Infraestructura de Medicina de Precisión asociada a la Ciencia y la Tecnología
Antimicrobial resistance (AMR) is a health threat to the public and individual health of patients. ADR generates an increase in morbidity and mortality, longer hospital stays, loss of effective coverage in patients with chemotherapy, transplants or major surgeries, and increased economic costs. AMR, mainly the appearance of pan-resistant bacteria, poses a real risk of reaching a scenario similar to that of the pre-antibiotic era; and this is now recognized by all national and international institutions.
The MePRAM project addresses this problem in a comprehensive way, using omics technologies to detect resistant microorganisms early, optimizing clinical management and personalized treatment of affected patients, as well as anticipating the development of multidrug-resistant resistance and infections. In addition, the project seeks to implement effective alternative therapies, such as phage therapy, and generate evidence on individualized approaches to treat these infections. Through interactive, standards-based platforms and harmonized data repositories from various sources, especially genomic and clinical/epidemiological (in collaboration with IMPACT), early and accurate decisions will be made, developing supporting algorithms with machine learning to personalize preventive and therapeutic measures against AMR.
The main goals of MePRAM include reducing infections with resistant microorganisms, improving the focus on infected patients, and controlling the general spread of these microorganisms.
To achieve this, we have structured ourselves into four work packages with the following specific objectives:
The creation of an integrated platform of semantically compatible and interoperable clinical, epidemiological and genomic (microorganism) data, which can integrate large case series of multidrug-resistant pathogens. The ultimate goal is the development of decision algorithms with machine learning and data mining techniques. WP1.
The development and application of bioinformatic analyses on whole genome sequences for the early detection of the emergence of resistance, the characterisation of cross-border outbreaks by multi-resistant clones and the prediction of resistance. WP2.
The establishment of the bases for the promotion of phage therapy in Spain, both at a scientific-technical and regulatory level. WP3.
The creation of a structure/platform for the implementation of clinical trials in an agile way; large adaptive and multi-branch trials that allow a real response to the challenges that arise in the field of antimicrobial resistance. WP4.
The impact of MePRAM is based on its ability to minimize the negative effects of AMR on the individual health of patients and on the general health status of the population.
Although the quantification of the impact will depend on different aspects such as the speed and extent of the implementation of the proposed measures, the great health and economic cost that AMR entails in current health systems, the multidisciplinary and coordinated approach at different levels of the proposed initiative, and the large number of institutions and Autonomous Communities involved grouped around a CIBER structure, make it possible to foresee that the impact of the action will be of great magnitude.
Scientific impact.
The development of bioinformatics tools for the study of resistome, viruloma and phylogeny of microorganisms.
The creation of sustainable structures over time such as the integrated clinical-genomic data platforms, the clinical trials platform and the national phage registry.
Impact on the NHS and patients.
In the prevention of infections caused by multidrug-resistant bacteria, especially those caused by those considered high-risk clones: Reduction of the burden of infection.
Reducing the circulation, and outbreaks, of multidrug-resistant bacteria: Reducing the burden of infection.
In the improvement of the clinical evolution of patients infected by multidrug-resistant bacteria: Reduction of admission time, reduction of complications.
Reducing infectious complications in patients undergoing medical procedures that require antimicrobial coverage: Reduction of morbidity and mortality.