Today marks the start of World Antimicrobial Awareness Week 2020. This annual event, organised by the World Health Organisation (WHO), aims to increase global awareness of antimicrobial resistance in order to stop the spread of drug-resistant infections. The theme of this year’s campaign is “united to preserve antimicrobials.”
Antimicrobial resistance happens when microbes such as bacteria and viruses adapt over time and, as a result, the drugs designed to treat their infections are no longer effective. This is primarily caused by the misuse and overuse of antimicrobials in humans and livestock. Some strains of microbes, known as ‘superbugs’ have now developed resistance to multiple types of antimicrobial drugs making them extremely difficult to treat.
The emergence of antimicrobial resistance means in the future, bacterial infections that are currently treatable may be deadly. Antimicrobial resistance will also threaten the safety of routine medical procedures that depend on antibiotics to prevent infection. It is therefore no surprise that the WHO have named antimicrobial resistance as one of the top ten global health threats facing humanity.
The NIBSC is rising to the challenge of antimicrobial resistance by supporting the development of novel vaccines, diagnostics and treatments. Together with our collaborators, we are undertaking a number of different standardisation and research activities as outlined below.
1) Developing reference materials for new vaccines
Vaccines can prevent many bacterial and viral infections, reducing antibiotic usage in the clinic. The NIBSC is a world leader in the production of biological reference materials, including WHO International standards. These are used by vaccine manufacturers and regulators to calibrate the assays used for vaccine quality control testing. They also play a key role in standardising assays which enables data from clinical trials to be easily compared and facilitates the path to regulatory approval.
The institute has developed or is developing standards for novel vaccines against drug-resistant bacteria, including five out of the eight types featured on the WHO top priority list. For example, our scientists are currently working on standards for the lipopolysaccharide (LPS) O-antigen of invasive non-typhoidal salmonella as well as the development of reference serum for shigella and group B streptococcus vaccines. A project aimed at producing standards for a new inactivated oral cholera vaccine is also underway.
2) Developing assays to characterise vaccine candidates
The NIBSC also supports new vaccines for drug-resistant bacteria by developing assays that are used to evaluate vaccine quality, safety and efficacy.
We have recently validated a new standardised assay for detecting typhoid antibodies. This Vi-PLL ELISA was found to be a suitable alternative to an existing commercial test meaning that there is now a reliable and freely available bioassay that can be used by scientists all over the world to evaluate typhoid vaccines currently in development. Additionally, we previously validated a cell-based test for meningitis B vaccines to replace existing methods that require the use of animals. The development of this test to assess new bacterial vaccines is ongoing.
3) Conducting early stage research into new vaccines
The NIBSC is involved in multiple research projects that support new vaccines in the early stages of development.
One such project is focused on a novel genetically engineered vaccine for group A streptococcus. Our scientists are investigating whether a new delivery method can enhance the protective immune response generated by this vaccine. They are also performing tests to establish the optimal dose. The findings of this research will eventually help to guide clinical trial protocols.
4) Developing reference materials to support accurate diagnosis
The accurate diagnosis of infectious diseases can help stop the spread of antimicrobial resistance by preventing the inappropriate prescription of antimicrobial drugs.
The NIBSC produces a wide range of quality control materials that can be used by clinical laboratories to rapidly identify different types of infection and support accurate diagnosis. Work is in progress to develop a panel of controls for nucleic acid amplification tests (NAAT) used to diagnose common sexually transmitted infections including gonorrhoea and chlamydia.
5) Researching novel therapies
Finally, the NIBSC is helping to combat antimicrobial resistance by researching novel therapies. One such treatment, known as faecal microbiota transplantation (FMT), is known to be highly effective against drug-resistant C. difficile infection. Our scientists are conducting experiments in order to better understand the mechanism behind this.
We are also contributing to the FERARO clinical trial which is investigating whether FMT can be used to eliminate multi-drug resistant microbes from the intestine and we have developed microbiome standards to support this analysis.
If you are interested in finding out more about our work related to antimicrobial resistance, please view our science and research pages or contact us by email.
Further resources related to World Antimicrobial Awareness Week are available from the WHO website.