Tackling antimicrobial resistance with global, interdisciplinary, and culturally-informed research
Antimicrobial resistance (AMR) poses one of the greatest threats to human health globally, but it is a highly complex issue with causes and implications that transcend international borders, and even humans as a species. The challenge this poses can only be met with corresponding levels of breadth and nuance, drawing in experts from across disciplines and sectors, including community actors, to create a holistic, culturally informed and interdisciplinary approach.
In this guest blog, researcher Dr Suparna Mitra talks about her research in this area, how her background has helped lay the foundations for global and interdisciplinary collaboration, and how she and her research team plan to make meaningful change in global health.
AMR and the gut biome
I am a microbiome data scientist, and most of my research at University of Leeds is focussed on the complex gut microbiome, a major potential reservoir for antimicrobial resistance genes.
AMR occurs when germs like bacteria and fungi develop the ability to defeat the drugs designed to kill them — this is recognised as one of the top global public health and development threats by the World Health Organisation.
The human body is home to several trillion microbes which combined is known as the microbiome. The most common types of microbes are bacteria, viruses, and fungi, and these can both potentially be helpful, or potentially harmful, and make us sick.
Specifically, my work is focused on how we can study and understand our microbiome within our body and in the environment, and providing answers to the question ‘how can we restrict the use of antimicrobials and ensure longevity of these life saving drugs for future generations? Unrestricted use of antimicrobials is of major concern in Low- and Middle-income Countries (LMICs), not only via human consumption, but also the use of antimicrobials in livestock, that can subsequently be transferred to humans.
Antibiotic use in High Income Countries (HICs) has remained flat over the past 15 years, while in LMICs, use over the same period has increased substantially because of economic improvements and changes in diet.
I want to help create a shared platform for tackling the global AMR challenge by connecting interdisciplinary research communities and addressing recent demands in medical science combining methodologies for data analyses with advanced sequencing techniques.
Laying the foundations for a meaningful One Health study
As someone born and brought up in India, and after studying, working in three countries (Germany, UK and Singapore), and learning techniques from fantastic supervisors and mentors, I now find myself equipped with the skills and expertise to match my motivation and passion for creating research-informed change. Both my personal and professional background has led me to work on microbiome research, and how to control antimicrobial resistance through various interventions, in LMICs.
My academic background is strongly interdisciplinary, originally coming from Mathematical and Statistical fields (my PhD was in Bioinformatics), and I was awarded the Michael Beverley Innovation Fellowship (MBIF) in 2022. This supported me to start a project in Bangladesh that became the founding pillar for understanding the Impact of unrestricted antimicrobial usage on the gut microbiome and antibiotic resistance genes (ARGs) among Bangladeshi population in a Low- and Middle-Income Country context.
As part of this project, supported by the International Strategic Fund (ISF), in December 2023,we held a community engagement day in Dhaka, Bangladesh, offering us the opportunity to understand the vastness of the problem and consider our future research plans.
Through all of this work, I have built an extensive collaborative network within Bangladesh, and am now planning a One Health study, obtaining human, animal, and environment samples. My team for this work is truly multi-sectoral, comprising of with doctors, data scientists, statisticians, microbiologists, molecular biologists, environmental microbiologists, veterinarians, bacteriologists, nutritionists, social workers and policy makers.
Exploring a global challenge
Since starting in this area, I have wanted to expand my research by understanding the effect of unrestricted antimicrobial usage, not only by direct human consumption but also from the food source and the environment. At the same time, I’ve been developing collaborations in this field with other researchers globally — looking at issues around AMR in One Health in different global contexts.
For instance, the Horizons Institute’s Global Academy Crucible helped me to connect with Dr Sherry Johnson, a Veterinarian and Field Epidemiologist at University of Ghana. Through Global Academy Crucible funding, I visited Ghana last June, and we are now writing a proposal for further funding of our pilot study in Ghana. This will, to some extent, mirror the study in Bangladesh but brings in the different cultural perspective.
An Interdisciplinary and multi-sectoral approach is important to provide new insights into antimicrobial resistance, with our co-creation work with communities being essential for gathering data outside of healthcare settings and influencing grassroot level people to understand the significance of AMR.
Collaborations and community co-creation
Through our One Health approach in Dhaka, we are aiming to gather knowledge from the communities, feeding back into community health choices through co-created community engagement materials.
It is important to understand the needs of the communities first, while also exploring the breadth of and potential for damage in Bangladesh, in order to find innovative, culturally informed and lasting solutions that have potential to make real and lasting impacts.
The challenge is not only significant now, but also has the potential to grow over time without positive, research informed interventions. While Antimicrobial use in HICs has remained flat over the past 15 years, in LMICs, use over the same period has increased substantially. In Bangladesh alone, 36 major antibiotics are now considered ineffective, and in and up to 26,000 people have lost their life over the last year due to multiple infections [Bangla].
Despite the threat of us all returning to the pre-penicillin era, I firmly believe that we can make this world a better place and save our lifesaving drugs for the next generations.
In helping build a shared platform for tackling the global AMR challenge, I hope to help connect interdisciplinary research communities so, together, we can create a clearer picture of the scale of AMR, and a plan we can all move forward together. But while we can lay these foundations as a research community, we can only succeed in this by using our collective expertise to motivate people — to be the stewards of the microbial world and to manage our microbial garden.
Dr Suparna Mitra is a senior lecturer of Bioinformatics (Microbiomics) and a researcher in Metagenomics and Metatranscriptomics to medical sciences at the University of Leeds, with a focus on the complex gut microbiome. Suparna is an active member of the Horizons Institute research community, and has participated in both Crucible and Global Academy Crucible programmes. To get in touch or find out more, you can visit her website or connect via LinkedIn.
