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Antimicrobial Resistance Antimicrobial Resistance Antimicrobial resistance Antimicrobial resistance References 1. Chief Medical Officer annual report: volume 2 https://www.gov.uk/government/publications/chief-medical-of- ficer-annual-report-volume-2 2. Antimicrobial resistance: global report on surveillance 2014 http://www.who.int/drugresistance/documents/surveillancereport/en/ Before the widespread use of antibiotics in the 1940s, it was much more common for women to die from post-childbirth infections, and diseases such as tuberculosis were rife. In addition, farmers often faced losing vast numbers of crops and animals to infectious diseases, leading to serious food shortages, even famine. The discovery and introduction of antibiotics gave us the ability to prevent these tragedies. However, as microorganisms become resistant to antimicrobial treatments, including antibiotics, there is a very real possibility that the drugs we have come to rely upon may become obsolete. Since 1928, when Sir Alexander Fleming accidentally discovered occurrence1. The World Economic Forum has suggested that smart surfaces and medical dressings, are also being developed. penicillin growing on a petri-dish of bacteria, antibiotics have antimicrobial resistance (AMR) be added to the global risk register, This timeline and series of case studies showcase some of these saved the lives of millions of people and animals. Their discovery is and the World Health Organization has highlighted the serious advances, supported by the Biotechnology and Biological seen as one of the most important scientific achievements of the implications for global public health in its AMR Global Report on Sciences Research Council (BBSRC), Engineering and Physical 20th century. But overuse and misuse of antibiotics has Surveillance2. Antimicrobial resistance is one of the Innovative Sciences Research Council (EPSRC) and Medical Research contributed to the emergence of resistance. Sir Alexander Fleming Medicine Initiative’s priorities and a Joint Programming Initiative Council (MRC). This work lays the groundwork for the himself, on collecting a Nobel Prize for his discovery, predicted the on antimicrobial resistance was set up in 2011 to streamline cross-Council antimicrobial resistance initiative that was launched dawn of this battle, saying, “It is not difficult to make microbes European research efforts in AMR. in July 2014. This will see all seven Councils working together to resistant to penicillin in the laboratory by exposing them to tackle AMR. A joined-up, multi-disciplinary approach is essential concentrations not sufficient to kill them…” The UK Research Councils support research, capability and training and so the initiative will coordinate the work of medical to pursue a range of strategies to tackle this global problem. Years researchers, biologists, engineers, vets, economists, social England’s Chief Medical Officer Professor Dame Sally Davies of research mean that we are now in a better position than ever to scientists, mathematicians and designers. It is only through warned in 2013 of the “catastrophic effect” of antimicrobial understand microbes such as bacteria, viruses and fungi, how tackling the problem at every level and in every environment that resistance and urged immediate action from global leaders before they interact with their hosts, and to identify possible routes for we will be able to take the next steps towards a solution. deaths from routine surgery once again become a common alternative diagnostics and treatments. New technologies which could help prevent the spread of bacteria and infections, including © Medical Research Council 2014 Antimicrobial resistance 1. Understanding resistant bacteria in context of the host 2007: 2010: 2011: University of Newcastle spin-out company The EU uses the results of research by Scientists at the MRC Research changes from its normal form to a e-Therapeutics Ltd identifies three BBSRC David Phillips Fellow Dr Mark Complex at Harwell determine the slow-growing antibiotic-resistant form drugs that are effective against Webber in two reports on the use of structure of NDM-1 using the STFC’s as part of its natural lifestyle to ensure antibiotic-resistant superbugs, common biocides3. During his fellowship, Diamond Light Source crystallography its survival10. including MRSA, using Grid computing Dr Webber characterised the genetic facility7. Understanding the structure and e-science techniques developed changes that grant Salmonella resistance will help researchers develop drugs that during research funded by EPSRC and the to the biocide triclosan and others4. There could inactivate the enzyme or that Department of Trade and Industry1. The were around 9,000 cases of Salmonella are not susceptible to it. Bacteria transmit