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Saskia v. Popescu, MPH, MA, CIC, is a hospital epidemiologist and infection preventionist with Phoenix Children's Hospital. During her work as an infection preventionist she performed surveillance for infectious diseases, preparedness, and Ebola-response practices. She is currently a PhD candidate in Biodefense at George Mason University where her research focuses on the role of infection prevention in facilitating global health security efforts. She is certified in Infection Control.

Swabbing Our Way to a Solution for Antibiotic Resistance—Part 2

NOV 17, 2017 | SASKIA V. POPESCU
As Antibiotic Awareness Week draws to a close, the struggles of not only antimicrobial stewardship, but also antimicrobial development come to mind. Antimicrobial resistance represents a global threat and one that is predicted to be responsible for 10 million global deaths every year by 2050. The Centers for Disease Control and Prevention reports that currently, in the United States alone, 23,000 people die each year because of infections that are resistant to antibiotics. Antimicrobial resistance is a huge threat and one that is very difficult to manage because its roots branch out to many areas, including misuse and overuse of antibiotics in medicine, agriculture, medical tourism, etc. However, many groups and even individuals are working to find some solutions.
 
Antimicrobial stewardship is one strategy that seeks to reduce the misuse and overuse of antimicrobials, while developing more efficient usage practices that improve patient outcomes. However, antimicrobial stewardship is only one piece of the puzzle. Another piece is drug development. In conjunction with efforts to change our prescribing and usage behavior, scientists are also working to develop new antimicrobials. Antimicrobial development is critical as there has been little in terms of new antimicrobial development since the 1980s. Antibiotic research and development (R&D) is an uphill battle, though, and there are not a lot of economic incentives for it. In addition, the process is extremely costly, takes a long period of time, and there are significant scientific roadblocks. These roadblocks are so daunting that there are several groups working to try and help overcome them to speed up the development of vital antibiotics. The Pew Charitable Trusts and CARB-X are just a few of these groups that strive to accelerate collaboration, research, and development in this antibiotic abyss.
 
Some scientists are also going it on their own. Adam Roberts, PhD, from the Liverpool School of Tropical Medicine, is working to find a novel antibiotic, but through a more traditional route—nature. The environment is a rich source for microorganisms, some of which produce compounds that can be utilized as antibiotics. Although most individuals would scour the earth to find obscure microorganisms, Dr. Roberts is looking in the battleground around us—the real world where people and bacteria are in close quarters. 

Earlier this year, I had the chance to chat with Dr. Roberts and learn about his citizen science program, Swab & Send. People from around the world are sending in their swabs—for £30, his team will send you 5 swabs—to his lab to help find a microorganism that may just have the golden ticket compounds that could be used to make antibiotics. Naturally, I jumped at the chance to participate in this program and as promised, report back to you what they found.

Upon receiving the swabs, I was excited to start finding unusual and hopefully, impacting, surfaces and objects to swab. First, I started with my own cell phone. Not only are cellphones dirty, but for someone who spends time in a hospital and travels frequently, it seemed like a worthwhile shot. Second, I swabbed a toy and food bowl from one of our dogs. Finally, I looked to sources at one of the hospitals I’ve worked with, swabbing a courtesy phone and information desk within the lobby.
 
What exactly did we find?

Not surprisingly, the swab from the hospital courtesy phone had microbial growth that had anti-candida activity. Dr. Roberts shared with me, “We know it has no activity against Escherichia coli. Of the 200 or so isolates we tested in this run, yours plus 3 others (2 from underneath a wristwatch [probably clones] and 1 from an ancient woodland) could inhibit the Candida albicans strains.” This inhibitory feature means that the Candida albicans strains were not able to grow, making it a fascinating finding!

The Swab & Send photos and results are available on their Facebook page, but I have included the picture of my swabs here:



Programs like Swab & Send are vital to helping identify potential avenues for antimicrobials and also raise awareness for not only the natural hiding places of future antibiotics, but also the critical threat of antimicrobial resistance. 
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