Paul Turner: Improving data for infection management

Hi, I'm Paul Turner. I'm a paediatric clinical microbiologist based at Angkor Hospital for Children in Siem Reap, Cambodia.

I have two real main areas of research. I'm a paediatric microbiologist, which means I'm interested in infections in children, the causes, the outcomes, and looking at potential preventative measures. More and more, I'm focused on antibiotic resistance or antimicrobial resistance, which is where infections are not treatable with the drugs that we have available to us. One of the main projects I'm involved with at the moment is called ACORN, and this is A Clinically(-Oriented) Antimicrobial Resistance Surveillance Network. So, this is really aiming to gather data from countries like Cambodia, in fact, nine countries across Asia and Africa, to understand better the burden and the impact of antibiotic resistance on patient treatment and outcomes.

The big question with ACORN, and the big question really about antibiotic resistance in low resource settings is: how much is there, and what does it mean? Does the antibiotic resistance actually make a difference? Of course, we think it does, but we haven't been able to quantify that very easily, which means it's very difficult to make decisions around what to do about it. So, ACORN aims to fill that gap, to gather data across a range of sites across these countries in Asia and Africa, to really understand better the extent of the problem and the impacts that has on patients and healthcare systems.

We hope that ACORN will have several impacts in the antibiotic resistance area. Firstly, direct patient care should improve as a result of the project. Encouraging clinicians to better use their diagnostic microbiology laboratories will mean that patients get results representative of their own infections, which will enable them to have better treatment right now. Secondly, when we aggregate the data across the hospital site, then we should be able to generate antibiotic treatment guidelines that will improve the treatment of all the patients in the hospital. And then finally, when we aggregate the data across sites for the whole network, then we'll be able to better understand the burden of antibiotic resistant infections and hopefully identify interventions that may improve the situation in the future.

Antibiotic resistance is one of the most important problems in global health at the moment. AMR affects all areas of the population, from newborn babies to surgical operations to patients in the intensive care. One of the biggest problems is we don't know the extent of the problem in low resource settings. We have an idea that it's a significant problem, but we lack the data to drive changes in practice, and policy makers to inject funds to mitigate this big problem. So, ACORN will fill that gap. It will provide some of the data that's missing and enable us to move forward.

Surveillance is one of the cornerstones of the solution of antibiotic resistance, gathering the data to know how much there is. We can then use this surveillance data to plan interventions, to restrict treatments to those that really need it, to improve access to vaccines, and then we can use that surveillance in the future to measure the impact of those interventions. We need to go from measuring to intervening.

My vision for the future is really simple. It's a future where patients have access to better antibiotics for their infections.

This interview was recorded in January 2024