In the wake of last week's landmark UN declaration, ARC@Imperial's 2016 conference offered a timely review of its cutting-edge research into AMR.

The ARC@Imperial collaborative consists of over 100 academic experts across the College, whose research is based upon interlinking themes.

The conference brought together a host of world-leading researchers in the fields of antimicrobial resistance and infectious diseases, as well as representatives from government, industry and funding bodies.

As it happened: ARC@Imperial’s 2016 Conference

 - Professor Alison Holmes, Department of Medicine, opened the conference by highlighting the UK’s pioneering role in AMR research, and said that she was “proud to see this work in action at Imperial.”

The first session of the conference centred on updates from ARC’s research fellows:

- Dr Myrsini Kaforou, Department of Medicine, discussed identifying bacterial and viral infection through biomarkers, and the development of a two gene signature to diagnose infections in children.

- Dr Enrique Castro-Sanchez, Department of Medicine, focused on new approaches to increasing global nurse participation in AMR stewardship, and highlighted the benefits of realist reviews of programmes in situ.

- Dr Simren Gill, Department of Medicine, presented work on the identification of novel antimicrobial targets in Pseudomonas aeruginosa, with nine potential targets having been identified as a result of the research.

- Dr Gabriel Birgand, Department of Medicine, then examined AMR governance in different healthcare settings across Europe, and considered how knowledge on antimicrobial resistance should be shared with the general public.

- Dr Johanna Rhodes, School of Public Health, discussed her work using nanopore sequencing to assess outbreaks of drug-resistant fungi.

The keynote lecture was delivered by Dr Mark Holmes (University of Cambridge Veterinary School), and focused on how the natural history of AMR genes can be examined in the animal host through the use of chromosome conformation metagenomics.

The second session looked at data linkage and data visualisation for research and policy:

- Professor Yike Guo from Imperial’s Data Science Institute considered how research data could be harmonised effectively, and demonstrated new visualisation techniques.

- The School of Public Health’s Dr David Aanensen then discussed how actionable data on drug resistance, emergence and spread could be produced, and showcased the potential uses of microreact.org.

- Dr Kris Murray from the Grantham Institute for Climate Change delivered a talk on the spatial and geographic dimensions of infectious disease systems, concluding that outbreak occurrences are still constrained by biogeographic processes despite globalisation.

Session three focused on identifying targets in AMR:

- Dr Luiz Carvalho of the Francis Crick Institute discussed the use of metabolomics to accelerate antibacterial target identification, with a particular focus on treatment of multidrug-resistant tuberculosis.

- Professor Ed Tate, Department of Chemistry, then probed how the host cell modification machinery, rather than the pathogen, could be targeted in order to prevent infection.

- Professor Gad Frankel, Department of Life Sciences, examined pathogen adaptation to the gastrointestinal environment during antimicrobial chemotherapy.

Dr Luiz Carvalho

Professor Ed Tate

The fourth session of the day was centred on understanding the emergence of resistance:

- Dr Jon Otter, Imperial College Healthcare NHS Trust, provided an insight into recent outbreaks of CPE in Europe, highlighting the costs of controlling its emergence at hospital level. In one case study, the bottom-line figure was approximately £1.2 million. Dr Otter stated that the “clear and present danger in our [healthcare] setting is mutational colistin resistance”.

- Dr Andrew Edwards, Department of Medicine, then considered the bacterial factors contributing to treatment failure, in his discussion of a novel mechanism of antibiotic resistance in Staphylococcus aureus.

- NHLI’s Dr Darius Armstrong-James delivered a talk on the global growth of antifungal resistance, concluding that there are clear environmental as well as clinical drivers behind the rapid emergence of azole-resistant Aspergillus fumigatus.

Dr Andrew Edwards

The fifth and final session included discussions on innovation in technology for diagnosis and dosing:

- Dr Jesus Rodriguez-Manzano, Department of Electrical and Electronic Engineering, highlighted the need for new diagnostic tools for rapid and effective treatment of infectious diseases, and scanned the horizon for new technological developments.

- Professor Tony Cass, Department of Medicine and Dr Tim Rawson, Department of Medicine, delivered a joint talk on precision antimicrobial delivery using closed-loop continuous control. Dr Rawson stated that antimicrobial dosing is an “incredibly dynamic process”, with a minority of patients receiving the appropriate dosage.

The conference concluded with a topical panel discussion. The panel members included Professor John Watson, Deputy Chief Medical Officer for the Department of Health, keynote speaker Dr Mark Holmes, Ghada Zoubiane of the MRC, and industry representatives Hideki Maki, Shionogi, and Helen Steel, GSK:

- Professor John Watson underlined the necessity of considering how resource-poor countries can be allowed full access to antibiotics, without causing problems of excess.

- The panel also discussed the impact of Brexit on AMR research, with all agreeing that collaboration would still be essential to future progress in the field.

- In his closing remarks Professor John Watson stated “one country alone clearly cannot deal with this problem [of AMR]”.

- The conference attendees were also given the opportunity to visit the Data Science Institute’s observatory, where Dr Ceire Costelloe demonstrated visualisations of antibiotic prescriptions and patterns of disease in the UK. 

You can find out more about the collaborative and its research interests on the ARC@Imperial website.