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How Do You Address the Challenge of Antimicrobial Resistance?

In November 2018, PLOS ONE attended the European Scientific Conference on Applied Infectious Disease Epidemiology (ESCAIDE) conference in Malta. The conference, which is organised annually by the European Centre for Disease Prevention and Control (ECDC), brought together 570 delegates from 50 countries in Europe and beyond, including clinicians and microbiologists.

Topics this year at ESCAIDE included emerging infections, zoonoses, prediction of outbreaks, whole genome sequencing as a tool for epidemiology, artificial intelligence, human migration influences on disease, and international responses to public health emergencies.

One topic of particular note was the ever-looming spectre of antimicrobial resistance (AMR). Prof Dame Sally Davies (Chief Medical Officer, UK) described current progress in reducing inappropriate antibiotic usage. Prof Davies reiterated that hygiene practices and vaccination remain the best preventive measures for infections, and that only responsible antibiotic use can be encouraged.

Prof. Dame Sally Davies, Chief Medical Officer, United Kingdom
Prof Dame Sally Davies speaking at ESCAIDE 2018. Credit: ECDC/ESCAIDE

Prof Michael Borg (University of Malta, Malta) also highlighted the differences in AMR observed between the different EU countries, and noted widely differing prescribing practices that could be broadly split between northern and southern Europe. He referenced a recent study on the socio-economic and cultural factors that correlate with these differences (namely uncertainty avoidance, and masculinity[!]), while also stressing the importance of governance quality (how countries manage their health policies). Prof Borg cited an ECDC-funded study that used data from the EARS-Net AMR surveillance network and reported on the burden of AMR in Europe, which is overtaking the burden of influenza, tuberculosis and HIV combined.

Prof Jan Kluytmans (Utrecht University, Netherlands) alluded to the rise of AMR as a tragedy of the commons, where a precious resource (in this case effective antimicrobial drugs) is depleted. The causing factors for this are both inappropriate antibiotic use in humans worldwide, and the high use of antibiotics in agriculture and food production.

To highlight and promote the important research being done to tackle this pressing issue, PLOS launched a cross-journal call for papers on antimicrobial resistance in March. The submission deadline has been extended to the 12th July 2019, and accepted articles will be selected for publication in a Collection at the end of 2019 by dedicated Guest Editors, including ESCAIDE 2018 speaker Dr. Alessandro Cassini (co-author of the AMR burden in Europe study), Prof. Alison Holmes, Prof. Kathryn Holt, and Prof. Jaap Wagenaar.

We also recently launched a call for papers on the mathematical modelling of infectious disease dynamics, bringing together different disciplines such as mathematics, biology, medicine and physics – submissions due by the 5th September 2019. This Collection will include articles that further the field by improving on existing methods and algorithms to better model real-world phenomena, and work tackling common problems related to disease forecasting, outbreak detection and containment, disease spread, vaccination and other management techniques.

More broadly, the work of the ECDC covers many facets of infectious disease research and monitoring. Examples of useful ECDC publications include providing guidelines on vector surveillance (native and invasive mosquitoes), an HIV modelling tool, annual influenza epidemiology reports, an infectious disease surveillance atlas, and guidelines on designing immunisation information systems. The ECDC also hosts a Virtual Academy, which provides training materials for public health professionals. Tracking disease epidemiology across 28 member states is no simple feat.

The 2019 ESCAIDE conference will be held in Stockholm, Sweden (home of the ECDC headquarters) on 27-29th November 2019.

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