Antimicrobial resistance
Our research
Antimicrobial resistance (AMR) arises when bacteria, viruses, fungi, and parasites evolve over time and no longer respond to treatment. Globalisation, migration, and (medical) tourism inevitably contribute to the worldwide spread of new (multi-)resistant mutant pathogens.
AMR is a crisis that intersects with many of the health challenges we address, from (myco)bacterial infections and leishmaniasis to HIV. The ecological, sanitary, and socioeconomic conditions that drive the overuse and misuse of antibiotics have never disappeared. In fact, due to urbanisation, population growth, and migration, the situation has worsened in many areas.
It is urgent to change how patients are diagnosed and how antibiotics are prescribed, distributed, and used. Additionally, the role of animal healthcare and infection prevention and control in healthcare facilities cannot be overlooked. Adequate diagnostic and treatment facilities are scarce, and to make matters worse, antibiotics of uncontrolled, often inadequate quality are widely available to uninformed populations and unlicensed or unskilled healthcare providers. Untreatable infections are becoming alarmingly frequent, while the research and development pipeline in the pharmaceutical industry remains extremely thin.
At ITM , we are coordinating research projects to combat AMR. An interdisciplinary approach is essential to counter this persistent threat. Our scientists collaborate on the development of novel diagnostic tools and treatment strategies for infection prevention and control, promote responsible antibiotic use, and investigate human, social, and cultural factors.
Success stories
Better adapted diagnostics for bloodstream infections in sub-Saharan Africa
Our SIMBLE project focused on developing a field-adapted blood culture bottle reading system and establishing a local manufacturing plant for bacteriological culture media (BactInsight) in Cotonou, Benin. It was unique in its aspects of reverse innovation, led by scientists from resource-limited settings, and in its ability to generate interest in local production and in vitro diagnostics. The project was funded by EDCTP.
Leishmaniasis and drug tolerance
The deadly Leishmania parasite is notorious for adapting to drugs through mutations and drug resistance. Our molecular parasitologists have discovered a second way it evades drug attacks: drug tolerance. This can lead to serious complications. Their findings were published in the esteemed journal Frontiers in Cellular and Infection Microbiology.
Rwandan PhD student unveils problem of multi-drug resistant tuberculosis and false resistance
Drug resistance is increasing in tuberculosis (TB), the world's deadliest infectious disease. Timely detection of resistance is essential to select the most appropriate treatment. Claude Semuto, a Rwandan PhD student, exposed a serious problem of false rifampicin resistance. His findings, published in Lancet Microbe, changed the diagnostic algorithm of the National TB Programme and enabled patients to receive proper care.
Monitoring the emergence of drug resistance in leprosy in the Comoros
We conducted a countrywide drug resistance survey in the Comoros and investigated whether post-exposure prophylaxis (PEP) with rifampicin led to the emergence of drug resistance in patients with leprosy. The results demonstrated that Mycobacterium leprae remains fully susceptible to rifampicin, fluoroquinolones, and dapsone. For the first time, our researchers showed the applicability of targeted sequencing directly on skin biopsies from patients with either paucibacillary or multibacillary leprosy. The findings were published in Lancet Microbe.
Rising resistance in sexually transmitted infections
There is a growing need for alternatives to antibiotics to prevent the transmission of STIs such as gonorrhoea, chlamydia, and syphilis. In the PReGo study, we aimed to test novel strategies to prevent the emergence of AMR in Neisseria gonorrhoeae. Our findings showed that Listerine and chlorhexidine mouthwashes cannot treat or prevent pharyngeal gonorrhoea. The study was funded by FWO, and the results were published in The Lancet Infectious Diseases and Sexually Transmitted Diseases.
N. gonorrhoea and C. trachomatis screening does more harm than good
We conducted a randomised controlled trial across five screening centres in Belgium and found that screening for N. gonorrhoeae and C. trachomatis in men who have sex with men (MSM) using HIV pre-exposure prophylaxis (PrEP) does more harm than good. The results of this study, published in Lancet HIV, led to changes in the Belgian HIV PrEP guidelines regarding the screening approach for these infections.
