The Wellcome Trust, a UK based philanthropic organisation, has published a report earlier this week putting in evidence the lack of action towards Anti-Microbial Resistance (AMR) despite evident political will. The main conclusion is that this is, in part, due to the public not championing the issue and forcing the government to act: “The public do not see the true scale and severity of antimicrobial resistance, and therefore it is not an issue the public is calling for political action on.” This is caused by the use of technical jargon with the topic being dominated by technical experts, even through social media, along with a lack of a strategic concerted effort by the media. The authors conclude that there is a need to reframe the manner in which AMR is perceived by the public by focusing on its urgency.   
 
Stakeholder interviews, social media analysis and focus groups held in seven countries (United Kingdom, United States, Germany, Japan, India, Thailand and Kenya) form the basis of this study. These showed that the multiplicity of terms (e.g. resistant bacteria/superbug, antibiotic resistance/antimicrobial resistance etc.) was confusing to people and that they often didn’t realise they all concerned the same issue (AMR). Furthermore, there are a number of different messages on the topic that are being pushed through such as: a need to decrease overall antibiotic consumption; a need to reduce antibiotic use in husbandry; a global antibiotic apocalypse; a serious threat of AMR mostly for vulnerable populations. Whilst all of these are not wrong, there is a lack of focus and coordination when putting out the AMR message, which is detrimental to the public picking it up.
 
The Wellcome Trust Foundation recommends five key principles to improve AMR communication to the public. The first would be to present AMR as an issue that affects ALL of modern medicine (e.g. surgeries, common infections, transplants etc.). Second, we should move away from the technical jargon when explaining and talking about AMR. Third, there should be an emphasis on the global component of AMR. Fourth, the focus when communicating about AMR should be on the here and now rather than the future as it makes it more concrete and urgent in the mind of the reader. Fifth, the problem should be framed in such a way that it seems solvable and the message should include specific calls to actions targeted to the specific audience.

Source: CIDRAP, 29 October 2019
 

A new study has shown the mechanism behind which skin cells are able to fight antibiotic-resistant Staphylococcus aureus (MRSA) before the bacteria has a chance to invade the body.
 
The study was done on mice that had human skin grafted onto them to showcase the action of human skin in vivo. The researchers observed that after colonization of the skin by MRSA, the skin cells recruited neutrophils that killed the antibiotic resistant bacteria. Understanding this immune response could be extremely helpful in developing new therapeutic strategies to dealing with antibiotic resistant MRSA.
 
This study is part of an emerging field showing that the once thought dry-barren outer skin layer is in fact an incredibly dynamic biological environment where immune cells and microbes are in constant stand-off to maintain a tenuous equilibrium.

Source: EurekAlert!, 29 October 2019
 

Penicillin is one of the most effective antibiotic available along with having very few side effects. Its use prevents the need to go for powerful alternatives or for cocktails of different antibiotics, with both options increasing the risk of AMR. However, many patients wrongly claim they are allergic to it. This misconception can be for a variety of reasons: believing that the allergy of a parent is automatically transmitted to the offspring; belief that side effects mean allergy; even people who were once allergic to it may not be anymore (Christopher M. Bland, clinical associate professor at the University of Georgia College of Pharmacy, saw, through studies, that after 5 years, half the patients were no longer allergic and that after 10 it rose to 80%).
 
This misconception can be easily seen through via questionnaires or penicillin allergy skin tests (PAST). Bland stated that simply by putting patients through the questionnaire, they were able to reduce the number of people believing to be allergic by 20%. Furthermore, by sharing best practices on PAST, Bland was able to get hospitals with non-dedicated allergists staff, to get rid of 98% of supposedly penicillin-allergic patients by having trained-nurses perform the PAST.
 
In addition to getting the patients on a safer regimen of antibiotics, the health care saving of debunking penicillin allergy are estimated by Bland to be in the tens of millions of dollars annually in the US.
 
"Our team is on a mission right now," said Bland. "Our goal is that every penicillin allergy is questioned and reconciled, with most coming off medical records and allowing patients to get the best antibiotic for their particular infection, which is often a penicillin."

Source: EurekAlert!, 29 October 2019
 

At the World Health Summit earlier this week in Berlin, the Global Antibiotic Research and Development Partnership (GARDP) unveiled its 5 by 25 plan. The GARDP is a not-for-profit public health R&D organisation, co-founded by WHO and Drugs for Neglected Disease initiative in 2016. It is a core element of the Global Action Plan on Antimicrobial Resistance.
 
The aim of the 5 by 25 plan is to have developed 5 new antibiotics by 2025 in order to address the rising threat of AMR. The target microbes will be the ones listed by the WHO as priority pathogens, including ones that cause serious and potentially life-threatening infections in hospitalized adults, neonatal sepsis and paediatric infections or sexually transmitted infections.
 
To achieve this goal, GARDP is aiming for a €500 million investment from the part of Member States, philanthropic and other global organisations. This will be a public-private partnership with a focus on late-stage development and the promotion of safe and responsible use along with affordability.
 
At the Berlin Summit, partners and donors reaffirmed their support for GARDP’s not-for-profit approach and Germany, Japan, the Netherlands, Switzerland and the UK committed investments.
 
Dr Manica Balasegaram, Executive Director, GARDP, highlighted that the development of new anti-microbial drugs cannot be done in isolation and that “GARDP’s donors and partners are the key to our success and I truly believe that by working together, we can be more than the sum of our parts. By working with experts in both the public and private sectors, GARDP can take advantage of the best available innovation, expertise, and resources.”
 
(other current investors include: Bill & Melinda Gates Foundation, German Federal Ministry of Education and Research, German Federal Ministry of Health, Leo Model Foundation, Luxembourg Development Cooperation and Humanitarian Aid, Luxembourg Ministry of Health, Médecins Sans Frontières (MSF), Principality of Monaco Ministry of Foreign Affairs and Cooperation, Netherlands Ministry of Health, Welfare and Sport, South African Medical Research Council, Swiss Federal Office of Public Health, UK Department of Health and Social Care, UK Department for International Development, and the Wellcome Trust)

Source: GARDP, 28 October 2019
 

Antibiotic resistant bacteria are a growing threat and alternatives that do not confer antibiotic resistance are an exciting avenue of research. One such example is being funded by CARB-X, with up to $4.98 million being provided to BioVersys AG for the development of their new small-molecule drugs that target Staphylococcus aureus bacteria.
 
These molecules are not antibiotics but are designed to disarm the bacteria of its virulence factors, such as phenol-soluble-modulin (PSM) and Panton-Valentine leucocidin (PVL) toxins, which are factors directly linked to the severity of Aureus-mediated skin infections and pneumonia. This is done by inhibiting the transcriptional regulator AgrA in charge of regulating some of the toxin production. These new molecules can therefore treat small skin infections alone or work in combination with antibiotics to treat more serious infections.
 
Kevin Outterson, Executive Director of CARB-X, which is based at the Boston University School of Law stated “This project is in early stages of development but if successful and approved for use in patients, it would represent tremendous progress in the fight against drug resistance, by offering an alternative therapy to traditional antibiotics and also restoring the effectiveness of existing antibiotics.”

Source: CIDRAP, 29 October 2019
 

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