In May, Lord Jim O’Neill published his final AMR report, which emphasized 10 key areas for urgent action and improvement. Elsewhere, there was a major development in Gram-negative resistance last November with the first description of plasmid-mediated resistance to colistin.
Monitoring for colistin resistance is, however, confounded by the poor reliability of many routine antibiotic susceptibility testing (AST) methods; at present, EUCAST and CLSI only recommend microbroth dilution for colistin (see here). We found mcr-1-positive isolates in the UK by mining our genome data (see here), which emphasizes the importance that genomics will play in the future of AMR services. Also, through leadership of a EUCAST subcommittee, we delivered a comprehensive assessment of the potential for whole genome sequencing to replace AST for bacteria.
Cardiac bypass heater-cooler units
The Infection Control section of AMRHAI has been part of the wider PHE investigation of bacterial contamination of cardiac bypass heater-cooler units (HCUs). A link between these machines website like this and infections with Mycobacterium chimaera appearing months or years after cardiac surgery was identified by researchers in Zurich; they found the same species in HCU water and in the air around working machines. As the heating and cooling of blood on bypass is indirect, via an impermeable membrane, and the machines are kept well out of the sterile field, it is hypothesised that transmission is via contaminated aerosols produced by HCUs.
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