Interview with Patrice Courvalin, M.D.

11-05-2016 Carianne Buurmeijer

Interview by Lindsay Uittenbogaard

Q: What made you decide on a career in microbiology?

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Patrice Courvalin, M.D.

As an MD, I had a two-year residency at Pasteur Hospital in infectious diseases where there were difficult and rare case. It turned out that the lab at the hospital was headed by the very competent Prof. Y. A. Chabbert who advised me on what treatments to give – and his recommendations worked.  I started to work in his lab the afternoon between patient visits in the morning and the counter-visits in the evening. Before not too long he offered me a position and I’ve since worked at the Pasteur Institute for 45 years, except for a six year position in the USA.

Q: What is your goal as a microbiologist?

When I began in 1971, my goal was to apply molecular biology techniques to medical bacteriology as I thought this would be extremely powerful. That turned out to be a good choice because a lot of important results were produced.  Applying these techniques to human bacterial pathogens led to concepts that challenged the current thinking, such as the transfer of genes: it was really a promiscuous exchange of genetic material. What I find interesting about this research is that it was of clinical importance but also provided an enormous number of genetic tools and important notions about the fundamentals of microbiology. It was difficult but very rewarding work. The Pasteur Institute was really at the forefront of molecular microbiology and, at that time, I was the only one there, as an MD, to do this for 10 years.

Q: You have received a number of awards, recently the ASM BD Award for Research in Clinical Microbiology in 2012. How do you feel about this recognition for your work?

It’s always pleasant – of course, it’s very nice (laughs) – and of course it’s always groups of people who achieve results.  Regarding the ASM award – one of the outputs of this work was translational research. As I said, I was an MD working on the importance of resistance, which led to the concept of “interpretive reading of in vitro antibiotic susceptibility testing”. Instead of testing single antibiotics, we tested various antibiotics belonging to the same class. By doing this and observing the resistance, you can infer the biochemical mechanism responsible for this resistance – then you can make predictions in terms of therapy. It was difficult to convince people in the field that this was a valid approach but it turned out to be extremely successful. In particular, by using artificial intelligence in automated systems for antibiograms.

Q: What would you say is the greatest challenge facing microbiologists today?

To me, the 21st Century will be mainly about microbiology because our major health problems will be microbe-related. The challenge will be to cope with the rapid evolution of micro-organisms and find new approaches to deal with these questions.

Q: You’ve been involved in research on AMR for some 45 years and are now delivering an advanced course on antibiotics via Fondation Mérieux and Institut Pasteur – what do you hope will come out of this?

AMR is a multi-factorial problem so the answer has to be multi-factorial.  I realised there was no advanced course really addressing antibiotic resistance and how to minimize its development – and the concept of the course has been extremely well received so far. The emphasis this year, the first year, is on finding new drugs and I hope the course will be annual. There is a need for it, not least because today’s automation in clinical bacteriology (with artificial intelligence involved in interpreting the results) has led to a decline in competence among bacteriologists. One of the aims of the course is to transfer competence from all 40 international teachers from all of their various related fields, to the 40 students who will participate. It’s really a Master Class, and an expensive one, which has made fund raising difficult, but the calibre of the teachers and students who will be interacting together will be incredible. We plan to record and share the best moments.

Q: You recently joined the EAM – what would you like to get out of being a part of this expert Network?

Experts can really contribute by advising Governments on topics of public health importance, not least by supplying the arguments needed for decision-making. I was once an expert witness in a legal trial between a private and a public sector organization where the evidence required was at a very high scientific level. We won the trial mainly because the decision was evidence-based. I expect that my membership of the EAM will lead me to answering questions, popularising notions and intervene with public life.

Q: Do you have a message for the FEMS Network?

In the US, they say that “united we stand and divided we fall”. The ASM has 40,000 members. The French Society has 1,700. Although the population ratio is 6:1, the membership ratio is 25:1. I am all in favour of working more collectively as a group because bacteria, genes, ecology – they don’t respect borders.

