Study from Limerick university marks milestone in battle against global health threat

A ground-breaking large-scale research study from the University of Limerick marks a major milestone in the battle against antimicrobial resistance (AMR), a global public health threat that could add a trillion US dollars to worldwide healthcare costs over the next 25 years.

Led by Professor Colum Dunne, Head of the School of Medicine, University of Limerick, the research is a collaborative ‘One Health’ initiative involving UL, HSE Mid-West, the Department of Agriculture, Food and Marine, as well as veterinary professionals.

The analysis of data on Escherichia coli (E. coli) isolates, from human and bovine populations in the region from 2012 to 2023, tracks a significant decline in AMR in that timeframe.

E. coli is a bacterial species and is one of the most common pathogens in both humans and bovines. It is also a critical indicator of AMR. Researchers analysed the data from more than 125,000 E. coli isolates from human urine, blood, and bovine samples. 

AMR is a global public health threat that compromises the effectiveness of treatment and increases risks for surgeries and cancer treatments, among other medical procedures. The World Bank projects that AMR could result in additional healthcare costs of a trillion US dollars by 2050.

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Professor Dunne highlighted the importance of the findings, which underline the success of Ireland’s National Action Plan on Antimicrobial Resistance that emphasises the ‘One Health’ collaborative approach across human, animal, and environmental health sectors, saying; “Most studies on antimicrobial resistance emphasise the threat to our future health. This is a rare study that describes how some of our efforts in prescribing and use of antimicrobials, especially antibiotics, are already making a difference and improving levels of potentially problematic resistance. It is encouraging.”

Professor Nuala O’Connell, Consultant Microbiologist, University Hospital Limerick, and Adjunct Clinical Professor at UL’s School of Medicine, said: “Antimicrobial resistance remains a global health threat, and this Irish study shows the importance of having a One Health Approach to stewardship in tackling this problem given the spread of resistant organisms between healthcare facilities, animals as well as food and the environment.”

The data suggest that increased use of "preferred" antimicrobials in humans, along with reduced usage of those "to be avoided," has contributed to the downward trend in resistance. The study’s results underscore the importance of continued surveillance and a One Health approach to monitor and combat AMR across human, animal, and environmental sectors.

“This study highlights the positive impact that responsible antimicrobial use and stewardship programs have on combating AMR,” said Professor Dunne. 

“It’s clear that a One Health approach, where we integrate human, animal, and environmental health, is essential for addressing this critical global health challenge.”

The study’s findings provide crucial evidence for public health policy and offer valuable insights for continued action against AMR. As antimicrobial resistance continues to threaten the effectiveness of treatments, this research offers hope that ongoing efforts to curb AMR may safeguard future healthcare outcomes.

Dr James Powell, Surveillance Scientist in UL Hospitals and a Principal Investigator for the study said: “It gives me great pride to see this study reaching completion and publication. It was a big undertaking for us to examine this very large dataset, but the findings are hugely significant with global implications for the very worrying threat of antimicrobial resistance.”

Published in the highly respected Eurosurveillance journal, the research highlights the effectiveness of antimicrobial stewardship and reduced antimicrobial usage practices in the Mid-West that have led to a significant decline in antimicrobial resistance (AMR) in community and hospital settings.