MICROBIAL TECHNOLOGY
(mpox) outbreak in 2023. This enabled rapid detection of mpox virus directly from skin swabs at a time when there was no existing test readily available. Next, she described the results of a study in the ICU in which a total of 112 samples from 69 patients were analysed over the winter period. Two false-negative results were obtained by the metagenomics where viruses detected by the clinical laboratory at a very low level by PCR were missed. However, in 18 (15%) samples, metagenomics detected organisms that were not cultured. Turnaround time was six to seven hours, which meant that a ‘run’ started at 9.00 am led to a preliminary report being released at 3.30–4.00 pm on that day. This is clearly a huge step forward and the first stage to a practical metagenomic method that can be introduced into the diagnostic laboratory.
Action planning to combat AMR To round off the day, Dr Alicia Demirjian, Clinical Lead, Antimicrobial Resistance & Prescribing (AMRP), UKHSA, described the UKHSA strategy and approach to tackling AMR and tantalised us with a preview of what we might expect from the soon-to-be-announced 2024–2029 UK Antimicrobial Resistance National Action Plan (NAP).
One of the UKHSA priorities is
to reduce the impact of infectious diseases and antimicrobial resistance. Activities across several work streams are coordinated to achieve this priority in human health, including: n Proactive activities, such as surveillance, analysis, and reporting, modelling cost-effectiveness
n Reactive activities, such as threat detection, management of incidents and outbreaks, reference microbiology, and providing urgent advice to (inter) national agencies
n Interventions such as infection prevention and control, antimicrobial stewardship, and developing evidence- based interventions to support prescribing.
Dr Demirjian showcased examples of resources available from the UK that support ways to tackle AMR as a strategic priority, such as the annual ESPAUR report (English Surveillance Programme for Antimicrobial Utilisation and Resistance), Antibiotic Guardian, eBug educational resources for children, and the Keep Antibiotics Working Campaign. The first AMR NAP ran from 2019– 2024 and focused on three key areas: i) to reduce the need and unintended exposure to antimicrobials; ii) to optimise the use of antimicrobials; and iii) to
18
Oxford Nanopore technology: sequencing using this system involves very low capital expenditure.
invest in innovation, supply and access. Dr Demirjian described the successes of the 2019–2024 national action plan and reflected on lessons learned, including the challenges and opportunities of the COVID-19 pandemic.2
Alongside influencing antibiotic
prescribing, diagnostics have a key role in addressing AMR and ambitions to support innovation and the rapid uptake of novel diagnostics were included in the first UK National Action Plan. Dr Demirjian discussed the role of genomics and AMR diagnostics, and we learnt how genomic services at UKHSA will have a central role in the next National Action Plan. To summarise, Dr Demirjian suggested that the next UK AMR Action Plan is likely to focus on the following key areas: n Big data and threat detection. n Maximising whole-genome sequencing capabilities.
n Modelling and evaluation of population-level interventions.
n A stronger focus on infection prevention and control.
n Harnessing research into policy outputs and public health actions.
n Tackling health inequalities.
In order to achieve the ambitious aims needed to combat AMR that will be outlined in the second UK AMR National Action Plan, Dr Demirjian concluded by emphasising the importance of building and strengthening cross-agency, cross- discipline collaborations.
The UK five-year action plan for
antimicrobial resistance 2024 to 2029 was published on 8 May.3
References 1 Alcolea-Medina A, Alder C, Snell LB et al.
Unified metagenomic method for rapid detection of microorganisms in clinical samples. Commun Med (Lond). 2024 Jul 7 (1); 4: 135. doi: 10.1038/s43856-024- 00554-3.
2 UK Government. Tackling antimicrobial resistance 2019–2024. The UK’s five- year national action plan. 24 Jan 2019 (
https://assets.publishing.service.gov.uk/ media/6261392d8fa8f523bf22ab9e/UK_ AMR_5_year_national_action_plan.pdf).
3 UK Government. Confronting antimicrobial resistance 2024 to 2029. 8 May 2024. (
https://assets.publishing.service.gov.uk/ media/664394d9993111924d9d3465/ confronting-antimicrobial-resistance-2024- to-2029.pdf).
The second of two reports on this year’s BSMT Annual Microbiology Conference was written by Carolyne Horner, Carmel Aldridge, David Westrip and Mark Wilks. The first report, on the morning session, can be found on page 23 of the June issue of this magazine.
If you enjoyed this conference, why not consider joining the committee to help organise the next one and make it even better? A quick look at the committee shows it doesn’t reflect the diversity of people who work in clinical microbiology laboratories and we’re very keen to correct this! So please drop us an email to
mwilks@bsmt.org.uk.
Next year’s conference will return to the RAF Museum in Hendon and will take place on Thursday 15 May 2025. We very much hope to see you there.
AUGUST 2024
WWW.PATHOLOGYINPRACTICE.COM
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