Antimicrobial resistance: UK research overview
Antimicrobial resistance (AMR) is one of the greatest challenges facing humanity today, but with the collective might of scientists across the globe, we can fight back – and that is exactly what UK researchers are doing. From social sciences to the arts, pioneering research is helping us to confront the problem from all sides and move towards tangible solutions.
UK Research and Innovation (UKRI) is at the very core of efforts to overcome antimicrobial resistance. The cross- research council initiative on AMR has been set up to develop collaborative approaches across disciplines, and there is a vast range of research taking place in the field.
Whether it’s state-of-the-art computer simulations of spreading infections or cutting-edge diagnosis technology, the UK is at the forefront of efforts to combat drug resistance.
Emergence and spread
Some of the deadliest bacterial species that have acquired antibiotic resistance live in the guts of all mammals. Understanding how such bacteria can travel between animals and humans, through the food chain, and across manmade and natural environments is the first step in our battle against AMR. The decision-making and behavioural changes we could make as result would have a huge impact on food security, poverty, pollution and human health.
A ‘One Health’ consortium of UK and Thai researchers is examining the potential drivers of AMR in the Mae Klong-Ta Chin Basin, a region picked for its incredible diversity of landscapes, populations and land use. There are villages, towns and industrial zones, with communities of varying socio-economic and education levels. It includes fish farms, fruit orchards and rice paddies.
Closer to home, a team from the Universities of Warwick and Exeter and the Centre of Ecology and Hydrology - funded by UKRI's Natural Environment Research Council - scrutinised 69 areas of the river Thames and discovered higher levels of drug-resistant bacteria near some waste water treatment works, showing how easily resistance can spread when we flush our loo.
15 minute diagnosis
A 15-minute diagnostic test to differentiate between viral and bacterial infections could be a solution to AMR, according to research funded by UKRI.
The solution for AMR seems simple: drastically reduce the prescriptions of antimicrobials. However, where antimicrobials are required for medical treatment, withholding prescription is dangerous for the patient and unethical, and could furthermore negatively impact on the general public through increased spreading rates.
There are two major types of infections: viral and bacterial. Only bacterial infections can be treated with antibiotics, but certain symptoms are common to both types of infections. A typical example is throat pain, which could be caused by a bacterial infection (e.g. Streptococcus pneumonia) or viral (e.g. influenza), or in fact could be caused by non-infection causes such as heart failure.
The researchers on this project, funded by UKRI’s Medical Research Council (MRC), Biotechnology and Biological Sciences Research Council and Engineering and Physical Sciences Council (EPSRC), are developing rapid diagnostic tests that can be performed by the doctor her/himself, which will give an answer in less than 15 minutes, quick enough to inform treatment before it is prescribed.
Tracking infection in the hospital
Glasgow School of Art architecture and design researchers - supported by UKRI's Arts and Humanities Research Council - have developed an interactive tablet-based tool that can help doctors and nurses ‘see’ the journey bacteria can take through a hospital environment and how it can spread. Bringing an invisible issue to life in this way means clinicians can come up with simple but effective changes to the behaviours and processes they use to halt the spread of life-threatening infections.
Combatting infection in implants
Despite improvements in surgical procedures, bacterial infection is still one of the main causes of medical implant or device failure, causing both significant trauma to the patient and a huge burden on the NHS.
Current solutions involve incorporating antibiotics into the devices, however, in response to the rising challenges of AMR a team of researchers led by the University of Bristol is developing novel antimicrobial surfaces. The project explores a unique physical means to kill AMR bacteria by puncturing their cell walls with tiny spikes, inspired by those found in nature on cicada wings.
With further commercial exploitation such novel antimicrobial surfaces have the potential to be used for next-generation biomedical devices and implants, with improved performance compared to those devices in current use.
The project received initial funding from MRC, with additional funding from EPSRC.
The hunt for undiscovered antibiotics must continue. A University of Bristol team supported by UKRI's Biotechnology and Biological Sciences Research Council, EPSRC and MRC has identified a sea sponge living 2km below the Atlantic ocean that has the potential to fight one of the most common superbugs found in hospitals, MRSA. The team are now investigating how it responds to the human body to see if it can be used as an effective treatment in the future.
Around 20 million patients around the world in intensive care need machines to help them breathe each year and many of these patients are treated with antibiotics. The Proteus Interdisciplinary Research Collaboration, led by researchers at the Universities of Edinburgh, Bath and Heriot-Watt University, are developing a bedside imaging tool that can detect whether harmful inflammation is present in a patient’s lungs in less than a minute. The technology uses a chemical probe targeting neutrophils originally developed with funding from MRC, that lights up when it attach's to inflammatory cells and this fluorescence is detected using fibre-optic tubes that are small enough to be threaded deep inside a patient’s lungs. Using optical signatures to detect and identify inflammation in this simple and quick way could help reduce the use of unnecessary antibiotics and speed up recovery in the most seriously ill patients.
Inspiration from nature
A team at the Bristol Dental School was inspired by the antibacterial properties of cicada and dragonfly wings. They are replicating their bacterial-killing nano-spiked surfaces in materials such as titanium and polymer with the aim of using them for common medical implants. With a rapidly ageing population and nearly a quarter of a million hip replacements already taking place in the UK each year, stopping infection in its tracks in this way would reduce patient trauma and save the NHS millions of pounds.
Researchers at the University of Liverpool are developing a new type of contact lens that will protect the corneas of patients who have undergone eye surgeries or treatments and protect against the risk of infection. In order to replicate the effects of both the bandage contact lens used post-surgery to protect the cornea and provide comfort for the patient, and the antibiotics that are usually administered to reduce the risk of infection the team has developed a new form of hydrogel. The hydrogel is designed to be naturally antimicrobial and be cast into a contact lens using existing moulding processes.
The team, led by Professor Rachel Williams and funded by UKRI through MRC, are also developing a therapeutic bandage contact lens that are able to deliver doses of antimicrobial drugs to the cornea to provide a sustained treatment for corneal infection. Corneal infection accounts for five per cent of cases of blindness worldwide, and treatment through the use of a contact lens would be more effective at killing the bacteria and fungi that cause infections than current treatment methods relying on eyedrops.
Throughout the project the researchers, who will collaborate with companies with experience of hydrogel synthesis and contact lens manufacture, will also investigate if the bacteria and fungi species develop resistance to the new hydrogel, with or without drugs.
UK research leads the way
The UK is a world-leader in AMR research, supporting a huge variety of research in the field. This is a complex problem, which requires complex solutions, and the multifaceted nature of UK research reflects this.
There’s no single magic bullet when it comes to resistance, and we’ll need to draw on the efforts of policy-makers, clinician and individuals if we want to see profound, long-term improvement. But one thing is for sure: if we’re to overcome the challenges posed by AMR, we’ll need a unified approach that draws on an array of innovative and pioneering research.