New science minister announces 'war cabinet' to tackle antimicrobial resistance on all fronts

Thursday 17 Jul 2014 @ 15:05
Economic and Social Research Council

The Medical Research Council (MRC) is to lead a cross-council initiative backed by eight government bodies and the Wellcome Trust to tackle antimicrobial resistance (AMR) on all fronts.

For the first time all seven research councils will collaborate on the ever-growing problem of antimicrobial resistance. The cross-council AMR initiative will coordinate the work of medical researchers, biologists, engineers, vets, economists, social scientists, mathematicians and even designers, in a multi-pronged approach to address all aspects of the multifaceted problem.

The MRC, which will lead the initiative, has calculated that in the UK alone £275 million has been spent on researching the problem since 2007. Yet, to date, no effective solutions have been found and it has been estimated that current antibiotics will be all but useless within the next two decades. The Science and Technology Committee report on antimicrobials, published last week, stated that collaboration between different areas of research is paramount in tackling AMR.

The problem of AMR extends beyond human health. Animals, particularly livestock, are increasingly being infected with antibiotic-resistant bacteria. Such bacteria are found in varied environments – from fields and rivers to hospitals or the kitchen sink but little is known about how human and animal AMR are related. The initiative will work to identify common characteristics of AMR in both humans and in farm and wild animals in order to find new drugs in a pipeline that has all but dried up.

At the same time, scientists will be investigating how to track the extent of AMR in different environments (the sea, rivers, air, soil and in organisms, as well as in food, homes and hospitals.) Researchers funded by the Natural Environment Research Council have revealed the first finding of an imipenam-resistant E. coli in a UK river, a broad spectrum antibiotic that's often used when other antibiotics don’t work. (See below case studies from the seven research councils illustrating the type of work they are doing in this area.)

In his first announcement in the new role, Science Minister Greg Clark said:

"This unique collaboration involving all seven research councils will help to drive forward important advances in the fight against antimicrobial resistance. The united strategy announced today will provide a more coordinated approach to research gathering by bringing together leading cross-industry experts against what is one of today's greatest scientific problems."

Professor Sir John Savill, Chief Executive of the MRC, which will head the collaboration, said: "Researchers have been waging a war on AMR for decades but up until now we've had no war cabinet to coordinate research on all fronts. This is about tackling the problem at every level and in every environment – from labs to livestock, from finding new diagnostic tools to educating professionals and the public. One hundred years ago 25 per cent of all deaths were due to bacterial infection. We cannot return to those days."

The MRC held workshops in 2013 to identify key research priorities. These have been grouped into four separate themes (see below) and two calls for research proposals are now open – the deadline is 2 September 2014.

