New science minister announces 'war cabinet' to tackle antimicrobial resistance on all fronts
17 July 2014
NERC has joined forces with the UK's other research councils and numerous government bodies in an initiative to tackle antimicrobial resistance (AMR) on all fronts.
This is the first time all seven research councils have come together to confront such a problem. The cross-council initiative will coordinate the work of environmental scientists, medical researchers, biologists, engineers, vets, economists, social scientists, mathematicians and even designers, in a multi-pronged approach to address all aspects of this multi-faceted problem.
An agar plate with four antibiotics pills on a culture of a pathogenic bacteria
The Medical Research Council (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. A recent Science & Technology Committee report on antimicrobials, published 2 July 2014, stated that collaboration between different areas of research is paramount in tackling AMR.
The problem 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 people and in farm and wild animals, and to find new drugs in a pipeline that has all but dried up.
At the same time, scientists will investigate how to track the extent of AMR in different environments - in the sea, rivers, air, soil and in organisms, as well as in food, homes and hospitals.
One of the Science & Technology Committee report's conclusions recognised that we need more information on environmental drivers of antimicrobial resistance. It goes on to recommend that the government publish, in its Action Plan, a research programme that will recruit expertise across the UK to fill the knowledge gaps on how antimicrobial resistance exists and may be transmitted via environmental routes.
Researchers funded by NERC have recently revealed the first finding of an imipenem-resistant E. coli in a UK river. Imipenem is a broad-spectrum antibiotic that's often used when other antibiotics fail. (See case studies below from all seven UK research councils illustrating the type of work they are doing in this area.)
In his first announcement in his new role, the new 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 Duncan Wingham, NERC's chief executive, said:
Scientists and researchers have attempted to solve this problem for many, many years, but so far, we haven't found a solution to antimicrobial resistance. NERC's coming together with the other research councils and other government departments gives us the very best opportunity to solve this problem, which ultimately affects everyone.
NERC media office
1. AMR case studies from all seven research councils
Arts & 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 & Biological Sciences Research Council (BBSRC): Testing AMR selection in the environment
With funding from BBSRC and AstraZeneca, Dr William Gaze of the University of Exeter Medical School 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 European Regional Development Fund and European Social Fund, 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 & 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% 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 & 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 & 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 imipenem-resistant E. coli in a UK river, an antibiotic that's often used when other antibiotics don't work.
Science & 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.
2. The funding call
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.
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.
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. NERC will lead on scoping this theme along with others.
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.
3. The Antimicrobial Resistance Funders' Forum
The Antimicrobial Resistance Funders' Forum - external link (AMRFF) has been established to provide a forum for the sharing of information on activities relating to AMR, and in particular anti-bacterial resistance, by the various member organisations. The forum provides a framework for a more coordinated approach to tackling AMR research to maximise impact on national and international policies and activities. Membership of the AMRFF includes the research councils, health departments, government bodies as well as charities with a direct or indirect interest in AMR and which provide significant research and development budgets in the area.
Press release: 18/14