[Ip-health] The Conversation: Longitude Prize worth £10m to go to researchers who target antibiotic-resistant bugs

Thiru Balasubramaniam thiru at keionline.org
Thu Jun 26 08:07:21 PDT 2014


26 June 2014, 6.06am BSTLongitude Prize worth £10m to go to researchers who
targetantibiotic-resistant bugs

Following a public vote, the 2014 Longitude Prize
<http://www.longitudeprize.org/> to develop an idea that will help solve
of the greatest issues of our time will go to a project working on
antibiotic resistance. The focus of the £10m award will go to the best idea
<http://www.longitudeprize.org/challenge/antibiotics> for a cheap, fast and
accurate detector for bacteria and their associated antibiotic resistance
mechanisms that could help better guide treatment.

Antimicrobial resistance is one of the most serious health threats to the
global community. Microbes that are resistant to multiple classes of
antibiotics are the cause of common infections including skin and soft
tissue infections, urinary tract infections, pneumonia, diarrhoea and
sexually transmitted infections.

Added to this, multi-drug resistant bacteria are making it increasingly
difficult to treat infections in vulnerable or at risk groups like the
elderly, organ transplant patients and premature babies. Globally,
resistance in microbes that cause tuberculosis and malaria, Candida (a
fungus that commonly causes serious infections in hospitalised patients)
and viruses such as HIV and influenza is prevalent and on the rise. It’s
not a pretty picture.

In the US, the Centers for Disease Control (CDC) conservatively estimates
<http://www.cdc.gov/drugresistance/threat-report-2013/> that more than 2m
illness are caused by antibiotic resistant bacteria and fungus each year
with 23,000 associated deaths – mostly in hospitals and other medical
settings, although they can occur anywhere. Methicillin resistant
aureus*, more commonly known as MRSA, was associated with more than than
80,000 <http://www.ncbi.nlm.nih.gov/pubmed/24043270> invasive infections in
2011. *Clostridium difficile*, a bacteria that causes severe recurrent
diarrhoea, is linked to antimicrobial use and resistance and estimated to
be associated with 250,000 illnesses and 14,000 deaths every year.

Antibiotic-resistant organisms develop from selective pressure caused by
the use of antibiotics during patient therapy or in food animals. The CDC
has proposed four core actions to fight the spread of antibiotic
resistance, including tracking resistant bacteria, improving the use of
antibiotics, and promoting the development of new antibiotics and new
diagnostic tests for resistant bacteria.

All of these actions are crucial to controlling global spread and
discovering new ways to treat antibiotic resistant microbes. Health care
providers need to prescribe appropriately and patients need to finish their
full course of therapy so that bacteria don’t have the opportunity to
survive and develop resistance.

But diagnostic testing to rapidly identify microbes and their resistance
genes is one feasible option that could improve targeting of antibiotic
drugs. This approach would pave the way for more intelligent antibiotic
use. Currently, initial therapy of an infection is often empirical, with
antibiotics selected to treat the most common microbes associated with that
type of infection.

Rapid diagnostics could also help the effort to detect and prevent the
spread of antibiotic resistant organisms. Diagnostics are being developed
<http://www.ncbi.nlm.nih.gov/pubmed/24841135> by groups and companies in a
bid to reliably detect numerous pathogens from a single biological sample
<http://www.ncbi.nlm.nih.gov/pubmed/24848132> and the presence or absence
of genes that encode for antibiotic resistance.

While diagnostics will be an important part of helping us to move beyond
resistance, the discovery and development of new antibiotics and
therapeutics that target the ability of microbes to cause infections are
critical. This is based on a more basic understanding of how these
organisms cause infections via the secretion of toxins that disrupt the
human immune system or direct toxicity to host cells, which is the case
with MRSA and *C. difficile* infections. This is important to the
development of new therapeutics that can target these molecules and
increase the efficacy of currently available antimicrobials.

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