SATURN will study the impact of antibiotic exposure on antimicrobial resistance (AMR) with a multidisciplinary approach that bridges microbiological, clinical, epidemiological and pharmacological research. SATURN will improve methodological standards and conduct research to better understand the impact of antibiotic use on acquisition, selection and transmission of antibiotic-resistant bacteria (ARB) in different environments, by combining state-of-the-art analyses of molecular, ecologic and individual patient-level data. The proposed program and anticipated results will help reduce the burden of AMR in Europe and guide both clinical decision making and policy decisions in this area.
SATURN responds to an urgent need, as stated in the EU Council conclusions (June 2008) on AMR, in which the EU stresses the need of research in the area of AMR, e.g. to increase the understanding of the mechanisms and underlying risk factors that advance the development of AMR and to increase the knowledge of the effectiveness of current and future control measures. AMR is rampant among bacteria that cause healthcare- and community-acquired infections, driving up costs and increasing the difficulty of therapeutic management. To gain a handle on the factors that are propelling the problem of AMR, molecular and patient-level investigations are necessary to better elucidate the time-varying and heterogeneous role of antibiotic selection pressure on emergence and selection of AMR.[+] Read More
SATURN aims at defining strategies to improve the knowledge about antibiotic selection pressure and judicious antibiotic use. One intervention study and three observational clinical studies will be conducted that will produce demonstrable improvements over previously generated evidence regarding the effect of antibiotic exposure and selection pressure on acquisition, selection and transmission of ARB within hospital and community settings. Molecular and pharmacologic issues generated by the four clinical studies will be also addressed.
The SATURN program will provide a comprehensive knowledge base on the effect of various antibiotic classes, duration of treatment, order of treatment and dosage used on AMR in the community, general hospital wards and in intensive care units. This comprehensive data will be generated at the individual level for both colonised and non-colonised patients and at the ecological (i.e. ward) level. Moreover, SATURN will provide data on the effects of antibiotics on resistance both at the human host level and at the bacteria level. Combining the results of epidemiological investigations with microbiological and molecular studies on epidemicity, virulence and fitness of strains will provide data for action. Thus, SATURN results will provide the basis for better treatment decisions regarding antibiotic choices in various settings to minimise AMR, without compromising patient outcomes. This unprecedented approach will allow development of guidelines on antibiotic use and formulary interventions at the local, regional and European level.
The gaps between scientific knowledge and current practices of misuse of antimicrobial agents are enormous. AMR represents a particular challenge, because it touches upon several aspects of care, from basic knowledge to antibiotic prescribing. The continuing emergence of new resistance traits or their spread to new species and new epidemiological chains permanently challenges our ability to contain AMR. SATURN will address this knowledge gap through a variety of research platforms focusing on the effect of various antibiotic agents and prescribing patterns on selection and spread of ARB. The ultimate aim is therefore to develop an educational knowledge base for better antibiotic prescribing practices reflecting the best of current knowledge. Links to the resources of the European professional societies relevant to the objectives (ESCMID, ESICM, ESPRM) and the existing networks (ESAC, EARSS) will allow to develop educational material. An integrated and structured repertoire of educational and training activities will be developed that will be made available for the training of clinicians scientists, infection control personnel and other relevant health care professionals, as well as for the public.