Dear All: Three brief items for you today.
First up: Perhaps like many of you, I’ve been wondering whether or not COVID-19 and bacterial resistance would begin to cross paths in some fashion. I can’t think of a reason why COVID-19 would directly cause resistance, but use of antibiotics becomes pretty common after you’ve been hospitalized for more than a few days, especially if you wind up on a ventilator … and this, in turn could drive AMR.
A just-published article entitled “Covid-19 May Worsen the Antibiotic Resistance Crisis” in Wired by Maryn McKenna (link) makes exactly this point and is a good summary on why this might emerge as a problem. The article’s subtitle says it all: “The disease can’t be treated with these drugs, but antibiotic use is rising anyway, in ICUs and among the worried well.” The article surveys bacterial infections with prior viral epidemics, the spike in demand for azithromycin, and and problem of the lack of suitable incentives for antibiotics … highly recommended!
In parallel and as place to start further reading if you are interested, Gerry Wright pointed out to me that Issra Bulgasim and Adam Roberts of the Liverpool School for Tropical Medicine have compiled and shared papers on this topic on their website (https://covid-amr.webnode.co.uk/) under the banner “Secondary infections, antibiotic chemotherapy and antibiotic resistance in the context of COVID-19.” Adam, a microbiologist with an interest in antibiotic discovery, is quoted by Maryn as saying “In the context of Covid-19, antibiotics should be considered as important as protective gowns or facemasks. We do not expect healthcare workers to go into hospital situations without the correct protective equipment. Nor should we expect clinics to do their job without the appropriate antibiotics. It is part of our defense for any pandemic situation.” Agreed!
It’s interesting to just scan the titles of the papers Adam and Issra have spotted: other viruses and invasive aspergillosis are noted but there’s not (yet) a lot of detail on secondary bacterial infections. It will be instructive to see what emerges. Many thanks to Issra and Adam for taking on this project.
[Post-note addendum #1, 24 Mar 2020, further updated 3 May 2021]: The University of Birmingham had a chat site (https://www.covid-coinfections.org/latest) focused on the question of co-infections with COVID-19 but it appears to now be defunct.
[Post-note addendum #2, 25 Mar 2020]: These two articles offer insights related to those offered by Maryn McKenna:
- Julie Gerberding (Director of CDC, 2002-2009), in STAT (link): “Antibiotic resistance: the hidden threat lurking behind Covid-19”
- Lord Jim O’Neill, Head of the UK AMR Review in The Article (link): “The other global threat to life that governments must now face”
[Post-note addendum #3, 3 May 2020]: This paper in Clinical Infectious Diseases by Clancy & Nguyen is a good survey of the data to date. In brief, (i) superinfections occur with COVID-19 but have not yet been analyzed in a comprehensive fashion AND (ii) new approaches to reimbursement are needed for antibiotics: “COVID-19, superinfections and antimicrobial development: What can we expect?” (link)
[Post-note addendum #4, 4 May 2020]: This title of this paper by Rawson et al. in Clinical Infectious Diseases is a good overview of its content — and the punchline is that they didn’t find a lot of hard data: “Bacterial and fungal co-infection in individuals with coronavirus: A rapid review to support COVID-19 antimicrobial prescribing” (link).
Finally, there are several meeting updates … see the list below. In particular, GARDP have just posted dates & times for new webinars and the excellent ICARe (Interdisciplinary Course on Antibiotics and Resistance) residential course has been cancelled for 2020 … but you can mark your calendar for 2021 in hopes that we’re back to safe travel by then.
Stay safe … and all best wishes, –jr
John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Operating Partner, Advent Life Sciences. Follow me on Twitter: @JohnRex_NewAbx. See past newsletters and subscribe for the future: https://amr.solutions/blog/. All opinions are my own.
Current funding opportunities:
- Dates for the 2020 funding rounds for Novo REPAIR Impact Fund will be announced May 2020. Go here for current details.
- 2020 funding rounds for CARB-X have not been announced.
- The Global AMR R&D Hub’s dynamic dashboard (link) summarizes funders and projects by geography, stage, and more.
