Breakthroughs Blog: Antimicrobial resistance

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign-up now to receive our weekly R&D News Roundup email. In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Researchers discovered that the meal times of malaria-infected organisms may impact the rate at which the malaria parasite multiplies in the host’s blood. A team at the University of Edinburgh studied the parasitic rhythms of reproduction and invasion of red blood cells in malaria-infected mice and found that the parasites timed their daily multiplication rhythms to match when the animals were fed. When the mice’s feeding time changed, the parasites altered the timing in which they invaded red blood cells. Researchers believe that interfering with the biological processes that link eating to these parasite rhythms—through diet, drugs, or other approaches—could reduce the spread of malaria infection A team of scientists recently created a prototype oral flu vaccine that does not need to be temperature controlled—paving the way for potential new oral vaccines that do not require refrigeration or freezing. Unlike traditional biological vaccines, which are made from part of a virus or bacteria and must be temperature controlled to remain stable, this oral vaccine prototype contains manmade peptides that mimic peptides in real viruses. Scientists found the prototype triggered a strong immune response when tested in human cell cultures and in mice. While more research is needed, these early results are promising. A heat-stable oral vaccine would be easier to transport and store, which could improve care in low-resource, hard-to-reach communities were immunization supply chains may be insufficient. Scientists at the Jena and Friedrich Schiller University Hospital are working to develop a rapid antibiotic resistance test. Current diagnostics for drug-resistant infections can take up to 72 hours to deliver results—a long amount of time for these infections, which can be acutely life-threatening. Using light-based analytical methods combined with microfluidic sample processes—which the researchers colloquially referred to as a miniature Lab-on-a-Chip system—the scientists were able to clearly identify bacterial strains and their resistances in fewer than three hours. New rapid tests for antibiotic-resistant infections could help get patients on treatment more quickly and reduce the overprescription of antibiotics.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign-up now to receive our weekly R&D News Roundup email.  In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Using a new research platform that extracts DNA directly from soil, researchers at Rockefeller University have discovered a new class of antibiotics. Scientists have long seen soil as a potential untapped source for new antibiotics; however, tapping this resource has proved challenging because only about 1 percent of bacterial species in soil can be cultured in labs. This new discovery platform is culture-independent. It allows scientists to extract, clone, and sequence DNA from the soil without growing bacteria in the lab. Researchers are hopeful this new platform can be scaled to systematically search for new antibiotics in the environment. With recent advances in gene therapy techniques, researchers are looking at the potential of these techniques to improve treatment for those living with AIDS and cure the disease. Scientists have used gene-editing tools to cut DNA at the exact spot to disable the HIV entryway gene both in immune T cells and blood stem cells. While the results of these initial experiments were less promising than researchers had hoped, there was a silver lining: Patients saw a decrease in the number of cells where the HIV virus lurked in a dormant state. Thus, researchers are looking at the potential to pair altered cells with existing antiretroviral medicines to improve the body’s ability to eliminate the virus. Scientists are also looking at the potential to use gene editing to introduce new genes that would help T cells recognize and kill HIV, similar to therapy introduced last year to treat cancer. Aeras announced resultsfrom an innovative clinical trial that provides new encouraging evidence that tuberculosis (TB) vaccines could prevent sustained infections in high-risk adolescents. A prevention-of-infection phase 2 trial in South Africa demonstrated that revaccination with the Bacille Calmette-Guerin vaccine significantly reduced sustain TB infections in adolescents. Another experimental vaccine candidate, H4:IC31, also reduced sustained infections, although not at statistically significant levels. However, these results mark the first time a subunit vaccine has shown any indication of ability to protect against TB infection or disease in humans.