Global intelligence on superbugs vital to stop antibiotic resistance

Wellcome is bringing together a new, international expert group, SEDRIC (Surveillance and Epidemiology of Drug-Resistant Infections Consortium). Professor Sharon Peacock, the group’s Chair, explains why it’s necessary and what it aims to do.

Professor Sharon Peacock

SEDRIC has a clear goal – to improve our understanding and help reduce the global impact of drug-resistant infections.

These infections currently kill an estimated 700,000 people globally each year – a death toll which could rise to 10 million a year by 2050 if we don’t act.

The SEDRIC board brings together expertise in infectious disease across human and animal health and the environment. Our aim is to help transform the way countries are able to track, share and analyse information about the rise and spread of infections which can no longer be affectively treated by existing antibiotics.

In recent years awareness has grown that this is among the most urgent health threats we face. In particular, much-needed investment has increased into the early discovery and development of new treatments.

Drug-resistant infections are international travellers

But new drugs and diagnostic tools must come alongside improvements in the way we monitor and control drug-resistant infections.

We need to know which pathogens are developing resistance and where.

We need to better understand where patients acquire bacteria that cause infections – are they acquiring bacteria from other patients, from healthcare settings, water or food or the general environment?

Drug-resistant infections are, like us, international travellers. We need to track which borders they cross, and how quickly. Without detailed and up-to-date information we cannot effectively intervene.

The data is vital on a number of levels, from direct patient care to national and international policy development.

Antibiotics must be treated as a precious resource

To minimise the spread of resistance, antibiotics – old and new – must not be overused or misused.

Surveillance and stewardship go hand in hand. Doctors and prescribers need accurate information to know which drugs, and in which doses, are needed to treat patients effectively. Without this, they must rely on best-guess, empirical prescribing.

Knowledge of how bacteria spread is also critical to improving infection prevention and reducing overall need for antibiotics, in human and animal health.

With better information, policymakers can initiate change at national and international level.

One evidence-led example is the recent ban in China of colistin as a growth promoter in livestock. This is in response to the emergence of a gene in E. coli that makes bacteria resistant to colistin, an antibiotic of last resort..

Globally, surveillance efforts are increasing, but there are major gaps and differing levels of capacity between countries. SEDRIC will work to:

  • improve global coordination
  • identify critical gaps and barriers
  • help countries adopt sustainable best practices and strategies.

The first report from the WHO’s Global Antimicrobial Surveillance System (GLASS), published this week, shows 52 countries have enrolled so far – 40 providing information about national surveillance systems and 22 data on levels of antibiotic resistance. The report highlights the challenges many countries face to improving surveillance.

SEDRIC will build on work by GLASS and others, including the UK’s Fleming Fund, to address the barriers.

We will provide technical expertise and knowledge, but will also look at how technology might be better employed to strengthen existing surveillance networks and activities.

Genomic technology and bacterial sequencing, for example, offer huge potential to help us understand the mechanism of resistance and how spreads. How can we better use these? And can we take advantage of the advances in Artificial Intelligence?

Only through better information can we speed up action and improve public health interventions to get ahead – and stay ahead – of superbugs, and save countless lives.

Professor Sharon Peacock is an academic clinical microbiologist at the London School of Hygiene and Tropical Medicine and the Wellcome Sanger Institute. She is expert in residence for Wellcome’s Drug Resistant Infections team.