Antimicrobial resistance (AMR) is a global health crisis. It is predicted to cause 10 million deaths annually by 2050 and add $1 trillion in healthcare costs. To combat this, the £8 million Longitude Prize on AMR, launched in 2013, encouraged the development of rapid, accurate point-of-care diagnostics for bacterial infections to reduce unnecessary antibiotic use.

Sysmex Astrego's Breakthrough.

Sysmex Astrego won the Longitude Prize for their PA-100 AST System. This system can diagnose urinary tract infections (UTIs) in just 15 minutes and identify the correct antibiotic within 45 minutes. This could significantly reduce "just in case" prescribing, a major contributor to AMR.

Biofilms can cause infection with urease producing bacterial species including Providencia rettgeri, P. vulgaris and P. mirabilis. This can cause a blockage at the catheter site.

As these catheters are no longer sterile, if a urine sample is taken, the urine may be contaminated by the catheter. This bacteria may not be necessarily causing the UTI and the patient may be started on antibiotics unnecessarily. One way to control the distribution of antibiotics in this case is to only process catheter samples from GPs and external sites if there are clinical detail on the form indicative of a UTI. But clinical details are not always provided so the next step would be to ensure a 100% antimicrobial coating on all devices inserted into the body.

Here is how the introduction of graphene coatings or tips on medical devices such as catheters may combat the challenge of antibiotic resistance:

Most infections occur in connection with the use of various medical technology products, such as catheters, hip prostheses, knee prostheses, and dental implants, where bacteria can enter the body via a foreign surface.

Chalmers researchers have explored how graphene technology can contribute to the fight against antibiotic resistance and infections in healthcare.

The team has previously been able to show how vertically standing graphene flakes prevent bacteria from attaching to the substrate. Instead, the bacteria are cut to pieces on the razor-sharp flakes and die.

Ivan Mijakovic, Professor of Systems Biology at Chalmers University of Technology, explained: “We are developing a graphene-based, ultra-thin, antibacterial material that can be applied to any surface, including biomedical devices, surgical surfaces and implants to exclude bacteria.

“Since graphene prevents bacteria from physically attaching to a surface, it has the added advantage that you do not risk increasing antibiotic resistance, unlike with other chemical alternatives, such as antibiotics.”

There is still a lot of research to be done in order to apply the graphene onto medical devices and the orientation of the graphene so that it is bactericidal and works effectively.

Key findings:

• High bactericidal effect: Graphene technology can kill up to 99.9% of surface bacteria.

• Orientation challenge: Controlling the orientation of graphene flakes has been a hurdle for practical applications.

• Magnetic field solution: Researchers have developed a method using magnetic fields to control graphene orientation.

• Potential applications: The new technology has promising applications in healthcare, batteries, supercapacitors, sensors, and packaging materials.

The breakthrough:

• By using a "Halbach array" of magnets, the researchers were able to induce a uniform orientation of graphene flakes.

• This uniform orientation led to a highly effective antibacterial surface that could be applied to medical plastics.

Benefits:

• Reduced infections: The technology could help reduce healthcare-associated infections.

• Improved patient outcomes: Fewer infections would lead to less patient suffering.

• Combatting antibiotic resistance: This could be a valuable tool in the fight against antibiotic resistance.

  
  

https://www.innovationnewsnetwork.com/new-graphene-technology-can-aid-the-fight-against-antibiotic-resistance/51393/

The university of British Columbia have recently published a paper in the American Society for Microbiology Journal 'Microbiology Spectrum' on a novel semi-synthetic compound which produces potent activity against Mycobacterium tuberculosis including the multi-drug resistant strains.

M. tuberculosis is the causative agent of TB, which is the leading cause of bacterial infection related death worldwide. The current antibiotic treatments are susceptible to antibiotic resistance.

Sanguinarine is a compound found in a herbacious flowering plant in North America. It usually has toxic affects on humans, but researched have redesigned the compound (BPD-9) for reduced toxicity and stronger antibacterial properties.

In tests in in-vitro and in mice it was found to be capable of killing strains of M. tuberculosis that are resistant to all front-line antibiotics. It also is effective at killing dormant and intracellular M. tuberculosis which has been difficult to treat in the past.

researchers have found this BPD-9 is only active against pathogenic bacteria and don't have the microbiome and other flora. More research will need to be done, but it looks though it could be a potential treatment to this worldwide disease.

10.1128/spectrum.01246-24

Genes associated with antimicrobial resistance (AMR) can be passed from one microbe to another via circular DNA molecules known as plasmids, a process that often occurs within the gut. Researchers in Iowa report that dietary zinc supplements might block the transmission of certain AMR plasmids.