resistance genes to company searched through tens of food poisoning in the UK in 2010, other bacterial strains by way of millions of compounds for any that although three quarters of cases may plasmids — small loops of DNA. Carrying showed action against superbugs in a go unreported5. these plasmids is commonly thought to fraction of the time it would take using Professor Hagan Bayley at the University ‘community-acquired’ MRSA strains, which reduce a bacterium’s fitness, so removal conventional drug discovery methods. of Oxford discovers that the antibiotic- can both resist antibiotics by making of antibiotic pressure should reduce the resistance of Escherichia coli is not due to changes to the bacterial cell wall and number of resistant bacteria. However, in the reduced size of OmpC — the channel maintain high levels of toxin production. a BBSRC and MRC-funded study, Professor 2008: in the bacteria’s membrane that allows Laura Piddock and Dr Mark Webber at the The first case of a bacterial infection with the entry of antibiotics — as is the cause University of Birmingham discover that resistance caused by NDM-1, a powerful of much resistance, but a change in its the plasmid pCT persists in the absence of enzyme that gives bacteria resistance electrostatic field8. Dr Andrew Edward at the MRC Centre antibiotics because it has evolved to have to most antibiotics, is discovered2. for Molecular Bacteriology and Infection little impact on the host11. They conclude MRC-funded researcher Professor Tim (CMBI), Imperial College London, that resistance genes will persist even with Walsh was part of the group that 2012: demonstrates that Staphylococcus aureus careful rationing of antibiotics. identified the enzyme, which is commonly BBSRC-funded researchers find a protein The gene which grants one strain of MRSA produced by Escherichia coli and Klebsiella on the surface of Streptococcus uberis found in hospitals resistance to a range pneumonia, but can also spread bacteria, responsible for bovine mastitis, of antibiotics also reduces the bacteria’s between different strains of bacteria. which plays a central role in enabling the ability to secrete the toxins that bacteria to cause disease6. The findings cause illness, according to a BBSRC and suggest it may be possible to develop MRC-funded study led by Dr Ruth Massey a vaccine against the disease, reducing at the University of Bath9. The results also farmers’ reliance on antibiotics. highlight the problem of © Medical Research Council 2014 Antimicrobial resistance In an MRC-funded study, Professor Gad and also increases its resistance to many conditions, such as those found in the stop growing and to use minimal Professor Laura Piddock at the University Frankel at Imperial College London uses a other antibiotics and the biocide triclosan, lungs of people with severe respiratory resources. The CMBI researchers of Birmingham sequences the plasmid mouse infected with bacteria genetically according to research by Professor Laura illnesses, including cystic fibrosis17. show that a protein called NtrC plays a pCT, which confers antibiotic resistance modified to produce light to show how an Piddock and Dr Mark Webber at the P. aeruginosa infection is one of the most central role in the process by controlling to bacteria carrying it. She concludes that infection moves around the body in real University of Birmingham15 and supported common causes of death in cystic the level of ppGpp. the plasmid’s success lies in its stability time12 & 13. Regular CT scans of the mouse by BBSRC and the MRC. fibrosis patients. in a range of hosts, the lack of a fitness could show how different vaccines and cost to the host bacteria — meaning that antibiotics change the way bacteria take carrying the plasmid has no detrimental over parts of the body. Researchers at the London Centre for effect — and efficient transfer between MRC-funded Professor Guy Frankel Nanotechnology, University College bacterial hosts20. at Imperial College shows how London, show how drug-binding 2013: enteropathogenic Escherichia coli (EPEC), mechanically weakens bacterial cells A research team from the Universities of a pathogenic strain of E.coli which is a and leads to their death, whilst unravelling Nottingham, Birmingham and Newcastle, common cause of infant diarrhoea in the how the antibiotic vancomycin works. funded by EPSRC and BBSRC, discover developing world, interferes with the host Vancomycin is one of the few effective that artificial materials based on simple cell’s normal antimicrobial response16. treatments for MRSA. The study was synthetic polymers can disrupt the way in EPEC injects a toxin into host cells during funded by EPSRC, BBSRC and the which bacteria communicate with each infection. This blocks the cell’s ability to Royal
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