Do you have a wound, an infection, or are you undergoing surgery? One of the things on your mind may be whether you are at risk of catching a superbug; one that won’t be cured by normal antibiotics. Antimicrobial resistance is often talked about in rather alarming ways, but much is still unknown about its evolution and how it spreads. The EvoTAR project is aiming to answer these important questions.
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Medical doctors normally use tedious laboratory tests to gain information about antibiotic resistance in a patient. This is a slow and limiting process, which EvoTAR aims to replace with state-of-the-art genetic techniques. This will make it possible to determine the potential for resistance in a patient’s gut, which is the most important source of resistant bacteria in humans.To do so, EvoTAR uses next-generation sequencing methods to track a wide variety of resistant bacterial species.
An important part of the project is to establish a procedure for creating a ‘catalogue’ of antimicrobial resistance in a patient through DNA sequencing. This catalogue of a patient’s tendency towards antimicrobial resistance builds up into a bigger profile called the resistome; like a guide to all the resistant genes present in a particular environment, in this case the human gastro-intestinal tract. With this information, scientists can map the bacteria and resistance genes carried by these bacteria, and they can use this to monitor patients before hospital treatment, identify the changes that occur while they are in hospital and check possible changes in the 6–7 months following treatment. This will allow scientists to measure whether resistomes change irrevocably, or return to where they were prior to hospital treatment. It’s important to know these things if doctors are to offer people optimum treatment over a period of time.
Resistance is not limited to one type of pathogen, such as Escherichia coli (E coli), or indeed to certain hospitals, so EvoTAR will look across patient groups, pathogens and hospitals too. Professor Willems, the project coordinator, is all the more motivated because the study is using groups of patients in Utrecht, Paris and Madrid to get a wide representative sample and monitor them over time.
On a wider scale still, bacteria may spread between humans and animals, and also between food and humans or animals and they may change on the way. This study is the first to focus on the full range of places where bacteria evolve and then spread, acknowledging that there are links between them and that resistance is a complex combination of factors. The research partners therefore include biologists, doctors and vets, as well as biomedical companies working in the field.
Cataloguing resistance is a moving target and depends on many factors, which traditional scientific methods have struggled to tie together. EvoTAR has many dimensions, but the central issue is to identify the origin and flow of resistance genes and determine the rules bacteria obey as they spread.
This project is an important stepping stone to future ways to control spread and combat the resistance problem. Future studies can build on EvoTAR results to adjust drug treatments to combat resistance and develop better procedures to safeguard against infection.
All the partners are naturally committed to sharing their own expertise and to seeing this reap greater rewards when combined with the other partners’ contributions. The big prize of one day developing treatments and procedures that overcome resistance puts the day-today burdens of administration that comes with coordinating such a large consortium into a better perspective.