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Vol 23, No. 11, November 2019For e-subscribers (PDF)
COLUMNS
Tackling Antimicrobial Resistance
The number of deaths caused by antimicrobial resistance is projected to reach 10 million people yearly by 2050. This will translate into significant impact on public health and world economies if measures are not taken.
by Deborah Seah

Antimicrobial resistance (AMR) is a major public health threat, affecting the efficient use of current treatments for infections caused by microbes. Based on a report by the World Health Organization (WHO), the insufficient development of new antibiotics will fuel the growing threat of antimicrobial resistance.

In an effort to play a proactive role in combatting AMR, Singapore’s National Research Foundation launched one of its key initiatives known as Singapore-MIT Alliance for Research and Technology Antimicrobial Resistance Interdisciplinary Research Group (SMART AMR IRG). This research group aims to address the need for innovative technologies to neutralize the effects of rapidly increasing antimicrobial resistance.

An area of focus for SMART AMR IRG is the development of quicker and cost-effective diagnostic methods to identify causes of infection, reducing the inappropriate prescription of antibiotics. Enlightening us on their research is Dr. Hadley D. Sikes from SMART AMR IRG.

Dr. Hadley D. Sikes is a tenured associate professor of chemical engineering at the Massachusetts Institute of Technology (MIT) and a Principal Investigator in the Antimicrobial Resistance Integrated Research Group within SMART, MIT's research enterprise in Singapore. She leads a team of researchers in the application of engineering design principles to identify molecules and invent technologies that are useful in detecting and classifying pathogens, with careful attention to device integration, stability, and scalability.

Antimicrobial resistance can spread in a few ways and can have dire implications on disease management and health outcomes.

  1. Bacteria spreads AMR through exchange of DNA fragments with on another containing genes that code for proteins that help them to evade antimicrobial drugs, making them resistant to the drugs. This can occur within the bacteria in our bodies or microbes in the environment.

  2. When microbes are exposed to antibiotics, they will kill off all the bacteria that do not carry the resistant genes, leaving only the bacteria with the resistant genes. The ones that are left will then continue to multiply and the same antibiotic will not be effective anymore.

  3. The use of antibiotics in farming and agriculture that may not have a direct impact on human health, but it will increase the prevalence of resistance genes in the environment.

  4. The misuse of antibiotics is another cause of AMR resulting in the population of bacteria containing the resistance genes in the patient’s body.

Dr. Hadley highlighted the importance of engaging clinicians in the research and development process to gain insight to the pressing needs and gaps to address AMR. Having gone out to interview clinicians from various medical institutions in Singapore, she explains that one of the needs is a diagnostic test that they could use while the patient is in the office that could identify whether the infection is viral or bacterial. Another was a request for a rapid diagnostic test for carbapenem-resistant Enterobacteriaceae (CRE) which is one of the most common form of AMR in Singapore.

The research team at SMART AMR aims to deliver clinical diagnostic solutions for tackling AMR and commercialize them for clinical use. As such developed an interdisciplinary approach for the development process, engaging with clinicians who will be prescribing the diagnostic tests and how it will fit into their workflow as well as having biologist onboard has allowed the team to have a well-rounded understanding of AMR and how to best formulate solutions for it.

“We are working on understanding new resistance mechanisms and then designing new therapeutic approaches corresponding to those mechanisms.” Explains Dr. Hadley.


Dr. Hadley D. Sikes, Principal Investigator at SMART AMR IRG


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