#FEMSmicroBlog: Where are we? Antimicrobial Resistance 2020

18-11-2020

In light of the global coronavirus pandemic, it is certainly true to say that 2020 has not been the year we all quite expected. Our everyday lives have been flipped upside down and with many resources directed towards the solution against Covid-19 the questions are: What about antimicrobial resistance (AMR)? Did the sudden shift of resources towards Covid-19 mean that AMR has been left on the side? Are we using the valuable lessons from Covid-19 towards making us better prepared for the battle to reduce AMR?, asks Eleni Koursari.

But first things first, let us deep more into the history of AMR

Never has the threat of antimicrobial resistance been more immediate and the need for solutions more urgent.”

— Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO

 

AMR in a glimpse  

Something that I always try to remind myself, is that microbes are much older than humans, and just by this we can argue that they can outsmart us in a lot of ways, including acquiring mechanisms of resistance. For example, when penicillin was first used by humans, only 6 years later, resistance was observed. Indeed, for most/nearly all antimicrobials we use to date, there is some stage of resistance reported, and sadly very soon after their first usage.  

Timeline of antibiotic deployment (top) and observed antibiotic resistance (bottom). Figure obtained from Clatworthy et al., 2007

There are different stages of AMR. Multi-drug resistance (MDR), Extensive drug resistance (XDR) and more recently Pan Drug Resistance (PDR) for non-susceptibility to all agents in all antimicrobial categories.  

It is very scary to think that we are getting closer and closer to an era where no antimicrobial works. This is utterly important as antibiotics are not just used to treat infectionsthey are also used to facilitate birth and cancer treatment to name a few. For instance, Salmonella Typhi, the bacterium that causes typhoid fever, has been found to be resistant to all recommended antibiotics, including first-line drugs, second line drugs and third-generation cephalosporins. Unfortunately, bacteria where able to develop resistance even with colistin, the last resort drug. This means that life-threatening infections caused by carbapenem resistant Enterobacteriaceae (ieE. coli, Klebsiella etc.) have no effective antibiotic treatment to date.  

 

AMR 2019/2020 moments to save in our diaries 

But there is good news! Research on AMR is very much growing field, with many researchers investigating mechanisms of resistance, epidemiology, prevention, new antimicrobials as well as involved in communicating results to policymakers, the general public etc. These are a few key moments for the year 2019/20 for AMR: 

  • The Global Antibiotic Research and Development Partnership (GARDP) launched a new goal to deliver five new treatments by 2025 to tackle drug-resistance infections 
  • In July 2020, twenty leading biopharmaceutical companies announced the launch of the AMR Action Fund, a partnership that aims to bring 2-4 new antibiotics to patients by 2030. For this cause, approximately $1 billion of funding has been raised to support clinical research 
  • The Global Antimicrobial Resistance and Use Surveillance System (GLASS) report (early implementation 2020) was released. The GLASS report contains data from surveillance of AMR in humans from approximately 100 counties including use of antimicrobials, monitoring of AMR in the food chain and in the environment
  • The White House released the National Action Plan 2020-2025, with coordinated, strategic actions using a One Health approach to improve the health and well-being of the population by changing the course of antibiotic resistance 
  • In October 2020, the U.S. Food and Drug Administration (FDA) cleared two Antimicrobial Susceptibility Test devices
  • In November 2020, the first global antibiotic resistance symbol was announced. The symbol created by David Ljungberg, can be easily crafted at home and will serve in raising awareness about this global threat
  • The Antimicrobial Encyclopedia was launched by GARDP to share definitions of key terms in the antimicrobial field, including expert videos.

And the list goes on! As you can see, AMR has been on the focus both at the regional/country level but also on a global perspectiveAlso, there are even more contributors dedicated to studying its cause including governments, pharmaceutical companies, individual researchers etc.  

 

The bigger picture 

Coming back to the question – where are we on AMR 2020? We cannot ignore the fact that 2020 has been a year of change, dictated by the Covid-19 pandemic. But ultimately, it is in our hands whether we utilize what we learned across all sectors and apply it to prevent future worldwide challenges such as AMR. 

Anni Zhang author of Online searching platform for the antibiotic resistome in bacterial tree of life and global habitats says that, compared to previous years, “We are now starting to transform from simply documenting the presence of AMR to the interpretation of its impact, i.e. risk to public health, risk of transmission, risk for evolution, risks for ecological effects etc.” 

We are now starting to transform from simply documenting the presence of AMR to the interpretation of its impact. 

— Dr Anni Zhang

In my opinion, one of the most important messages of this year is that we know now even more how important it is to collaborate between different sectors. It is like a giant Jenga: everything depends on everyone, and to allow the tower to grow up we need to support each other. It is critical to act in an interdisciplinary way but also to make sure that all sectors involved have the right communication channels to make sure that nothing is lost in translation.  

My last message for this blog is that everyone has a role to play, whether as professional in diagnostic, research, policymaking or science communication but also as private consumer and voter. Each one of us can do little things that can help reduce the burden on AMR. 

United we can preserve antimicrobials! 

About the author of this blog 

Eleni Koursari is the Science Communications Assistant at FEMS, where she contributes on the digital and social media channels and helps with various communications projects and volunteer teams with a SciComms focus. 

Before FEMS, Eleni completed her Masters in Antimicrobial Resistance at The University of Sheffield (United Kingdom) and Bachelor’s in Medical Biochemistry. She also worked in different microbiology research laboratories on Streptococcus pyogenesNeisseria gonorrhoeae and Salmonella Typhi 

About this blog section

The section #MicrobiologyIsEverywhere highlights the global relevance of microbiology. The section acknowledges that microbiology knows no borders, as well as the fact that microbiologists are everywhere and our FEMS network extends well beyond Europe. This blog entry type accepts contributions from excellent blogs translated into English. Regional stories with global relevance are welcomed. National or international events sponsored, organised or connected to FEMS are also covered.

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