Objectives
The aim is to address key pathogens and groups of pathogens causing major drug resistance problems through multi-disciplinary translational research, bringing basic research forward through clinical research to improved patient management and towards product oriented research on new diagnostic tests, treatments and prevention strategies.
The EU collaborative research strategy is focused around five main approaches:
Firstly, research into the basic phenomena of drug resistance, aim to better understand the molecular mechanisms of resistance, how resistance genes emerge and how they spread between bacterial species, how bacteria colonise and spread from individual to individual, how bacteria interplay with the host immune system and why bacteria cause disease. This type of new knowledge is then used to develop completely new treatment and prevention approaches, as successfully done for the respiratory pathogen Streptococcus pneumoniae, where novel targets for vaccines, drugs and diagnostics have been identified.
Secondly, epidemiological research unravels the wider clonal spread of multi-drug resistant strains over regions and continents with the aim to develop improved control and prevention tools. Multi-drug resistant Staphylococcus aureus (MRSA) spread in hospitals and the community, Vancomycin-resistant Enterococci (VRE), multidrug-resistant Pseudomonas aeruginosa, Extended-Spectrum-Beta-Lactamase (ESBL) producing Enterobacteriacea and the recent sharp rise in incidence of Clostridium difficile are subject to in-depth analysis.
Thirdly, translational research that brings basic science on microbial and human genomics forward towards clinical research and even further into public health research and health economics is used to develop guidelines for evidence-based clinical practice and patient management. This approach is for example successfully used in a project that aims to fundamentally change current clinical practice in the treatment of respiratory infections into a modern patient management strategy based on proper diagnosis and prudent use of antibiotics. A similar translational research approach is also applied to learn about the dynamics and transmission of the major emerging multi-drug resistant pathogens in hospitals and to develop tools to combat them. The outcome of these approaches will guide clinicians to better patient care and help to improve antibiotic prescribing.
Fourth, as a means to reduce the inappropriate use of antibiotics, the European biotechnology industry is being mobilized to develop point-of-care diagnostic tests, validated in the clinical setting, that will help clinicians to take fast and accurate decisions on appropriate antibiotic (or no antibiotic!) prescription. Projects here address pathogens like MRSA, Clostridium difficile and vancomycin-resistant Enterococci.
Fifth, given the dangerous withdrawal of large pharmaceutical companies from the field of antibiotic research and development, the last but very essential approach in the EU research strategy is devoted to strengthening the scientific base for early anti-infective drug discovery and innovation in Europe. Research projects address both new molecular targets in pathogens and identification of new compounds derived from antibiotics-producing organisms, but also a better knowledge of basic bacterial physiology and pathogenesis. Since the need for new drugs is particularly urgent for severe Gram negative hospital infections, a special effort has recently been made to fill this gap.