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Tackling antimicrobial resistance worldwide

14 February 2018

Antimicrobial resistance (AMR) is a serious and growing global health challenge. It occurs when microorganisms (such as bacteria, fungi and viruses) emerge that cannot be killed by normal doses of an antimicrobial drug (such as antibiotics and antivirals), making them less susceptible or resistant to antimicrobial agents. AMR can jeopardise the success of surgery and chemotherapy, and could have grave implications for the future of modern medicine. As such, it is an urgent global threat which requires a coordinated cross-government, academic and industry response. A GW4 research community has brought together leading AMR expertise across four universities to help tackle this issue.

To prevent the emergence of AMR, it is vital to understand how it develops in different environments and communities. This area of research requires rapid development to stem a spread of AMR strains of bacteria worldwide.

To explore how AMR bacteria are transmitted in different environments, a GW4 community identified synergies in research areas in which the four universities hold complementary expertise but are not currently collaborating, such as genomic characterisation of resistant bacteria, environmental detection and novel sensors.

The community built on GW4’s research strengths across engineering, physical, life, environmental, veterinary, clinical and social sciences, and its extensive UKRI-funded AMR research portfolio, which includes over 60 active grants 

Building an international network

The community held a workshop at the University of Bristol to coincide with a ‘Bristol Tackles Global Challenges’ week, which brought together international AMR researchers from Thailand, Malaysia and Kenya to plan opportunities for funding through the Global Challenges Research Fund.

The one day workshop on ‘Systems Approaches to AMR in Different Environments’ was supported by BristolBridge – an EPSRC-funded network project that aims to ‘bridge the gaps’ between the physical sciences and engineering, and AMR, and a GW4 Building Communities Initiator Award. This workshop specifically brought together leading AMR investigators from all the GW4 universities alongside representatives from some of the most important research centres involved in environmental AMR research, including the NERC Centre for Ecology and Hydrology and Cefas.

Community lead Dr Katy Turner, University of Bristol and BristolBridge, explains: “The workshop provided a unique combination of skills and complementary research, led by GW4 academics, many of whom are leaders in their own AMR-related fields. It enabled us to engage with wider stakeholders who could provide fresh perspectives on the problem we want to solve.”

The workshop led to a joint bid to the MRC-led UKRI and Department of Health’s ‘AMR in a Global Context’ call, from the GW4 universities (Bristol, Bath and Exeter), and key Thai delegates. Dr Katy Turner says:  “The workshop preceded the MRC call, but demonstrated to the funder that this was an authentic collaboration with activities already underway.”

The resultant development award for ‘One Health Drivers of Antibacterial Resistance in Thailand’, led by the University of Bristol’s Dr Matthew Avison, has provided £87k to develop a GW4-UK-Thai network to tackle the challenge of antibacterial drug resistance in Thailand. It will do this by combining interdisciplinary expertise to understand the drivers behind antibacterial drug resistance and typical behaviours around the use of antibiotics.

GW4 researchers travelled to Thailand in December 2017 and January 2018 to hold workshops, gather preliminary data and further develop this new network in Thailand.  Work is now underway to submit an invited full proposal to the UKRI and Department of Health. If funded, it could provide up to £3m to explore whether resistant bacteria circulate within environments in rural Thailand, how antibiotic use by farmers could influence the development of antibacterial drug resistance and how people in Thailand make decisions around their own healthcare and use of antibiotics.

Key ingredients to research collaboration: time, trust and effort

For community lead Dr Katy Turner, one of the most vital benefits of the GW4 award was time. She explains: “Building a credible group of interdisciplinary researchers is an iterative process that takes time and trust. We have to recognise that we can’t tackle global health challenges in isolation:  we need people who are willing to make an effort to link between disciplines. The results can be revolutionary, from finding a new perspective on human health mechanisms to getting physicists excited about detecting bacteria. Often you find that if you don’t truly understand the problem, you’re unlikely to find a solution. GW4 funding enabled us to ask new questions and pursue curiosity-led research to address this major global problem.”

Plans are afoot to develop the GW4 AMR network, and ensure that this collaboration continues to tackle the challenge of antimicrobial/antibacterial drug resistance for many years to come. The GW4 AMR community, alongside representatives from Rothamsted Research, have already held further meetings and workshops in Bristol to develop bids for tackling AMR as a global health challenge.

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