Upcoming meetings of interest to the AMR community:
- 28 Apr 2020 (online, 17:00-18:30 CEST): GARDP REVIVE webinar. Title: “Inhaled antimicrobials: Do we get the drug to the bug?” Speaker: Harm A. W. M. Tiddens. Go here to register.
- [NEW] 12 May 2020 (online, 17:00-18:30 CEST): GARDP REVIVE webinar. Title: “Probability of target attainment analyses for dose selection in antimicrobial drug development.” Speaker: Shampa Das. Go here to register.
- [NEW] 19 May 2020 (online, 17:00-18:30 CEST): GARDP REVIVE webinar. Title: “Assay development for measuring antibiotic accumulation in Gram-negative bacteria.” Speakers. Jessica Blair, Mark Bronstrop, David Six. Go here to register.
- [NEW] 9 Jun 2020 (online, 17:00-18:30 CEST): GARDP REVIVE webinar. Title: “Test tube to patient: PK/PD of fixed dose beta-lactam/beta-lactamase inhibitor combinations.” Speaker. Vincent Tam. Go here to register.
- [NEW] 30 Jun 2020 (online, 17:00-18:30 CEST): GARDP REVIVE webinar. Title: “Clinical development of antimicrobials – Phase 1 development challenges.” Speaker. Markus Zeitlinger. Go here to register.
- 9 Jul 2020 (online, 09:00-10:30 CEST): GARDP REVIVE webinar. Title: “The challenges and opportunities for antimicrobial R&D in low- and middle-income countries – India case study.” Speaker: Anand Anandkumar and Kamini Walla. Go here to register.
- 17 Jul-2 Aug 2020 (Marine Biology Laboratory, Woods Hole, MA): Residential course entitled “Molecular Mycology: Current Approaches to Fungal Pathogenesis.” This 2-week intensive training program has run annually for many years and gets outstanding reviews. Go here for details.
- 29 Jul-2 Aug 2020 (Philadelphia, PA): Small World Initiative Instructor Training Workshop – training for undergraduate professors and high school teachers in wet lab techniques, parallel curricula, pedagogical instruction to engage students in the hunt to find new antibiotics in soil. Go here to register.
- 4 Aug 2020 (Silver Spring): FDA workshop entitled “Development Considerations of Antifungal Drugs to Address Unmet Medical Need.” Go here to register.
- 5 Aug 2020 (Silver Spring): FDA workshop entitled “Developing Antifungal Drugs for the Treatment of Coccidioidomycosis (Valley Fever) Infection.” Go here to register.
- September 2020. University of Sheffield (UK). Applications are being taken for a new 1-year (full-time) or 2-year (part-time) Masters of Science course in Antimicrobial Resistance. The program runs annually from September and covers microbiology, clinical practice and policy. The course webpage is here.
- 9-10 Sep 2020 (Washington, DC): US PACCARB public meeting. Go here for details.
- 22-25 Sep 2020 (Albuquerque, New Mexico): Biannual meeting of the MSGERC (Mycoses Study Group Education and Research Consortium). Save-the-date announcement is here, details to follow.
- 26-29 Oct 2020 (Rotterdam), Annual ESPID meeting (European Society for Pediatric ID, #38)
- 10-13 Apr 2021 (Vienna): Annual ECCMID meeting (#31)
- 20-24 June 2021 (Toronto): International Symposium on Pneumococci and Pneumococcal Diseases (ISPPD-12). Go here for details.
- 3-7 Jun 2021 (Anaheim), ASM Microbe 2021. Go here for details.
- [NEW] 8-11 Oct 2021 (Aberdeen, Scotland): 10th Trends in Medical Mycology. Go here for details.
- [RESCHEDULED] 16-24 Oct 2021 (Annecy, France): Interdisciplinary Course on Antibiotics and Resistance (ICARe). This is a soup-to-nuts residential course on antibiotics, antibiotic resistance, and antibiotic R&D. The course is very intense, very detailed, and gets rave reviews. Registration is here and is limited to 40 students.