Inter-disciplinary work underway at the Northern Ireland Antimicrobial Resistance Network is ensuring joined up thinking on this important issue.
The threat of antimicrobial resistance (AMR) is an increasingly serious global public health issue which jeopardises the effective prevention and treatment of infections. From a food safety perspective, antibiotics are used in food animals not only for treatment, but also for disease prevention and growth promotion in some non-EU countries. The World Health Organisation and other international bodies have recognised that antimicrobial use in animals contributes to resistance problems in human health. Foodborne infections caused by resistant bacteria, such as Salmonella and Campylobacter spp., pose a particular risk to human beings because of possible treatment failure. Resistant commensal bacteria, such as Escherichia coli and Enterococcus spp., also pose a risk, as they can carry resistance genes that can be further transferred to human pathogens.
As Dr Patrick Dunlop – Chair of the Northern Ireland Antimicrobial Resistance Network – explains, it is a ‘One Health’ issue. “This big problem of antimicrobial resistance joins everyone together. It links human health, animal health and the environment because our ecosystem is one continuous circle.”
Patrick, a lecturer at the School of Engineering in Ulster University, says: “Antibiotics were developed and commercialised back in the 1940s and 1950s very successfully. As new compounds were introduced, people stopped using the old ones and we were able to keep one step ahead of the bugs. However, this pipeline dried up and there have been no new classes of antibiotics in 30 years. This is a big problem. Bacteria have developed resistance against low levels of antibiotics used in human medicine – and in many cases they can share their resistance traits. Bacteria sitting beside each other ‘shake hands’ and physically exchange genetic elements encoding resistance - referred to as horizontal gene transfer. These natural exchanges, along with random mutations, can develop quickly due to the speed that bacterial organisms replicate. This advantageous trait is carried on as well - it's natural selection". Patrick highlights that antibiotic development has gone out of fashion in the pharmaceutical industry: thee is not enough return on antibiotics to develop new compounds.
In addition, he says an increase in the use of growth promoters in human and animal systems in other nations is contributing to this problem, "and with Brexit we may not have the protection we currently have with imports".
The Northern Ireland Antimicrobial Resistance Network started as an unsuccessful grant proposal - "I had applied for a multidisciplinary grant. It wasn't successful but then I realised that I had a group of people gathered together from government departments, academia and industry who were keen to address AMR issues so we decided to meet up anyway". The first meeting was in April 2015. Patrick anticipated 20 people turning up and 50 arrived. "There turned out to be a real appetite for a cross disciplinary approach to tackle AMR. Getting people from all areas – medical, veterinary, academics, industry – meant that we could address the real problems on the ground. It was also a great way to meet people working in different fields. The island of Ireland is a small place and these connections are a big strength for the network’s aims. We are all working under the same ‘one health’ banner and meetings allow for opportunities to learn and share collective thoughts and expertise.
“From an academic point of view, it is really interesting for me. There is really good crossover between the sectors, which helps me to expand out different applications of technology,” he continues.
The Network has grown since that first meeting, from 50 to 200 members. The aim of the network is to address the threat of AMR and allow for joined up thinking which is mostly achieved through formal workshops, meetings and via social media. “The interdisciplinary approach is at the heart of what we do. We have representatives from a range of organisations who are heavily involved. On the clinical side, the network includes lab scientists, doctors, nurses and the whole sphere of people working in infection control.” Vets and veterinary consultants, pharmacists and health care workers who look after medical management are also involved and the Network looks to address common issues between human and animal medicine.
For industry, some of the largest food companies on the island of Ireland are members, while academics in every shape and form are involved from both Northern Ireland institutions, including chemical engineers, microbiologists, environmental scientists and psychologists. “On the computer side of things, storing information, examining animal and human health care data and predicting where problems might arise in order to come up with solutions is also key to addressing AMR.”
Patrick points out some of the progress that has been made by the network. “Firstly, we’ve identified commonality between companies and organisations that may have appeared to be in competition before. Now they are working together towards a common goal. We have actively encouraged companies to work together on early research at competence centres funded by Invest NI, such as AgriFood Quest. Projects have come out of the Network into funded structures such as these, while from an academic point of view, the Network has been indirectly involved in bringing in €50m of EU funded projects and £15m from UK Research Councils, where we can act as a route for dissemination for these proposals. We try to have funding at the heart of our agenda and encourage companies to become involved in R&D.”
ABOUT PATRICK
Hobbies/Interests: If I’m not looking after my kids, it’s rugby – I’ve had to stop touring around Europe following Ulster rugby but I still make it to Ravenhill for the home games.
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