Upon completion of this workshop, the attendee should be able to:
•Describe the important antimicrobial resistance mechanisms of problematic bacterial pathogens such as Gram-positives MRSA/CMRSA USA300, EMRSA-15, hVISA/VISA, VRE, and in Gram negatives resistance to Beta-lactamase resistance such as MBL, ESBL, AMPC, KPC etc..
•Apply CLSI and CDS latest Standardised Guidelines to detect resistance antimicrobial agents in the laboratory in the light of evolving resistance in various organisms; and
•Understand the various phenotypic and molecular methods and approaches used to track the development of antibiotic resistance – epidemiology.
LOCATION
Faculty of Medicine. Infectious Diseases and Immunology Laboratory. Level 4 Classroom Blackburn Building, University of Sydney. Bus will take attendees from Darling Harbour to the University.
Lunch (Tea and Coffee breaks when required) will be provided at the venue and is included in the cost of registration.
PRELIMINARY PROGRAM
This full day workshop is divided into two parts:
Morning Session: Series of small lectures and updates from the experts
Afternoon Session: Hands on tutorials and practical demonstration with discussions. Notes will be provided to all attendees.
09:00 – 09:30
Registration
University of Sydney
Topics: Titles to be confirmed.
LECTURE SESSION
Theme: Bacterial Antimicrobial Resistance, Guidelines and Epidemiology
09:30 -10:00
Dr. John Merlino – Antimicrobial SIG Convenor/Chair – ASM
Welcome; The Problem of AMR: What can we do about it in the Laboratory?
10:00 -10:30
Prof. John Turnidge
Updates on CLSI and EUCAST Guidelines in detecting Resistance
10:30 -11:00
Prof. Sydney Bell
CDS Users Update Guidelines in detecting Resistance
11:00 -11:30
Prof. Patrice Nordmann (overseas invited speaker – France)
MDR in Gram-negatives from a European experience.
11:30 – 12:00
A/Prof. Jon Iredell
MDR and Transmissible Resistance in Enterobacteriaceae from a local experience.
12:30 – 13:00
Dr. Peter Kennedy
Biofilms and Antimicrobial Resistance
13:00 – 13:30
Prof. Iain Gosbell
“Reduced Vancomycin Susceptibility in Staphylococcus aureus”
13:30 – 14:30
LUNCH BREAK
PRACTICAL/DISCUSSION SESSION14:30-17:00
Theme: Mechanisms of Resistance and Methods of Detection – from Phenotype to Genotype
Attendees broken up into small groups and rotated along various demonstrations showing antimicrobial resistance mechanisms and detection methods – these will be discussed and notes provided. MRSA, clindamycin D-test, VRE, hVISA/VISA, B-lactamases – MBL, ESBL, AmpC, Mod. Hodge test, PCR Molecular gene Markers.
Tutors / Demonstrators:
Dr. John Merlino, Dr. J Pham, Lee Thomas , Justin Ellem, Jan Bell (to be confirmed), Prof. Iain Gosbell & TBA.
The development of antimicrobial agents (antibacterials, antivirals, antifungals and antiparasitics) to treat infections has been one of the most notable medical achievements of the past century. These advances in medical care are threatened, however, by a natural phenomenon known as “antimicrobial resistance.” Antimicrobial resistance, whereby microbes mutate and become less susceptible to these “miracle drugs” over time, creates problems for infectious diseases physicians as they must work quickly to determine what drug will work on a patient’s infection. Microbes’ ability to become resistant to antimicrobials not only impacts individual patients, but also can have devastating impacts on the general population as resistant microbes pass from one individual to another.
Worrisome recent examples of drug resistance include vancomycin-resistant Staphylococcus aureus (VRSA) and community-associated methicillin-resistant Staphylococcus aureus (MRSA). The emergence of VRSA is of great concern to clinicians and public health officials as vancomycin is typically the drug of last resort in treating S aureus and several other infections. MRSA, in the recent past, only affected immune-compromised individuals and the elderly in hospital settings. Now, it is occurring across the country in local communities—infecting healthy and strong individuals.