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Novartis has launched patient testing of a new anti-malaria compound with the hopes of staving off the development of further drug-resistance. The experimental compound—KAF156—will be tested in combination with another medicine in children and adults across nine countries in Africa and Asia over the next few months. In recent years, there have been increasing reports of malaria parasites that have become resistant to the standard treatment regimens against malaria, spurring the need for new treatment options from different classes of antimalarial compounds. Novartis expects to complete phase 2b studies of the compound by late 2019. It remains too early to tell whether the product will eventually reach market. A strain of gut bacteria taken from the diaper of a baby could hold promise in saving the lives of thousands of newborns in poor regions. Scientists conducting a large clinical trial in India found that babies who were fed a probiotic strain of Lactobacillus bacteria for a week were 40 percent less likely to develop a deadly infection called sepsis, which kills 600,000 newborns per year in India and other nearby nations. Babies who took the probiotic also had fewer cases of pneumonia, diarrhea, and ear infections. Researchers believe this probiotic—which costs only US$1—could be a “game changer” in advancing the health of infants in poor nations. Scientists at Harvard University are genetically engineering relatives of Mycobacterium tuberculosis (TB) in the hopes if speeding development and clinical trials to develop a better TB vaccine. The only currently available TB vaccine is partially effective in children and performs poorly in adults, so scientists are working to develop other vaccine candidates. However, performing clinical trials on vaccines is challenging because a typical clinical trial involves observing large numbers of people over long periods of time to monitor results in a small subset of people that naturally come into contact with the microbe. Alternatively, “challenge studies” infect people on purpose, so are faster and less expensive, but these studies are only possible if the disease can be detected and treated easily. TB can take time to detect and many months to treat, so is not appropriate for this type of study. The team at Harvard is working to genetically modify TB so it can be safely given to people as part of challenge trials, and thus help speed vaccine development. 

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Nearly three-fourths of new and emerging human diseases are zoonoses, animal diseases that spillover into humans. Now, scientists are reporting “spillback” of human diseases into monkey populations in South America, as Zika virus becomes endemic and as Brazil faces its worst yellow fever outbreak in years. Human strains of Zika have been found in black-striped capuchin monkeys and marmosets, a concerning trend as these species could become a reservoir for the virus. Capuchins are often kept as pets, employed as street entertainers, or hunted as meat, and these routine interactions could lead to future human outbreaks. Meanwhile, Brazil’s yellow fever outbreak has killed nearly 70 people and more than 600 monkeys, threatening rare and endangered species in the Atlantic rainforest. Researchers at the University of Southampton have designed miniscule 3D spheres that can simulate conditions inside the human body, an exciting development that could help scientists better understand how pathogens interact with human cells. The researchers created one such sphere with a collagen matrix, similar to the makeup of human lungs, to study antibiotics that target and kill the tuberculosis bacterium. The 3D spheres can be used four times longer than existing 2D systems, enabling researchers to monitor the progression of infections over time. Colistin is often the last line of treatment for multidrug-resistant infections, however, its use as a growth promoter for livestock in China has led to the development of colistin-resistant bacteria on chicken farms. While colistin resistance was first reported in China in 2015, it has now spread to 25 countries across four continents. Scientists have discovered a specific gene (mrc-1) that confers resistance to colistin and that can be easily spread between bacteria. Now, a new study has revealed that mrc-1 is much more prevalent than previously believed. The gene was found in nearly all bacteria collected from chicken farms in China, even though only half of the samples proved resistance to colistin. The findings also suggest that flies may be accelerating the spread of colistin resistance by transporting resistant bacteria from farms to surrounding communities. A cocktail of three bacteria-killing viruses could provide rapid protection against cholera, filling a critical need during outbreaks, as vaccines do not provide protection until approximately two weeks after administration. The technique is known as phage therapy as it utilizes bacteriophages—viruses that target and kill specific bacteria. While phage therapy has been around for nearly a century, it was largely eclipsed by the advent of antibiotics, but has gained increasing attention in recent years in response to the growing threat of antimicrobial resistance. To develop the regimen, researchers at Tufts University School of Medicine first identified phages that target the cholera bacterium, and then narrowed their focus to those that can survive and function in the human small intestine, where cholera infection takes place. Animal studies suggest that the cocktail could prevent infection when taken just three hours prior to exposure. The research team has established an independent company, PhagePro, and plans to further test and develop the therapy.