With antimicrobial resistance increasing, bioMérieux has committed significant resources to combat it. Labs are critical to this mission.
By Chris Wolski
Antibiotics were the miracle drugs of their age. Infections that once killed with abandon could be effectively treated with a pill or an injection. However, with the increased use of antibiotics, the pathogens that they were designed to combat fought back and now antimicrobial resistance has become a real and growing crisis for health care professionals.
CLP recently interviewed Kristen Smith, senior medical science liaison at bioMérieux, about why antimicrobial resistance should be a concern, how labs can be at the vanguard of identifying both the resistant pathogens and potential treatments, and why bioMérieux is committing significant resources in this fight.
Smith’s answers have been edited for length and clarity.
CLP: How prevalent is antimicrobial resistance and why should the medical community and public be concerned?
Kristen Smith: If you test for AMR in a population, you will likely see it and from that perspective it is very prevalent. We see it in bacteria and fungi. We also know that rates of resistance are increasing. The medical community and the public alike should be very concerned about an issue that has been termed the silent pandemic. Not only is AMR concerning from the perspective of known infections, without antibiotics we lose the ability to perform other treatments such as chemotherapy and joint replacements.
CLP: What role can labs play in helping to combat antimicrobial resistance?
Smith: Labs are an essential part of the puzzle for combating AMR, they are the alarm for this silent pandemic. Without their expertise, we could not identify the pathogens and gain insight into possible effective treatment options. They are responsible for staying up to date on regulatory requirements, including those that enhance our understanding of what therapies are most effective for what infection. Our labs also analyze their data so they can share resistance profiles, also known as antibiograms, to the clinicians at their institution. This local data can be helpful in guiding empiric treatment and increase the likelihood that patients will get on the most appropriate antibiotic in a timely manner. By collaborating with clinicians and pharmacists, the labs also help to combat AMR through participation in antimicrobial stewardship committees.
CLP: It’s my understanding that bioMérieux has dedicated significant resources to researching diagnostics tests in the fight against AMR—why is this a priority and not another condition or disease?
Smith: AMR is a threat to public health at a global level. Prior to 1940, infectious diseases were the leading cause of death. After the advent of antibiotics in the 1940s, that shifted to heart disease and cancer. It’s easy to forget how deadly infectious diseases are when you have easy access to antibiotics and see loved ones facing other health challenges. However, AMR could impact our ability to treat something as minor as a papercut, let alone transplants, implants, or many other medical interventions. In fact, there are estimates that if we do not make strides in the fight against AMR that infectious diseases will be the leading cause of death again by 2050.
CLP: bioMérieux has tests already that can help with rapid, precise diagnostics that can identify infections. How do these work and how are they helping to combat antimicrobial resistance?
Smith: From the simplest perspective, our tests can help answer the question of whether or not the genetic material of an organism known to cause infection is present in a sample. They can also detect antimicrobial resistance at a molecular, or genotypic, level for some resistance genes. This data can allow clinicians to get their patients on effective therapy in a matter of hours, which contrasts with standard culture-based, or phenotypic, methods. We are also working to decrease the amount of time that phenotypic methods take as well because timing is everything. One way to limit AMR is to get patients on the most narrow-spectrum antibiotic as soon as possible.
CLP: Certainly, antimicrobial resistance is an important medical issue we need to be concerned about—and there’s been a lot of bad news around these infections. Is there any good news in general and for laboratories in particular?
Smith: The good news is that there have been amazing innovations in the clinical microbiology labs in the past 10 years, and I am confident that it is a trend that will continue. New methods are being developed each year that are providing faster and more accurate results that will aid in patient care and improve treatment outcomes.
CLP: During a press conference bioMérieux hosted during the recent AACC Scientific Meeting, one of the presenters quoted the CDC: “Diagnostics can be just as critical for fighting infections as antibiotics.” I think we can all agree on that point broadly, but specifically for antimicrobial resistance, in the long-term, is testing really the key to fighting AMR? Where do you see this campaign in five years?
Smith: Microorganisms are living and have been for a very long time, long before humans were around to infect. They can adapt by changing their genetic material and sharing it with each other. They also reproduce very quickly, sometimes in mere minutes. This means that they are worthy adversaries with many survival strategies.
AMR is not just a problem to humans, but to animals as well. There are now calls to have a One Health approach to combat AMR, which considers not only human health, but animal and environmental health as well. That means that our diagnostics must be versatile as well, because without diagnostic testing, we are just guessing.
In five years, I hope to see diagnostics that are as adaptable as the “bugs” that challenge us. Tools that can be deployed for both humans and animals and are affordable for any type of lab. Devices that include the newest antimicrobials through collaboration with our partners in the pharmaceutical sector. I hope to see this campaign moving in a direction that will ensure we never again face a world without antibiotics.
Chris Wolski is chief editor of CLP.