Q: And more about you – if you received a Nobel Prize, how would you celebrate?

If I would win the prize, I would spend the money on the Advanced Antibiotics course because it has been so difficult to secure the funding. Then, with the leftovers I would buy a convertible car. I’ve always wanted this and I’m a bit claustrophobic so I just want to drive in an open topped car.

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Patrice Courvalin, M.D., is Professor Emeritus de Classe Exceptionnelle at the Institut Pasteur in the Antibacterial Agents Unit. He and his collaborators are experts in the genetics and biochemistry of antibiotic resistance. In particular, he first described and then elucidated vancomycin resistance in Enterococcus. His research has led to a revision of the dogma describing natural dissemination of antibiotic resistance genes. He and his colleagues demonstrated that a wide variety of pathogenic bacteria can promiscuously exchange the genetic material conferring antibiotic resistance, proved that conjugation could account for dissemination of resistance determinants between phylogenetically remote bacterial genera, elucidated the transposition mechanism of conjugative transposons from Gram-positive cocci, and more recently, has obtained direct gene and protein transfer from bacteria to mammalian cells. His work is reported in more than 330 publications in international scientific journals.  Dr Courvalin received master’s degrees in Sciences and in Human Biology from the University of Science in Paris, his Doctorate in Medical Sciences cum laude from the Medical School in Paris, and was a medical resident at the Hopital de l’Institut Pasteur. Since 1970, he has held many positions at the Institut Pasteur where he served as Chairman of the Department of Fundamental and Medical Microbiology (2002-2003). He was a Research Associate at the University of Wisconsin–Madison (1974-1977) and was Visiting Scholar in the Department of Biology, University of California-San Diego (1989-1990). Prof. P. Courvalin is Doctor honoris causa of the University of El Bosque, Bogota, of the University of Mons, Hainaut, Belgium, of the Technical University of Denmark, and of the University of Zurich, Switzerland. He is the recipient of the Thérèse Lebrasseur (1983), Jacques Monod (1989), and Jean Valade (2007) awards of the Fondation de France, the Louis Garrod award of the British Society for Antimicrobial Chemotherapy (1994), the Hamao Umezawa award of the International Society for Chemotherapy (1995), the Hoechst Marion Roussel (1997) and BD Research in Clinical Microbiology (2012) awards of the American Society for Microbiology, the gold medal of the International Union of Biochemistry and Molecular Biology (2013), the ISI Award « French Microbiologist Citation Laureate » (1991-1998 and 2004), the ESCMID award for Excellence in Clinical Microbiology and Infectious Diseases (2001), and the AGF Grand Prix of the French National Academy of Sciences (2004). Dr Courvalin is a Fellow of the American Academy of Microbiology, of the European Academy of Microbiology, of the French National Academy of Technologies, of the European Academy of Clinical Microbiology and Infectious Diseases, of the Royal Academy of Medecine, Sarragossa, of the Royal College of Physicians, London, and an honorary Fellow of the Australian Society for Antimicrobials. He serves in the editorial board of several international journals in microbiology and infectious diseases.

One of Patrice’s current projects is the launch of an Advanced Course on Antibiotics (AdCAb), offered by Fondation Mérieux and Institut Pasteur. It will run from 9 – 20 October 2016 at Les Pensières, Annecy (France). The goal is to bring leaders and innovators in academics and industry together with highly trained scientists. The course was conceived and developed by an international group of thought leaders from the Institut Pasteur, Harvard Medical School, McMaster Universty, diagnostic, biotech, and pharma industry, teaching hospitals, health care, and governmental and non-governmental agencies. Graduates will emerge with a state-of-the-art understanding of existing antibiotics. The course is intended for early career scientists – assistant professors, new industry scientists, MDs, and postdoctoral research associates. Attendance is limited to 40 students. Select Continuing Medical Education and other education credits will be offered.

 

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