Diagnostics: A crucial tool in the ongoing public health battle with antimicrobial resistance

Global, inevitable threat 

AMR, which WHO has described as a “threat to the cornerstone of modern medicine”, occurs when microorganisms, such as bacteria, viruses, parasites, and fungi develop resistance to antimicrobial agents they were once susceptible to.

This is not something that we can stop, but there is much the healthcare community can do to slow its march. As a new joint progress report from the Global AMR R&D Hub and WHO states, we need to "think ahead and act together”.

Wanted: Global effort 

The report, published in May 2023, said the current pipeline of just 77 agents in clinical development, was “insufficient” to tackle the challenges we face.

“Most are derivatives of existing antibiotic classes with well-established mechanisms of drug resistance, and the majority are unlikely to make it to market,” said the paper, calling on G7 countries to deploy “innovative financing measures” to improve market conditions and stimulate activity.

However, with some degree of AMR being inevitable, new antimicrobials are only part of the solution. Stewardship, or preserving the lifecycle of existing antimicrobials by only using them at the right time, in the right patient, at the right dose, is crucial. 

The WHO’s 2015 Global Action Plan acknowledged this and spoke about the need to optimize the use of antimicrobial medicines in human and animal health. The misuse and overuse of antimicrobials are the main drivers of drug-resistant pathogen development, but diagnostics can be used to guide tailored, right-first-time treatment plans.²

Antimicrobial susceptibility testing (AST), for example, can quickly and accurately determine a pathogen’s susceptibility to a given agent. Clinicians can then use these results to make informed drug selection, dosing, treatment duration, and escalation or de-escalation decisions.

Since the WHO action plan was published, numerous national initiatives, as well as stewardship programs at site, setting, and regional levels, have reflected the key objectives it set out.  Yet, as shown by the Global AMR R&D Hub and WHO progress report, we have some way to go before we declare the mission accomplished.

A focus on diagnostics  

As a healthcare community, we all must play our part in fighting this ongoing battle, in which resistant pathogens will continue to emerge. At Thermo Fisher Scientific, our contribution is diagnostics – and we take it seriously.

The Thermo ScientificTM SensititreTM AST platform, for example, delivers definitive minimum inhibitory concentration (MIC) results. An MIC, or the lowest concentration of an antimicrobial that will inhibit the visible growth of a microorganism after incubation, is a quantitative method of AST that can help ensure existing antimicrobials are used only when necessary, and in the smallest possible doses. 

Accuracy, then, is essential, but commercially available systems that use algorithms to extrapolate results from an incomplete dataset have no way of recognizing new kinetic models of growth – and, therefore, inevitable new resistance mechanisms. 

The Sensititre System, which uses microbroth dilution to closely align to the gold standard reference method, is different. It generates observable, quantitative, endpoint results – even if the isolate behaves unpredictably in the presence of antibiotics. 

We also work closely with our pharmaceutical partners during clinical development to ensure new agents can make the leap from bench to bedside as quickly as possible. We were the first, for example, to include cefiderocol testing solutions in our routine ancillaries.

Crucially, flexibility is central to our offering. More than 300 antimicrobials, on standard and customizable MIC plates are available, allowing laboratories to tailor testing solutions to their local formulary and requirements. We also offer a broad range of simple-to-use, manual Thermo Scientific™ Oxoid™ AST discs, including many of the latest antimicrobials.

Learn more about how our One Health solutions for clinical microbiology help to fight against antimicrobial resistance

Visit the One Health & Clinical Microbiology page

References

1. Global AMR R&D Hub & WHO. (2023). Incentivising the development of new antibacterial treatments 2023. Available at: https://cdn.who.int/media/docs/default-source/antimicrobial-resistance/amr-gcp-irc/incentivising-development-of-new-antibacterial-treatments-2023---progress-report.pdf?sfvrsn=72e4f738_3  Last accessed: 31 July 2023.
2. WHO. (2015). Global Action Plan On Antimicrobial Resistance. Available at: https://www.who.int/publications/i/item/9789241509763 Last accessed: 31 July 2023