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Centre to Impact AMR enables transdisciplinary approach to tackle AMR

The Centre to Impact AMR was formed to enable and coordinate a transdisciplinary approach to the problem of AMR. We draw on expertise of our 200-strong Monash team embedded in seven faculties, expertise that spans evolutionary biology, nanotechnology, biomedical sciences, chemistry and pharmacology, microbiology, education, clinical research and social sciences. Acknowledging that within our current global environment new drugs are often followed by new resistance, our experts collaborate to investigate, interrogate and integrate the knowledge and procedures that can underpin sustainable solutions that will reduce the impact of AMR. We also serve to increase awareness of AMR, listening to those affected by it; advocating for and developing phage therapies; providing a surveillance and collaboration hub in Australia and across the Indo-Pacific region; optimising use of existing antibiotics; and engineering the built world to minimise superbug transmission. This diversity of approaches and experts collaborating with national and international partners, across industry, government, academia and the general public provides a unique perspective to our unifying mission to Impact AMR.

Sustainable solutions to AMR

First and foremost the Centre to Impact AMR was founded to support the many researchers across Monash to collaboratively tackle the threat of AMR. In order to do this, we have established multidisciplinary programs implemented through focussed working groups. These groups of researchers from various faculties serve together to identify the information and/or evidence needed for advances in: federal- and state-level government policy to impact AMR at a local level, and developing educational resources for national and regional (Indo-Pacific) dissemination; advanced surveillance of AMR focussed at addressing specific questions and analysed with a view to One Health understanding; identifying and actioning work towards unmet clinical needs; and building relationships for more effective industry engagement. To this end, the Centre to Impact AMR has created an R&D facility, open to Centre members and available to external parties for preclinical testing (animal and cultured cell line testing of new compounds and devices) and surveillance testing (both culture-based and culture-free detection of bacterial species and/or AMR genes from environmental samples that range from water sources, agricultural samples to swabs from clinical environments). In addition, we have established a comprehensive phage facility for the characterisation, production and use of medically relevant phage.

 

Indo-Pacific Collaborations

We are a collaborative, transdisciplinary hub for research, advocacy and education. Our aim is for sustainable solutions to AMR, beyond the common actions of new drug development and better drug stewardship.

Within our first two years of operation the Centre has been establishing itself as a hub to support local researchers and inform local governments, education providers and the Australian public. As our influence and capabilities have grown, we are now positioned as a Centre within the broader Indo-Pacific region. Countries that are defined as the Indo-Pacific Region are drawn from three of the WHO Regional Offices: South-East Asia and the Western Pacific, and 22 of the 24 countries historically regarded as the representing the Indo-Pacific region now have AMR National Action Plans. Many of our researchers already have individual relationships with these countries and, collectively, we are exploring opportunities to apply our expertise and capabilities to the regional issues of AMR.

     

A collaborative hub for research, advocacy and education    

We have a collaboration with Phage Australia to further our aim of professionalising phage therapy in Australia as the third major intervention for infectious diseases. In order to further the effectiveness and impact of policy and communications solutions we work closely with the Social Science Network in AMR, and have also contributed to the Victorian State Government AMR strategy. Furthermore we are working with BehaviourWorks Australia to identify and prioritise public behaviours to slow antimicrobial resistance.

The Centre to Impact AMR and CSIRO are collaborating on a project investigating the impact of nutritional interventions to reduce AMR by altering the gut microbiome with the aim of boosting immunity and reducing resistant bacteria. Our R & D Facility led by A/Prof Thomas Naderer will conduct molecular and biochemical analysis of clinical samples to better understand the impact of antibiotics on AMR in the human gut microbiome.

In order to create a coordinated response of targeted surveillance, behaviour change and other sustainable solutions to the country-specific problems of AMR, the Centre to Impact AMR in Australia is working closely with partner organizations in India, Bangladesh, Malaysia, Singapore, Timor Leste, Indonesia, New Zealand and Fiji. These and future partnerships in other countries in the Indo-Pacific provide a means to share capacity and knowledge through the region to effect changes that benefit all of our partners.