The human gut has been proposed as a reservoir for the lateral transfer of antimicrobial resistance and virulence genes in bacteria through plasmid conjugation. In this study, the effect of dietary zinc supplements on the incidence of plasmid conjugation in vitro was studied. Supplement effects were analyzed through standardized broth conjugation assays.

The avian pathogenic Escherichia coli (APEC) strain APEC-O2-211, which carried a multidrug resistance plasmid, served as the donor, while the human commensal E. coli HS-4, which had no plasmid, acted as the recipient. The bacterial strains were standardised, mixed them in equal parts, and either water or zinc (from commercial supplements or zinc gluconate) was added at various concentrations. Their results showed a significant drop in plasmid transmission in bacterial strains treated with zinc, and higher zinc levels corresponded with further reductions.

From this experiment, Dr. Melha Mellata, a microbiologist and senior study author from Iowa State University and her team discovered zinc’s ability to inhibit plasmid transfer, and at low doses, it has minimal impact on gut bacteria. This finding is significant, as eradicating gut bacteria could harm the microbiome and negatively impact health. “By simply preventing plasmid transfer, we could slow the spread of antimicrobial resistance without disrupting beneficial gut bacteria.”

This outcome was intriguing, as previous studies had suggested that heavy metals might actually stimulate plasmid conjugation. To better understand zinc’s unique effects, the team used qPCR to analyze the genetic mechanisms involved. They found that zinc induced overexpression of replication genes to such an extent that it likely caused an overload, inhibiting the process. While zinc promoted certain conjugation-related genes, it suppressed key proteins needed for constructing the bacterial structures used in conjugation, effectively halting transmission.

While the exact mechanism of zinc antimicrobial action is unclear, the accepted mechanism is the dissociation of zinc derivatives into charged zinc ions (Zn²⁺) in the gut; charged zinc ions then readily react with cellular components to form reactive oxygen species (ROS). Generated ROS further interact with extra- and intracellular molecules, which leads to cell membrane damage, leakiness, and reduction and damage to sugars, proteins, and nucleic acids.

Further studies are required to determine the applicability of this approach in an in vivo model. Next steps for this research include testing zinc’s effect on plasmid transfer involving other AMR genes and experimenting with animal models to verify these findings in living systems.

Dr. Mellata is optimistic that such an affordable and widely available supplement like zinc could contribute to countering the AMR crisis.

The findings from this study showed that there were 10,557 cases (81.8% in 2024 alone), which is a 58.8-fold increase over the annual median (2015–2023). The 2024 outbreak was initially confined to North Brazil; however it expanded to all 27 federal units. The majority of those affected were between the ages of 20 and 59. When compared to the BeAn19991, this new reassortant strain (AM0088) demonstrated increased virulence and replication rates. The AM0088 virus clustered with related strains from Brazil, Peru, and Italy based on genomic research. Antibodies from prior OROV infections neutralized the AM0088 strain to a limited extent. Mouse models revealed similar results, with less cross-protection between the new and old strains. Peaks in cases coincided during the rainy season. This indicates that weather-related factors including humidity and temperature may have played a role. New cases appeared in historically unaffected regions such as Bahia and Rio de Janeiro, and internationally.

The study emphasizes how critical it is to improve molecular surveillance, create vaccines, and use OROV in the differential diagnosis of febrile illnesses. The results highlight the risks to naive populations across the Americas and beyond.
Gaps in historical data, a lack of information on health-seeking behaviour, and difficulties differentiating OROV from related arboviruses like dengue and chikungunya are some of the study's limitations. Future research should focus on understanding viral fitness, immune responses, and the broader public health impact.

https://doi.org/10.1016/S1473-3099(24)00619-4

Rapid AST is a developing aspect of the microbiology laboratory and on average most ASTs take 18-24hrs with the exception of some rapid AST methods from blood cultures.

Their approach combines fluorescence microscopy with Convolutional Neural Networks (CNNs), a type of AI, to analyze bacterial subcellular structures in the presence of antibiotics. The study examined four antibiotics—ciprofloxacin, gentamicin, co-amoxiclav, and rifampicin—each representing different mechanisms of action.

In their method, E. coli cells of varying resistance to the antibiotics were stained and these cells were exampled with a two step deep learning process (AI) which detected any potential phenotypic changes and then listed the isolates as resistant or susceptible. The authors achieved a single-cell classification accuracy of 80% across the four antibiotics and demonstrated that their approach can provide results equivalent to traditional AST in just 30 minutes. The method also enables the prediction of the minimum inhibitory concentration (MIC) of antibiotics based on phenotypic changes in the cells.

Obviously there was limitations to the study such as a single bacterial type and only four antibiotics tested however this breakthrough is a great start in regards to further research with the method and if all goes well there is definitely potential future clinical applications for this sort of technology.