistant Enterobacteriaceae (MDR-E) have become a major public health threat in many European countries. While traditional infection control strategies primarily target the containment of intra-hospital transmission, there is growing evidence highlighting the importance of inter-hospital patient traffic for the spread of MDR-E within healthcare systems.
Combating MRSA; increasing our understanding of transmission success will lead to better control of MRSA (MACOTRA)
The primary aims of the MACOTRA project are three-fold 1.To develop and provide a framework for evaluating differences in transmission of MRSA. 2. To unravel the different contributions to MRSA clonal success on a genetic and population level. 3. To develop a mathematical model which predicts and unravels the rise and shine of clones.
The impact of Host restriction of Escherichia coli on Transmission dynamics and spread of antimicrobial Resistance (HECTOR)
The prevalence of antimicrobial resistance (AMR) is increasing rapidly worldwide, including in bacteria colonizing healthy human and animal populations. The recent reports of plasmid mediated colistin resistance, potentially associated with colistin usage in agriculture, further raise fears of infections that have become untreatable due to AMR.
Prevention and Restriction of Antimicrobial Resistance in Pneumococci by Multi-Level Modelling (Restrict-Pneumo-AMR)
Streptococcus pneumoniae is a major health threat in industrialized and developing countries. The pathogen affects both young and old people, immune-competent as well as immunocompromised individuals. By genetic recombination within diverse populations, individual strains are not only able to evade vaccination but also able to acquire antimicrobial resistance (AMR), which can then be transmitted onwards.
Mechanisms for acquisition and transmission of successful antibiotic resistant pneumococcal clones pre- and postvaccination (PNEUMOSPREAD)
AMR in Streptococcus pneumoniae is spread globally by a limited number of clones. PCV vaccination has decreased AMR among vaccine-type strains. AMR now emerges by expansion of non-PCV types.
Using collateral sensitivity to reverse the selection and transmission of antibiotic resistance (COLLATERALDAMAGE)
Urgent action is required to stem the “apocalyptic” spread of antimicrobial resistance (AMR). However, because the pace of novel drug development lags behind the evolution of novel AMR determinants, new strategies of containment are required.
Inhibition of antimicrobial drug resistance: Exploiting an old drug as a basis for inhibitory discovery (EXPLOIT)
Antimicrobial resistance (AMR) is a serious emerging threat for patients and the healthcare systems. It has been anticipated by the Institute and Faculty of Actuaries in Britain that AMR has the potential to reduce Gross Domestic Product (GDP) by 3.5% globally and to kill an additional 10 million people by 2050, and as such the topic is of high importance to the public.
Network on quantification of veterinary Antimicrobial consumption at herd level and Analysis, CommunicaTion and benchmarking to improve responsible use (AACTING)
This network aims at developping guidelines and describing best practices for data collection systems of antimicrobials usage (AMU) in food-producing animals at farm level, applicable for herd level antibiotic stewardship, including benchmarking and result-communication to stakeholders and risk managers.
Bridging the gap between exposure to AMR in the environment and impact to human health
Exposure to antibiotic resistant bacteria in the environment (water, soil, air) will impact human health involving complex interactions between bacteria and humans. Our network of experts, and advisors, will explore and summarize available tools and study protocols to systematically quantify environmental exposures to antibiotic resistant bacteria.
The growing risk of multi-drug resistant bacteria is a global public health crisis recognized by many governments; therefore, to combat the spread of resistant-bacteria and superbugs, new antibiotics, or alternative therapies must be developed. However, the financial attraction for R&D investment from large pharmaceutical companies is lacking, therefore, innovation in this therapeutic area is predominantly steered by small and medium pharma companies.
The Antimicrobial Resistance in Intensive Care (AMRIC) Network: A global surveillance network to monitor the role of the ICU environment in the emergence of AMR; Phase 1 (AMRIC)
The intensive care unit (ICU) treats the most seriously ill patients in the contemporary health care system. Because of pre-existing illnesses and a high prevalence of infection – both as an admitting diagnosis and as a complication of ICU care – up to 75% of ICU patients are exposed to antibiotics during their ICU stay, and colonization or infection with resistant organisms is common.
Appropriate use of antibiotics: the role of CAM treatment strategies
Worldwide strategies to control antibiotic resistance and its consequences (mortality, costs) are being developed, but are currently insufficiently, as for example demonstrated in the unchanged European consumption rates of antibiotics during the last years (RAND, 2016).
Consensus group on the design, analysis and reporting of antibiotic stewardship trials
Overuse of antibiotic is a major contributor to increasing resistance to antibiotics. One of the tools to reduce the inappropriate use of antibiotics is by antibiotic stewardship. Antibiotic stewardship interventions prevent antibiotic misuse by influencing the prescription behaviour of doctors.
Flies (Diptera: Muscidae) and the spread of antimicrobial resistant bacteria
It is now common knowledge that antimicrobial resistant bacteria can be transmitted via direct contact in health care facilities and the community setting. However, recent studies highlight the importance of alternative transmission routes, such as zoonotic spread or potential dissemination through environmental sources (water, food items). In this context, vector-borne transmission of antimicrobial resistance has rarely been investigated.
Histidine Kinase Inhibitors as Novel Anti-infectives
The growing problem of antibiotic resistance and the lack of newly discovered antibiotics poses a major threat to human and animal health. We have previously identified a panel of inhibitors targeting bacterial histidine kinases in bacteria that block expression of activities required to cause disease and cope with environmental stresses.
