Research and cooperation against antimicrobial resistance
The World Antimicrobial Resistance Awareness Week (WAAW), promoted by the World Health Organization (WHO), will take place from 18 to 24 November under this year’s theme “Preventing Antimicrobial Resistance Together: Protecting Our Present, Securing Our Future”.
The main goal is to raise global awareness of the danger of antimicrobial resistance (AMR) – a phenomenon that occurs when bacteria, viruses, fungi and parasites evolve to resist the effects of medicines, making infections increasingly difficult to treat.
In the lead-up to this globally significant event – from health, scientific and social perspectives – Area Science Park organised today in Trieste, in collaboration with the University of Trieste, the International Workshop “Tackling Antimicrobial Resistance: Prevention, Monitoring and Counteraction”. The event focused on prevention, monitoring and counteraction strategies to fight antimicrobial resistance (AMR).
The initiative, developed within the PRP@CERIC project and promoted under the patronage of major national and international scientific institutions – including the Ministry of University and Research (MUR), the Italian Society of Microbiology (SIM) and the University of Trieste – the initiative brought together experts from academia, clinical research and industry to discuss the latest studies and innovative solutions aimed at addressing the growing threat of drug-resistant bacteria.
In recent years, scientific research has been striving to find effective answers and strategies to stop the spread of antibiotic-resistant bacteria and develop therapies capable of treating infections that no longer respond to traditional treatments. International scientific cooperation remains one of the key factors in tackling what is widely recognised as one of the greatest public health challenges of our time.
During the workshop, experts emphasised that monitoring is a cornerstone of the Italian National Action Plan on Antimicrobial Resistance (PNCAR). Antimicrobial resistance is an evolutionary and global process responsible for 1.27 million direct deaths and 4.95 million total associated deaths each year – a figure that exceeds the combined totals of tuberculosis and HIV. The ESKAPE group of bacteria (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Escherichia coli), together with Mycobacterium tuberculosis and Streptococcus pneumoniae, are currently among the main culprits of the most difficult infections to treat.
“The situation regarding antibiotic resistance is highly heterogeneous. In Italy, we are observing growing caution and awareness in the prescription and correct use of antimicrobials — both in human medicine and in livestock farming — but globally, management of the issue remains inconsistent,” said Federica Mantovani of Area Science Park. The World Health Organization and the European Commission have both pointed out that, despite preventive measures, there is still a serious lack of innovation in this field. Of the roughly ninety drugs currently under development, only fifteen are considered truly innovative. It is crucial to intensify research — including basic research — to develop radically new therapies and overcome antibiotic resistance, since continuing to rely on existing therapeutic models will not be sufficient”.
To combat the spread of AMR, coordinated action is needed at both international and local levels, based on antibiotic stewardship programmes – promoting the rational and targeted use of antimicrobials – along with continuous epidemiological surveillance and the “One Health” approach, which recognises the interconnectedness of human, animal and environmental health.
“Antimicrobial resistance is a global phenomenon that requires local action,” highlighted Stefania Stefani of the University of Catania. Its impact varies greatly, with much more severe consequences in Africa, India and the Far East, where there are critical issues in accessing care and new antibiotics. In Italy, for instance, we face high mortality rates due to multidrug-resistant Gram-negative microorganisms. It is a multifactorial problem with no borders. To address it, the One Health approach is essential, recognising that resistance arises equally in humans, animals (livestock) and the environment. We must study the problem in all these contexts, identifying hotspots for resistant microorganisms — such as wastewater treatment facilities — to understand their origins and assess future risks to human health”.
A significant portion of the workshop was devoted to presenting innovative therapeutic strategies, including research on human monoclonal antibodies isolated from convalescent patients, capable of preventing and treating bacterial infections and helping to identify new antigens for vaccine development. These advances open up concrete perspectives for countering resistant pathogens and reducing the global public health burden of AMR.
“Monoclonal antibodies represent a promising alternative to traditional antibiotics,” explained Claudia Sala of the Biotecnopolo Foundation of Siena, “as they can target only pathogenic bacteria with high specificity, preserving the ‘good’ microbiota that is often harmed by conventional antibiotics. Monoclonal antibodies are already approved for other diseases, such as cancer and autoimmune disorders, where their use is well established. As for antibacterial antibodies, we are still in the discovery phase — and human trials take time, as they must go through multiple stages of testing”.
Another promising approach, discussed by Mariagrazia Di Luca of the University of Pisa and the ICGEB, involves the use of bacteriophages, viruses that infect and destroy bacteria, emerging as precision antimicrobials for targeted therapies — for example, in cases of chronic infections. These viruses offer a highly specific solution because they selectively attack pathogenic bacteria while preserving beneficial microbiota. Thanks to scientific advances, researchers can now engineer phage cocktails and derivatives to overcome bacterial resistance mechanisms, with encouraging results already observed against multidrug-resistant pathogens such as Pseudomonas aeruginosa and Staphylococcus aureus. Nevertheless, significant challenges remain, particularly in terms of regulatory approval and large-scale production.
Fighting antimicrobial resistance requires shared commitment and strengthened international cooperation — through the promotion of responsible antibiotic use, improved hygiene and infection prevention (including vaccination), and sustained support for research into new therapies.