Antimicrobial resistance in Thailand: a holistic approach

Antimicrobial resistance (AMR) is one of the most serious global threats to human health in the 21st century. One of the Bristol researchers taking on this challenge is Professor Matthew Avison who is leading the ‘One Health Drivers of Antibacterial Resistance in Thailand’ consortium project, supported by the Medical Research Council. Here, he tells us about the benefits of working together across borders and disciplines, and how the consortium’s approach can help inform AMR research worldwide.

In Thailand, AMR is estimated to have led to 38,000 deaths in 2010 and cost the economy $1.2 billion. Since then, the problem has continued to grow.

The Thai authorities are monitoring the situation closely and the World Health Organisation recognises their surveillance as an exemplary model for other low and middle income countries (LMICs). But the research to date has been in discrete areas.

This is making the key biological, social, cultural and economic drivers behind AMR (and how they all interact) hard to pinpoint. The long-term impacts of Thailand’s educational campaigns and regulations aimed at curbing AMR are also largely unknown, making effective evidence-based preventative measures difficult to design.

A gut problem

Two of the deadliest bacterial species that have acquired antibiotic resistance are Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli), and they’re the ones our ‘One Health’ project focuses on.

They live in the guts of all mammals and we’re interested in how and why they might spread between animals and humans, through the food chain and the environment. Their prevalence in human infections in Thailand has been rapidly increasing. And, worryingly, infections caused by antibiotic-resistant K. pneumoniae have risen from none before 2010, to 10-20% in 2016.

Covering all AMR bases

Our project takes a more holistic view of this complex problem. We’ve chosen an 80km square region in the central and western area of Thailand for our study: the Mae Klong-Ta Chin Basin. We picked it due to its incredible diversity of landscapes, populations and land use.

There are small villages, large towns and industrial zones, with communities of varying socio-economic and education levels. It includes fish farms, fruit orchards and rice paddies. Such variation is crucial because it gives us the opportunity to investigate and compare potential drivers of AMR across different cultural and environmental settings.

And our team is just as varied. We’ve brought together a consortium of UK and Thai researchers covering a wide spectrum of specialities, including veterinarians, clinicians, ecologists, chemists, microbiologists, mathematicians, statisticians, social scientists and project managers. Each researcher benefits from having a mirror version of themselves based in the other country, to collaborate with and learn from.

Operation data collection

Our data will cross disciplines, from chemical analysis of environmental and food samples, to findings of anthropological studies into how and why people use antibiotics. Over three years, we’ll repeat our collection cycles at specific sites and in different weather conditions and seasons.

Then our mathematicians will help us understand the patterns and relationships within this data. And our timing coincides with a Thai review into their National Strategic Plan on AMR, so we hope our findings will help influence future policy that will benefit people in Thailand.

Local and global connections

We’ve found that collaborating with on-the-ground Thai researchers who are connected to the local healthcare and farming systems is invaluable. They help engage with people in communities with varied levels of poverty and literacy and negotiate the sensitive ethical and practical considerations of data collection.

Involving early-career researchers from both countries has also been a huge benefit. They’ve brought fresh ideas, new ways of working and an energy that’s revitalised our approach. I hope this early experience of international collaboration will encourage and support them to continue in academic research.

We live in a small, connected world and the devastating impact of AMR stretches all around it. Our hope is that our project can complement work being undertaken in other communities and countries. AMR is such a multi-layered issue with huge ramifications across all aspects of human society. Our findings and those of our peers can help meet this global challenge and contribute to maintaining food security, combating poverty, reducing pollution and protecting human health.


 ‘One Health Drivers of Antibacterial Resistance in Thailand’ It is a consortia project between the Chulabhorn Research Institute, Mahidol University, University of Bristol, University of Bath, University of Exeter and the NERC Centre for Ecology and Hydrology.

 This project is one of four ‘AMR in a Global Context’ Consortia awards, totalling £12 million, which have been jointly funded by the cross-research council AMR initiative and the National Institute for Health Research (NIHR).

