Genomic surveillance may be key to fight deadly antimicrobial resistance

LONDON: An international group of researchers have called to harness the potential of genomic surveillance to tackle antimicrobial resistance (AMR) -- a major global challenge that could ultimately result in many more deaths than the coronavirus pandemic.

AMR already causes substantial sickness and death worldwide, responsible for approximately 1.27 million deaths in 2019. Some estimates suggest that by 2050, it could kill as many as 10 million people each year.

During the Covid-19 pandemic, genomic surveillance proved vital in helping us understand the evolution and spread of the SARS-CoV-2 virus.

"Over the past century, antibiotics have transformed our ability to treat infection and illness and reduce mortality. But bacteria are becoming increasingly resistant, and with a limited pipeline of new antibiotics, we risk effectively returning to the pre-antibiotic era where we can no longer treat infections," said Professor Sharon Peacock from the University of Cambridge in the UK.

"When the world was hit by the Covid-19 pandemic, we showed how powerful a tool genomic surveillance could be in helping us fight back. This work grew out of its increasing application to real-world problems such as detecting outbreaks in hospitals and in the community -- including foodborne outbreaks. We now need to take what we learned from the pandemic including its bold and large-scale use and reapply it to the complex problem of AMR," Peacock added.

The genome, which is 'written' in DNA or RNA, consists of a string of nucleotides. Each time a copy of the genome is made, errors can arise -- for example, one of the A, C, G and T nucleotides of DNA might get swapped.

These changes allow scientists to create lineages -- family trees -- showing how the genome has evolved and spread. In the case of SARS-CoV-2, they allowed scientists to identify sources of infection, spot so-called "variants of concern" and see whether public health measures such as lockdown, travel restrictions, and vaccination were working.

The potential to improve surveillance of AMR pathogens may be even higher than for SARS-CoV-2 as the genome data can detect and track outbreaks, provide a prediction for effective antibiotic treatment, reveal the mechanism for resistance including mutations and the acquisition of new DNA, and help understand the movement of resistance mechanisms between bacteria.

"We are on the cusp of realising the full potential for genomics in tackling AMR, but there is still a lot of work that needs to be done. We need the scientific, public health and political communities to work together to make this happen. AMR is an urgent problem. It is not something that will happen in years to come -- it is happening now," said Professor Kate Baker, of the University of Cambridge.