We need to EMBRACE engineers in the fight against HCAI and AMR

Embrace logo ok

I attended the first EMBRACE seminar today at Imperial College London. EMBRACE (Engineering, Medicine, Natural Sciences and Physical Sciences Bridging Research in Antimicrobial resistance: Collaboration and Exchange) is a gap-bridging collaborative aiming to bring together Engineers, Scientists, Doctors, and others to find new ways to address AMR and tackle HCAI. I thought I’d share some of my highlights from the seminar.

The keynote lecture was delivered expertly by Prof Paul Tambyah from Singapore. (I have recently published a paper with Paul on reducing VRE, and so I know what a hard academic task-master he is!) Paul begain by highlighting how advances in medicine are already being held back by AMR – and worse is to come, exemplified by the recent emergence of transmissible colistin resistance. Paul spent some time discussing the necessity of surveillance, particularly in high risk populations (and cleverly likened the ICU to the canary in the coal mine; an early warning of AMR and other emerging microbial threats). The majority of the talk centred around where infection prevention meets engineering: advanced diagnostics, endoscopes, vascular and catheter lines, taps, ventilators, water hygiene…and water heater coolers! (This included reference to a ‘The case against the catheter‘ (from 1958) and some discussion of the challenges of catheterising a mouse. Seriously.) Paul concluded with a somewhat encouraging view of infectious diseases (as we come towards the end of antibiotics), referring to a 1999 MMWR report to illustrate that deaths from infectious diseases in the US were well on the way down before antibiotics or vaccines came on the scene!

The rest of the programme was jam-packed with interesting science:

  • I present some slides on behalf of Dr Ceire Costello about applied data linkage, based on recent discoveries from a CPE screening dataset (that will be presented at ECCMID).
  • Sam Reed (http://www.dnae.co.uk/) outlined DNA Electronic’s vision to miniaturise and simplify genome sequencing tech for point of care applications.
  • Dr Larrouy-Maumus presented interesting work using MALDI-TOF to detect microbes and resistance mechanisms.
  • Dr Frankie Bolt presented another novel diagnostic approach: mass spec with a twist (REIMS).
  • Along similar lines (in terms of application), Dr Myrsini Kaforou described how patterns of gene expression in blood to can be used to detect bacterial infection.
  • Dr David Birch showed us around his seriously cool KPMG Data Observatory (think Minority Report twinned with The Beautiful Mind).
  • Prof Ed Tate highlighted the potential role of protein modification in preventing difficile sporulation, and other ID applications.
  • Dr Martina Valentini presented data on interrupting biofilm formation in Pseudomonas aeruginosa.
  • And finally, Dr Miraz Rahman introduced me to G-quadruplex DNA structures, and their potential to interrupt AMR.

All in all, a very interesting day. There is a great deal of potential and pretty much completely unrealised synergy between experts in engineering and the physical sciences and I hope that EMBRACE and other similar initiatives will lead to fruitful new developments in our fight against HCAI and AMR.

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