News
All news-
Better diagnosis thanks to improved stool analysis -
From 20 to 23 January, a blood culture sampling training session was organised at CHU-YO in Ouagadougou, Burkina Faso, as part of the SIMBLE project.
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ITM researchers discovered that the reliability of blood culture bottles varies in tropical conditions, calling for better testing to improve life-saving diagnostics and reduce waste.
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Safe antibiotic levels in food might fuel superbugs.
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Throughout six weeks, a research team aimed to assess the acceptance and adoption of the BactInsight system and lensfree microscope at CNHU-HKM in Cotonou, Benin, as part of the SIMBLE study.
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From 19 till 21 February 2024, the SIMBLE team visited the Centre Hospitalier Universitaire Yalgado Ouédraogo (CHU-YO) in Burkina Faso for a first monitoring visit.
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Impact stories
"I'm one of those idealists who graduated with the goal in mind: 'That's where I want to work!'" - Dr Liselotte Hardy
Dr Liselotte Hardy received her PhD from ITM. She has been working on the SIMBLE project since 2021. As part of the project, she is developing diagnostic devices adapted to conditions in Africa. We spoke to her about the project and why she chose to work at ITM. -
On 26 December 2023, the SIMBLE field study successfully started at CHU-YO in Ouagadougou, Burkina Faso.
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The third, annual consortium meeting of the EDCTP SIMBLE project took place from 13 till 15 November 2023.
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Interview with alumnus Jean-Claude Semuto Ngabonziza
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After a few training days, the first patients were enrolled in the SIMBLE project in Benin.
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On 20-23 March 2023, Liselotte Hardy and Barbara Barbé (ITM’s coordinating and principal investigator of the SIMBLE project) visited the “Centre Hospitalier Universitaire Yalgado Ouédraogo" (CHU-YO) in Ouagadougou, Burkina Faso.
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Our publication on the development and installation of SIMBLE microbiology culture media production facility was featured in The Lancet Microbe.
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Articles
Antimicrobials: Handle with Care
Innovating and building local capacities to fight antimicrobial resistance -
De Morgen spoke with Liselotte Hardy
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Immediately after the consortium meeting, the first batch of agar plates and blood culture bottles was produced.
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Liselotte Hardy, ITM and Jean-Claude Senou, CHNU-PPC visited the Spanish SIMBLE consortium partner, Reactivos Para Diagnóstico.
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The research was undertaken because of the increasing need for alternatives to antibiotics
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It's World Antimicrobial Awareness Week - Antimicrobials: handle with care
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Based on this finding, the diagnostic algorithm was changed and patients now receive proper care.
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Salmonella bloodstream infections are assumed to account for more than 3 million cases per year in Africa.
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The event takes place from 5 to 7 December in Phnom Penh, Cambodia.
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Tropical parasite was pre-adapted to drugs even before the treatment was discovered
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ITM researchers set out building blocks for clinical bacteriology in poor countries and host international expert for short course on antibiotic resistance.
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Investigation into suspected typhoid fever epidemic in the Democratic Republic of Congo (DRC) leads to identification of a multidrug-resistant strain of Salmonella Typhi.
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WHO warns that sexually transmitted infection gonorrhea becomes harder to treat
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ITM and others to assist the government of Georgia in developing a provider incentive payment scheme for tuberculosis
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25 April is World Malaria Day.
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Health care professionals deepen their knowledge of antibiotics resistance in low resource settings.
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Promising new drugs and shorter MDR-TB treatments are in the pipeline and may lead to an increase in the cure rate
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ITM contributes to worldwide analysis of drug-resistant typhoid in Nature Genetics
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€ 1.35 million for three research chairs on diagnostics, treatment and human behaviour
