IHEEM REGIONAL CONFERENCE 2018
The history of antimicrobials Next, Dr Robert Spencer, a consultant in Clinical & Environmental Microbiology at Index Microbiology, examined the history of antimicrobials, in an address entitled ‘A celebration of a 20th Century medical triumph’. Originally qualified at St Mary’s Hospital Medical School at the University of London in 1970, ‘Bob’ Spencer has recently retired after 45 years as a medical microbiologist, having worked in senior positions in the NHS, at Sheffield University, with the Public Health Laboratory Service, The Health Protection Agency, and Public Health England. His presentation looked back at some of the leading scientists who had discovered some of the 20th century’s best-known antimicrobial drugs, such as Paul Ehrlich, who, having tested over 600 arsenical compounds to fight syphilis, finally, in 1909, with the help of his Japanese assistant, Hata, found one – Salvarsan 606, ‘which worked’.
A roll-call of luminaries Among a roll-call of other scientific luminaries discussed were German pathologist and bacteriologist, Gerhard Domagk, credited with discovering Sulfonamidochrysoidine, the first commercially available antibiotic – marketed as Prontosil, for which he received the 1939 Nobel Prize in Physiology or Medicine; Sir Alexander Fleming, the Scottish physician, microbiologist, and pharmacologist, best known for discovering the enzyme, lysozyme, and the world’s first antibiotic substance, benzylpenicillin (Penicillin G) in 1928, for which he shared the same Nobel Prize with Howard Florey and Ernst Boris Chain; mycologist, Charles la Touche, who undertook ground-breaking asthma research; Dr Cecil G Paine, celebrated for the first documented use of penicillin, René Jules Dubos, who in 1939 discovered Gramicidin, the first clinically tested antibiotic agent, and the famous ‘Oxford Group’ – Howard Florey, Ernst Chain, Norman G Heatley, and Sir Edward Penley Abraham. Dr Spencer went on to mention the discovery, first use, and clinical benefits, of medicines including Colistimethate, Erythromycin, Vancomycin, and Metronidazole, in a very comprehensive address.
Warning against over-prescription In summing up, he said that while prudent antibiotic use remained ‘a critical component of patient care’, and, ‘with appropriate use’, helped reduce the emergence of resistant organisms, the over-prescription and ‘indiscriminate’ use of such drugs were dangerous. He cited two salient quotations to make his point, the first from Felix Marti-Ibanez, who in 1955 presciently noted: ‘Antibiotic therapy, if indiscriminately used, may turn
22 Health Estate Journal October 2018
Dr Marion Lyons, senior Medical officer, Health Protection, at the Welsh Government, drew some interesting comparisons between the NHS in 1948, and as it is today.
out to be a medical flood that temporarily cleans and heals, but ultimately destroys life itself.’ Over 30 years later, EJL Lowbury warned: ‘In the battle of human wits against bacterial genes the bacteria are seen to have the advantage of unvarying obedience to their genetic codes, while sadly our codes of practice are fallible and easily disregarded.’
Addressing cybercrime
In a complete switch of topic, the day’s third speaker, Martin Webley, CISSP, head of Cyber Security at NHS Wales Informatics Service, discussed ‘The role of NWIS Cyber Security in protecting national services, supporting collaborative improvement across NHS Wales, and embracing new technology and innovation’. He explained that NWIS Cyber Security’s roles and functions included ‘awareness, secure file sharing, third-party assurance, vulnerability and penetration testing, incident response, security monitoring, and consultancy’. Unfortunately, he said, healthcare was becoming ‘the most targeted industry for cybercrime’, driven by the large number of interconnected organisations involved, increasing connectivity with third-party
Dr Robert Spencer, examined the history of antimicrobials in an address entitled ‘A celebration of a 20th Century medical triumph’, which touched on some of the illustrious scientists involved.
organisations, numerous local and third- party managed services, third-party supplied devices, and non-NHS IT managed devices. Among the resulting threats were ‘hacking’ of Internet-facing services, infection via third-party suppliers, and malicious code and ransomware, as well as those from internal sources – such as medical devices, and both accidental and intentional data loss / theft. While there was ‘no silver bullet’, he explained that NWIS Cyber Security strove to adopt a ‘layered and proportionate approach’ to cybercrime, key elements of which included: n Senior management support. n Effective security polices and awareness.
n Human resources security – through ‘screening’.
n Physical access controls. n Asset management. n ‘System’ – acquisition, development, maintenance, support and disposal.
n Incident response. n Operational – Third parties, back-ups, segmentation, and monitoring.
n Risk assessment, treatment, review, and ongoing improvement.
Martin Webley, head of Cyber Security at NHS Wales Informatics Services, warned that, for a number of reasons, healthcare was becoming ‘the most targeted industry for cybercrime’.
Huw Shurmer, Programme manager at Fujifilm UK, described how the company is working to manage the acquisition, storage, and diagnostic viewing, of over two billion medical images for NHS Wales.
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