We are also proud to have nominated two members of our 200-strong Centre team to serve on the AMR Insights Ambassador Network, (Dr Sue Chin Nang and PhD candidate Rupinder Dhamoon).

     

Interview with Director Professor Trevor Lithgow

Meet Professor Trevor Lithgow, Director of the Centre to Impact AMR based at Monash University in Australia. Prof Lithgow takes us from his initial beginnings in Melbourne, through to his formative years as a bacterial cell biologist, and his unwavering commitment to fundamental science and his Centre’s application of transdisciplinary research to sustainably curb and even reverse antimicrobial resistance.

“We started the Centre to impact AMR in February 2020 with the main driver being that there were brilliant people at Monash working on solutions to AMR, but we were each of us located in different faculties and departments around the University. We had no visibility, no forum in which we could come together and talk about our work, or even the clarity of purpose that we could do something of significance collaboratively at Monash. There was a really clear case for a new, transdisciplinary Centre..”  Go to full interview >>

     

Introducing Dr Sarah McGuinness, Chair Indo-Pacific Working Group

Dr Sarah McGuinness is the Chair of the Indo-Pacific Working Group and newest Centre Leader to be appointed, an infectious diseases physician with a passion for regional engagement. Sarah currently holds dual positions as Consultant Physician in the Department of Infectious Diseases at the Alfred Hospital (Travel Medicine Clinic) and Lecturer in Clinical Epidemiology at the School of Public Health and Preventive Medicine at Monash University. With her research interest on improving the prevention and treatment of infectious diseases in vulnerable populations including those travelling to, and residing in, low-resource settings Sarah brings a focus on risk factor identification and prevention to the Centre to Impact AMR and valuable expertise to our burgeoning Indo-Pacific focus.
     

Documenting the Social Burden of AMR

As the numbers of patients with AMR infections in Australia increases, we have initiated an empirical study of their experiences - and those of their carers - as they navigate this often complex and uncertain medical journey. We are still recruiting more participants for this study, of which the outcomes will inform better psychosocial supports for patients, and assist in health messaging for the general public around the nature of AMR. In addition, for clinicians it will provide new insights into better management of this unique, under-appreciated and rapidly growing cohort of patients.
     

Mapping the extent of AMR through surveillance

With limited surveillance data available on the extent of AMR across natural, agricultural and built environments we do not know the extent of the problem we are facing. Traditionally, investment into AMR surveillance in Australia has targeted only clinical environments, the end-point at which AMR has its worst human consequences. However, critical interventions and sustainable solutions to the problem of AMR need to be enacted outside of hospitals too. As such a cornerstone of the Centre to Impact AMR is to reveal the extent of the problem, the crux at which effective solutions will have the greatest impact which must therefore be where we focus our efforts. To that end our R&D facility conducts surveillance testing, both of cultured and uncultured environmental samples. In addition to providing this service for researchers of the Centre we are working with commercial and government research partners, both in framing the questions to be addressed by surveillance, and in obtaining data of sufficient richness and value to provide answers to these questions. 
     

Spin out Monash Phage Foundry

Currently the use of phages for therapy in Australia is restricted to “compassionate use”, treatments of last resort. Recently, it has been trialled with phages imported from certified producers overseas. In order to create a viable and rapidly accessible source of therapeutic phages for deployment in Australia (and internationally upon request), the Centre to Impact AMR spun-out the Monash Phage Foundry, which draws together experts in phage therapy, phage discovery and characterisation, and the engineering and supply of phage and products. Our relationship with the Alfred Hospital Bacteriophage referral hub (VICPhage) aims to rapidly diagnose AMR infections, and to identify relevant phage that can then be purified to treat patients who have run out of conventional antibiotic options.