Policymakers and the public may view IDSA’s statements; relevant reports from the U.S. Public Health Service, General Accounting Office, Institute of Medicine and WHO/UN; and other useful policy documents, resources and links concerning antimicrobial resistance below.
IDSA Testifies to FDA on the Need to Update Susceptibility Breakpoints 10/26/2009
At a recent FDA Anti-Infective Advisory Committee meeting, IDSA testified about its position on updating the Microbiology subsection of product labeling for systemic bacterial drug product labeling and provided recommendations on how FDA could accomplish this task.
IDSA Urges Senate to Boost ID Public Health in Economic Stimulus Plan 01/21/2009
IDSA submitted proposals to Senate leaders urging the stimulus plan include investments in public health infrastructure for infectious diseases. Two proposals emphasize the crises of antimicrobial resistance and emerging infections, and HIV / AIDS and tuberculosis.
IDSA Preliminary Statement on Antibiotic Home Stockpiling 06/18/2008
At a meeting of the National Biodefense Science Board, IDSA delivered public comments raising concerns about an HHS intiative to inform the public about home stockpiling of doxycycline for use in a potential anthrax attack.
IDSA, HIVMA Call for Action on XDR-TB 03/19/2007
A fact sheet details the threat of Extensively Drug-Resistant Tuberculosis (XDR-TB) to the United States and the globe, and outlines urgent federal funding needs for FY08.
IDSA Supports FDA’s Preliminary Approach to Breakpoints Updates in a Response to U.S. Rep. DeLauro 11/17/2009
IDSA notes that FDA Appropriations Chairwoman appears to have received some faulty information when she took FDA to task on its plans to update antibacterial breakpoints on drug labeling (e.g., we disagree that the agency is “outsourcing” this essential function to the Clinical Laboratory Standards Institute).
IDSA Urges NIAID Clinical Trial Networks Expansion into New Areas 10/19/2009
NIAID officials are examining the possibility of expanding the Institute’s clinical trials networks to cover tuberculosis, hepatitis C, influenza research. IDSA supports this proposal and has requested that resistant bacterial infections also be considered.
IDSA and TFAH Support FDA’s New Thinking on the Use of Antimicrobial Drugs in Animal Agriculture 07/17/2009
On July 13th, FDA testified in support of phasing out the use of antimicrobials in animals for growth promotion/feed efficiency and requiring that all other uses of antimicrobials in animals be carried out under the supervision of a veterinarian and within the boundaries of a valid veterinarian-client-patient relationship.
IDSA Supports FDA’s Review of the Use of Antimicrobial Agents in Animals 10/27/2000
Supported FDA’s review of the human health risks associated with the use of antimicroibial agents in animals in a statement. One drug company sponsor, Abbott, has agrreed to withdraw its product. A second company, Bayer, is challenging FDA’s decision. IDSA will continue to monitor this issue.
Antimicrobial Resistance: Issues and Options 12/01/1998
IOM summary is the product of a workshop to provide an opportunity for representatives of academia, industry, government and professional groups to examine and discuss scientific and policy dilemmas of common interest that are specifically related to research on and the prevention, detection and management of emerging infections.
Of 3,004 gram-negative bacilli collected from intra-abdominal infections in the Asia-Pacific region during 2007, 42.2% and 35.8% of Escherichia coli and Klebsiella spp., respectively, were extended-spectrum _-lactamase (ESBL) positive. Moreover ESBL rates in India for E. coli, Klebsiella pneumoniae, and Klebsiella oxytoca were 79.0%, 69.4%, and 100%, respectively. ESBL-positive E. coli rates were also relatively high in China (55.0%) and Thailand (50.8%). Ertapenem and imipenem were the most active drugs tested, inhibiting over 90% of all species, including ESBL-positive isolates with the exception of Pseudomonas aeruginosa isolates (<90% susceptible to all study drugs) and ESBL-positive Klebsiella pneumoniae isolates (<90% susceptible to all study drugs except imipenem). Quinolones achieved 90% inhibition levels only against ESBL-negative K. pneumoniae and ESBL-negative K. oxytoca. A decline in ampicillin-sulbactam activity was noted, with only 34.5% of all Enterobacteriaceae inhibited in this study.