AMR case studies from all seven research councils

Arts and Humanities Research Council (AHRC): Visualising invisible hospital microbes
Hospital-acquired microbes that are resistant to antibiotics are a huge public health problem. Visualising the Invisible, a project funded by the AHRC and the Scottish Funding Council, is helping healthcare staff prevent and control healthcare-associated infections by helping them visualise the invisible but very real threats that microbes present. The project has examined how staff think about infection in healthcare settings, how they envisage microbes, and where they perceive risky areas to be. This has then fed into creative ways to help inform and educate people who work in healthcare about antibiotic resistance, such as digital visualisations of risky areas.
Biotechnology and Biological Sciences Research Council (BBSRC): Testing AMR selection in the environment
With funding from BBSRC and AstraZeneca, Dr William Gaze is investigating whether the low levels of antibiotics in the environment, from both humans and animals, could be contributing to AMR. Recent research showed that just 100 micrograms per litre of antibiotic was enough to favour growth of resistant bacteria ― the same concentration found in surface waters. Dr Gaze’s research aims to determine the minimum amount of antibiotic required to promote resistance and to develop new tests so that impacts of environmental antibiotics can be monitored. AMR at the seaside: In research funded by the Natural Environment Research Council, Dr William Gaze is also involved in analysing samples of seawater from beaches, and rivers running into bathing waters, across England and Wales to assess the risk of exposure to resistant bacteria faced by swimmers, surfers and other beach users. Preliminary results suggest that England’s coastal waters can contain significant numbers of bacteria carrying antibiotic resistance genes. He now hopes to identify the sources of contamination and propose measures to reduce any risks.
Economic and Social Research Council (ESRC): Tackling drug resistant TB in India
Anthropological research funded by the ESRC and Department for International Development (DFID) has demonstrated the difficulties in combatting TB in India, where 20 per cent of the global incidence of multi-drug-resistant TB (MDR-TB) is estimated to be found. Despite recent government attempts to tighten up monitoring of pharmacies, regulations are routinely ignored and so antimicrobial drugs are still readily available over the counter and overuse of broad spectrum antibiotics is common. Poverty also plays a role: people with unstable incomes, poor living and working conditions, as well as lifestyle risk factors, are likely to be missed by the government’s anti-TB programme, and rarely take anti-TB medicines in the right combinations or durations for them to be successful. This contributes strongly to the growing prevalence of MDR-TB in India and globally.
Engineering and Physical Sciences Research Council (EPSRC): Engineering, maths and physics in the fight against AMR
Rachel McKendry’s research at the London Centre for Nanotechnology (LCN), UCL, aims to transform the early diagnosis, treatment and tracking of antimicrobial resistance by exploiting advances in nanotechnology, telecommunications and big data. Recent research highlights include unravelling how the antibiotic vancomycin works, one of the few effective treatments for ‘superbug’ MRSA. This research provides new insight into how drug binding mechanically weakens bacterial cells, leading to their death. Working together with Joseph Ndieyira and Gabriel Aeppli, they have developed mathematical models to disentangle the interplay between antibiotic levels and how effective they are at killing bacteria in the human host. Rachel is also Director of the new EPSRC IRC which aims to identify outbreaks of serious infections – including pandemic influenza, MRSA and HIV – much earlier than ever before by linking web data sources with mobile phone connected diagnostic tests. This research highlights the important role basic engineering and physical science research plays in building a pipeline of bold, innovative technologies to tackle AMR – benefitting patients and populations.
Medical Research Council (MRC): Cells which lie low to avoid antibiotics
David Holden’s lab at the MRC Centre for Molecular Bacteriology and Infection (MRC-CMBI), has studied ‘persister’ cells in Salmonella, visualising them for the first time using a fluorescent protein produced by the bacteria. Persister cells are a form of the bacteria that don’t replicate and ‘lie low’ to evade antibiotic action. David has also shown that the cells are formed immediately after being consumed by the host’s immune cells, in response to the acidic environment inside cells of the immune system and the nutrient deprivation that this imposes on the bacteria. Most antibiotics only work on active, replicating bacterial cells, so this work has major implications for antibiotic drug design
Natural Environment Research Council (NERC): Finding hidden AMR in the environment
Elizabeth Wellington at the University of Warwick studies the link between the environment, bacteria and human health. A recent study by Elizabeth’s lab looked at the impact of sewage treatment on AMR bacteria in a river. River sediment samples were taken from downstream and upstream of a waste water treatment plant, revealing a seven-fold increase in resistance to several common antibiotics, such as cephalosporin, downstream of the water treatment plant. This work also revealed the first finding of an imipenan-resistant E. coli in a UK river, an antibiotic that’s often used when other antibiotics don’t work.
Science and Technology Facilities Council (STFC): Recreating bacterial membranes
Harmful strains of Escherichia coli such as enterohaemorrhagic E. coli have been responsible for fatal outbreaks of food poisoning, and other strains can lead to meningitis and septicaemia. E. coli are ‘gram negative’, meaning they have a characteristic outer membrane made of lipids which can act as a barrier to antibiotics. To learn more about the membrane and how it defies antibiotics, scientists from STFC’s ISIS, Newcastle University and the Bragg Institute in Australia have assembled membranes that mimic this bacterial outer membrane in the lab. They hope their membranes will act as a model for future study.

For more information about the funding call themes

Theme 1: Understanding resistant bacteria in the context of the host. Covering both human and animal bacteria, it will encompass understanding of resistance from genomic, through to cellular and host pathogen interaction. It will aim to deliver new targets for potential treatments, ways of predicting and influencing the evolution of resistance and targets for diagnosing bacterial types, virulence and resistance. This call is open.

Theme 2: Accelerating therapeutic and diagnostics development. Addressing the development of new (and revisiting of old) small molecule antibiotics and delivery strategies. Development of new non-small molecule based treatments to avoid resistance altogether and the diagnostics to target all of these therapies including rapid point of care diagnostics. This call is open.

Theme 3: Understanding the real world interactions. It is clear that the environment and the way people and communities interact with the environment hugely influences the way bacteria behave and the transmission of genes within and between bacterial species.

Theme 4: Behaviour within and beyond the health care setting. This theme will aim to elucidate the underpinning motivations for human behaviours relating to AMR, and how behaviour can affect development and spread of antibacterial resistance. It will also explore how to best enable effective behaviour change interventions in a variety of settings, relevant to both humans and animals. It may also serve as the basis for research into the economics of AMR.

The Antimicrobial Resistance Funders Forum

ESRC Press Office

Susie Watts
Email: susie.watts@esrc.ac.uk
Telephone: 01793 413119

Channel website: http://www.esrc.ac.uk

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