By Evan McRobb, third year medical student
The third episode of the Re-Translate Symposia in Translational Science, held at the Peter Doherty Institute for Infection and Immunity, featured world leaders in the field of antimicrobial resistance. Director of the Institute, Professor Sharon Lewin, introduced the evening, setting the scene and highlighting the complexity of antimicrobial resistance.
During the night, five speakers and an expert panel took the audience on a journey through the issues: from agricultural and environmental factors, to how we can track the origins of resistant strains (a lesson in phylogenetics based on familiar families of chocolate bars); the challenges in consultation rooms and hospitals; and finally, the best opportunities for effective antimicrobial stewardship.
Professor Jodie McVernon was the first to speak, highlighting interesting aspects of the historical context and likening the imprudent use of antibiotics in the medical profession to the era when doctors were advertising smoking. The analogy may be surprising, but future practitioners might marvel at the difference in attitudes and practice, as we do about old tobacco advertising. Professor McVernon went on to show crossover patterns of some resistant bacterial strains making their way from livestock to humans. Her final few minutes were awe-inspiring as she demonstrated the scale of the AMR problem. She cited recent research showing that one third of travellers returning to Scandinavia were colonised by resistant bacteria when returning home!
Professor Benjamin Howden, a master of genomics, followed, giving the audience a crash course in phylogenetic trees and using different brands of chocolate bars to illustrate the concept of genetic relatedness. Professor Howden described a recent movement of resistant bacteria into Victoria, specifically, a group known as carbapenemase-producing enterobacteriaceae. Although it is a mouthful of words, he beautifully simplified it for the audience. He presented a map showing many locations the bacteria had been sent from in Victoria, indicating this is not an isolated event, and indeed something that requires careful attention.
Professor Karin Thursky then launched into the issue of ‘who's being naughty and nice’ in the realms of antibiotic prescribing. Professor Thursky told us hospitals are doing well, with studies showing persuasive prescribing, rather than restrictive programs, yield better results. That is, creating educational information and resources for doctors, rather than adding bureaucracy to prescribing. She finished with sobering statistics; 44.7% of the Australian population had antibiotics prescribed in 2015 – 27% of those being broad spectrum – and one third with no signs of symptoms attributed to the prescription. Naughty indeed.
Professor Cheryl Jones delivered the final speech. She painted the possibly grim future for humanity if antimicrobial resistance isn’t dealt with. Occasionally, headlines show the death of a traveller returning from a third world country, but such deaths may be the tip of the iceberg in coming times. Professor Jones showed projections of 10 million deaths by 2050 due to antimicrobial resistant organisms having made simple lifesaving surgery, intensive care, chemotherapy, and transplants no longer possible.
Overall, Re-Translate left our inner geek squirming with excitement, and our realist side sobered by this massive healthcare challenge. Nicolas Soputro, lead organiser of the symposium, and Tal Koren, President of the Student Ambassador Program, gave the farewell. I think I can speak for all attendees when I say we're very much looking forward to Re-Translate 2018!