Guest blog: AMR Insights Symposium November 2019

Guest blog by Franca Jonquiere, DVM; Faculty of Veterinary Science,  Utrecht University.

Thanks to antimicrobial agents we have seen a dramatic reduction in the number of deaths from infectious diseases over the last 70 years. However, due to the over use and incorrect usage of antimicrobials (AMU), we are now fighting a public health crisis: Antimicrobial Resistance (AMR). AMR is responsible for an estimated 33,000 deaths per year in the EU. It is also estimated that AMR costs the EU EUR 1.5 billion per year in healthcare costs and productivity losses. Within this light, it remains vital that we, as doctors, workers and researchers in the medical field, continue to share insights, knowledge and innovation across all fields that help combat the further rise of AMR.

Therefore, I was pleased to be able to participate in the recent AMR Insights Matchmaking Symposium, titled: “Emerging Antimicrobials and Diagnostics in AMR 2019”. This 1.5 day event offered a nice insight into current and ongoing threats to Antimicrobial Resistance, and, even more important, also offers a platform for newly developed products and technologies that can be used in the global fight against AMR. The goal of the symposium is connecting people and companies in the ongoing struggle against AMR.  Many new technologies that can make this happen were highlighted in great detail across two days.

Professor Jan Verhoef opened the first day by making the valuable point, that, due to rising health care costs, the focus is shifting more and more towards prevention of (infectious) diseases and preventative care, with emphasis on vaccinations, hygiene, diagnostics and, also an important role for, antibiotics. While the aim is to reduce usage of antimicrobials to a minimum, there will always be patients and areas of medicine (like surgery, transplantation, oncology and elderly care), that will depend on antibiotics and may even have a continuous need to use them. This makes prudent usage of these life saving medicines so important. Jan Verhoef pointed out that for a unified and effective approach towards the problem of AMR, we nééd a One Health approach, that ties together human medicine with veterinary medicine and the environment; everything is interconnected and we all have to work together to reduce AMR now.

Dr Jennie Hood’s talk nicely connected to this insight of working together, by emphasizing the need for further collaboration within research as well. She discussed the upcoming Global AMR R&D Hub that will play a role in connecting potential financial funders to R&D teams worldwide, related to AMR. A great, and much needed step towards bringing together developers and funders. This is vital for the development of new antimicrobials for example, where the current business model is mostly failing.This last point was made by several speakers, some of whom also shared some ideas on new business models in this vital area.

The third interactive session ‘Synergizing Global Databases in AMR’  focused on on how to better unlock and combine existing databases related to AMR.  According to James Kirkham (Senior Scientist at the AMR Centre) any overview of databases regarding AMR R&D, should be user-friendly, contain chemical structures of new molecules and needs to be open source. There  should be consistency in how terms are defined and all data should be shared, including “soft” information such as lessons learned and why certain projects failed. One can see the merit in these conditions, but also why these could be potentially hard to combine with a financial business model that should promote new antibiotics in the fight against AMR.

Professor Gilles van Wezel (Leiden University) showed very promising new ways to use a known, antimicrobial producing bacterium and research hidden opportunities for new drugs by developing more than one molecule that is being produced by these bacteria, into new antimicrobial drugs. This novel approach could bring about many new opportunities to combat AMR and introduce new antibiotics to the market.

Professor Paul Savelkoul from Maastricht University Medical Centre, then highlighted another area that plays a vital role in AMR reduction: diagnostics. Several speakers highlighted the need for more specific, faster and more reliable AMR diagnostics, where everyone agreed that a patient-side, rapid susceptibility test would be a giant step forward in the tackling of the problem of AMR. Paul Savelkoul also mentioned the important point that, in our current way of diagnosing disease and susceptibility to antimicrobials, we are too often reliant on the ability to culture a type of bacterial strain in vitro before we can use diagnostics to identify the strain correctly. This is especially important in regards to horizontal transmission of AMR genes between bacteria, through usage of mobile genetic elements, which requires a new perspective on diagnostics. We need to move from phenotypic testing towards molecular testing.

These main insights of day 1 were echoed on day 2, where a special matchmaking program, connected people from different backgrounds and companies in the fight against AMR. In parallel with the matchmaking program three ‘Buzz Sessions’ took place on respectively ‘Neglected Antimicrobials’, ‘Companion Diagnostics’ and ‘AI and AMR’. The plenary program then offered lectures on Azole resistant Aspergillus, Integrative Medicine as well as on the use of biotherapeutics for lung infections. 

The afternoon program offered two series of lectures with ‘Technology updates’ and ‘Product updates’ by representatives from Academia, start-ups and SMEs. The last part of the Symposium was a Forum Discussion on how to drive innovation to combat AMR. 

All in all it was very stimulating to see so many new developments in diagnostics, therapy and laboratory research, and even more inspiring to see many great minds working together in a unified battle against AMR. It was very promising to be invited to be part of this event as a veterinary researcher on AMR in animals, as it shows a true understanding that, to fight AMR, we need to work together across medical, veterinary and environmental fields.

Drs Franca Jonquiere is a veterinary researcher at the Faculty of Veterinary Science at Utrecht University. As a project manager on AMR she is looking at ways to further coach farmers to continue to reduce their AMU. Franca also holds a Masters degree in Communication and Media Studies at the University of Amsterdam and is available for lectures and talks on the topic of AMR in Livestock.