Behavioural approaches to optimise antibiotic stewardship in hospitals
Antibiotic stewardship is seen as a key strategy to prevent antibiotic resistance and reduce healthcare associated infections. Our group has recently completed the most comprehensive systematic review to date of 221 intervention studies to improve hospital antibiotic prescribing.
Novel drugs and drug combination against bacterial growth, survival and persistance; form high-throughput screening to mechanism of action (Combinatorials)
Control of bacterial infections is threatened by the rapid emergence of drug resistance, drug tolerance that mitigates antimicrobial efficacy, and the lack of new antibiotics in recent years. Combination treatments and/or re-purposing of known drugs can provide a cost- and time-efficient solution.
Developing combinations of CO-ACTIVE antimicrobials and non-antimicrobials (CO-ACTION )
The CO-ACTION project aims to develop and provide a framework for evaluating and validating the effectiveness of antibiotic- and non-antibiotic combinations (COMs) in the preclinical setting based on pharmacokinetic/pharmacodynamic (PK/PD) principles, with a specific emphasis on Neglected and Disused AntiBiotics (ND-AB) as well as COMs with non-antibiotics (NA) both for human and veterinary medicine.
Repurposing disused antibiotics with immune modulators as antimicrobial strategy for respiratory tract infections (ABIMMUNE)
Bacterial respiratory infections represent a real threat to public health worldwide, especially in hospital-acquired situations where patients frequently present several co-morbidity factors. Although antibiotics are recognized as the most effective therapy, treatments are often associated with failure due to bacteria that are resistant to multiple firstline antibiotics, and patients who are immune compromised.
Sensiting Pseudomonas aeruginosa biofilms to antibiotic and reducing virulencce through novel target inhibition (SENBIOTAR)
The traditional approach to combating bacterial infections has been based on the use of antibiotics which kill bacteria or inhibit their growth. There has also been a strong emphasis on the identification of essential gene targets for drug intervention. A major problem with therapeutic approaches targeting viability is that they induce strong selective pressures resulting in the rapid emergence of antimicrobial resistance. An alternate approach is to inhibit virulence rather than bacterial viability and this will be explored in the SENBIOTAR project.
Investigating the mechanism of eradication of MDR bacteria by inorganic, organic, and protein-based nanoparticles (NPERDMDR)
The increase in nosocomial infections is adding a substantial burden to the medical system as they result in extended periods of hospitalization. This increase is strongly associated with the emergence of antimicrobial-resistant bacterial strains over the last two decades.The widespread use of antibiotics has resulted in the evolution and spread of these resistant genetic determinants: multidrug resistant (MDR) and extremely drug resistant (XDR) bacteria. There is an urgent need to develop novel antimicrobial agents to be able to kill antibiotic-resistant bacteria.
New intervention strategy for tuberculosis: blocking multiple essential targets (noTBsec)
Mycobacterium tuberculosis is the causative agent of tuberculosis (TB), a disease responsible for almost 1.3 million deaths per year. In recent years, different classes of drug resistant M. tuberculosis strains have emerged, making the discovery of novel anti-TB drugs a major global priority. This awareness has resulted in several new initiatives to find new (classes of) antimicrobial compounds. One of these initiatives is NM4TB, a consortium containing two noTBsec members, which discovered the benzothiazinones as promising new antimycobacterial compounds. A major disadvantage of most existing and new TB compounds is that they target a single molecule, which significantly increases the chance that resistant strains will emerge.
Repotentiating Beta Lactam antibiotics (REBEL)
The most common form of resistance to ß-lactam antibiotics is the expression of ß-lactamase enzymes. These bacterial enzymes are capable of inactivating ß-lactam drugs by hydrolyzing their ßlactam ring, rendering them ineffective. Co-administration of a ß-lactam antibiotic with a ßlactamase inhibitor is a recognized strategy to circumvent this type of bacterial resistance, yet the number of compounds that have actually made it to clinical application so far is extremely limited.
Structure-guided design of pan inhibitors of metallo-p-lactamases (DesInMBL)
The fight against infectious diseases is one of the greatest public health challenges, especially with the emergence of pan-drug resistant carbapenemase-producing Gram-negative bacteria. In particular, the pandemic NDM-1 and other plasmid-borne metallo-ß-lactamases (MBLs) disseminating worldwide in Gram-negative organisms threaten to take medicine back to the pre-antibiotic era as the treatment options remaining for infections caused by these “superbugs” are very limited.
Non-conventional approaches for peptidoglycan cross-linking inhibition (NAPCLI)
Peptidoglycan (PG) is an attractive and validated target for antibacterial drug development for two main reasons. First, it is an essential and unique bacterial cell wall polymer with no counterpart in human cells, minimizing the risk of drug toxicity. Second, the essential PG synthases are exposed at the outer surface of the cytoplasmic membrane, making them highly accessible for antibiotic inhibition.
Capturing the natural antibiotic’ome: Developing Nature’s EVOIved AntiBIOTIC Collective (EVOBIOTIC)
Naturally evolved antibiotics are our primary mode of treating drug-resistant pathogens. Although individual antibiotics do succumb to resistance via pressures they place on organisms, the producers of these agents innovate through modular antibiotic drug (bio)synthesis programs to naturally thwart drug resistance mechanisms.