 All four projects will contribute to the UK’s commitment to Official Development Assistance (ODA).  The Research Councils’ contribution will be made through the Global Challenges Research Fund (GCRF) which supports cutting edge research addressing the problems faced by developing countries. The NIHR contribution supports human health research and will be made through its Global Health Research ODA allocation. NIHR’s ODA funding is aimed at supporting internationally-outstanding applied research for the direct and primary benefit of patients and the public in low and middle-income countries (LMICs).

 

 

 

 

LGBT STEM day

On Thursday 5th July we celebrated LGBTSTEM day, the first International Day of LGBTQ+ People in Science, Technology, Engineering and Maths.

The campaign is organised by four groups: Pride in STEM, House of STEM, InterEngineering, and Out in STEM; and is supported by over 40 organisations including CERN, the European Space Agency, and Wellcome. A day of recognition honours the memory of LGBTQ+ scientists who came before us and supports those who are currently in STEM. We believe it should be possible to follow your passion whilst being yourself.

We celebrated LGBTSTEM Day in Biochemistry with a rainbow themed coffee and cake morning, and also collected donations for a local charity which works with LGBTQ+ young people called Off The Record. Off The Record is a mental health charity working across Bristol and South Gloucestershire. Off The Record run a number of LGBTQ+ youth groups and offer one-to-one counselling with LGBTQ+ young people – all of their services are free of charge.

The official hashtag for LGBTSTEM day is #LGBTSTEMDay.

Bristol University cleaner Herman Gordon cries tears of joy after students raise £1,500 for him to go on holiday

Herman Gordon, one of the most positive and friendly characters within the Biomedical Sciences Building was presented with the money and a note that said:

“On behalf of the students at Bristol, we would like to thank you for all the positive energy you have given to us throughout the years. You have brightened many of our days and we want you to know that we love and appreciate you. We have come together to give you a special gift as our way of saying thank you. Have a lovely summer!”

Wiping away his tears with his cleaning cloth Herman said:

“God bless you man, God bless, I want to say thank you for everything you have done and God bless every one of you.”

The students who helped raise the money chose to remain anonymous but issued a public statement:

“We would like to thank everyone who contributed to this incredible gift. It is truly amazing what we can achieve when we come together. It is thanks to your generosity that we’ve been able to raise about £1,500 – meaning both Herman and his wife will be able to visit Jamaica for the first time in 4 years!”

Creative reactions 2018 – Merging research and art

‘Creative Reactions’ brings together scientific researchers and artists to bring to life the amazing diversity of University research through the medium of art.

  • 'Hepatic' by Emily Krainc, a piece focused on research of Professor John Iredale based on fibrosis, the process of scarring.

Over 30 University of Bristol researchers from many different Schools got involved in Creative Reactions, including those from BiochemistryBiological SciencesCellular and Molecular Medicine and Experimental Psychology which from August this year will be part of the new Faculty of Life Sciences.

The event was a great success, with art being displayed in Hamilton House for members of the public view and talk to the researchers and artists behind each piece.

One of the event organisers Matthew Lee said:

‘Creative Reactions allows for engagement between researchers, artists and the public to allow researchers to communicate what their research is all about.

This is a great way to encourage the public to get involved with science and also encourages the academics and artists involved to think about their work from different perspectives.’

Event Organisers from left to right: Luke McGuinness, Charlotte Mugliston, Andrea Diaz-Gaxiola, Catherine Gilmore, Anouk Spelt and Matthew Lee.

Success at the Southwest Big Bang Fair 2018

The Southwest Big Bang Fair which ran on the 27 June is one of the biggest outreach events in the Southwest region, giving children the opportunity to engage with a range of different science exhibitors.

This year outreach volunteers from the upcoming Faculty of Life Sciences ran stands to highlight and enthuse thousands of school children, inspiring the next generation of scientists, who will be needed to help tackle global issues.


Dr Gail Born, Life Sciences Faculty Engagement Officer said:

“The Big Bang events are a wonderful opportunity to engage with and inspire thousands of primary and secondary students from around the southwest.

They are fully hands on and the students love being able see and use some amazing bits of equipment and talk to real scientists.”

The event is part of a programme of events taking place across the South West region, click here for more information on events near you.

Any staff or students interested in particpiating in future outreach events please contact Dr Gail Born

outreach-biomedsci@bristol.ac.uk