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This conference brings together infectious diseases specialists, physicians, clinical/hospital microbiologists, and pharmacists, and has also had increasing input from researchers (including drug discovery and antimicrobial susceptibility testing) over the last few years.  The Doherty Institute was well represented, with participants from the Microbiological Diagnostic Unit Public Health Laboratory (MDU PHL), the Victorian Infectious Diseases Service (VIDS), the National Centre for Antimicrobial Stewardship (NCAS), and research laboratories amongst others.

Plenary speaker Lance Price (USA) presented on ‘Food Animals as a Source of antimicrobial resistance (AMR) in Humans’, in a fascinating study where his research group collected and sequenced human (urinary tract infection) and food animal Escherichia coli isolates from a single small town in the USA for one year. The study showed that some clones were restricted to human infections, some clones were restricted to animal colonization, and in many clones there was an intermingling between the two, demonstrating likely spread from food to human infections, but surprisingly, also humans to animals in a few cases.  He also presented on his favourite organism, E. coli, and particularly the global success of the H30-Rx multidrug-resistant (MDR) clone of ST131 E. coli. 

Another plenary speaker, Matthew Holden from University of St Andrews, Scotland, showed applications of genomics to hospital infection control. Whilst investigating a prolonged methicillin-resistant Staphylococcus aureus (MRSA) outbreak in a neonatal intensive care unit, they were able to demonstrate likely transmission pathways, including the occasional involvement of colonised healthcare workers, which led to successful infection control interventions and the resolution of the outbreak.

Greg Cook from University of Otago, New Zealand, also described some fantastic work they are doing on bacterial energetics as a new target space for drug development to combat antimicrobial-resistant bacterial pathogens in humans and animals.  The highlight of his group’s work on tuberculosis (TB) was the promise of a 2 month treatment course for multidrug-resistant (MDR) TB, which is a vast improvement on the 20-24 months of highly toxic treatment that patients currently receive, with incomplete cure rates.  We look forward to hearing more about this exciting work.

Other highlights included John Turnidge giving the 2018 Howard Florey Oration, where he described his many years of work on antimicrobial susceptibility testing, and his more recent role as the European Committee on Antimicrobial Susceptibility Testing (EUCAST) Secretary (despite not being from Europe).  He highlighted the inherent variability in susceptibility testing, even when performed in reference laboratories under the strictest of conditions, emphasising that we should be cautious when interpreting minimum inhibitory concentrations (MICs) as things are not always as black-and-white as they seem.

Local speakers and topics also included ‘Concurrent outbreaks of highly-resistant Shigella sonnei and Shigella flexneri in men who have sex with men, Melbourne Australia’ (Danielle Ingle), ‘Genomics based insights into Klebsiella pneumoniae antimicrobial resistance patterns in nation-wide invasive infections’ (Claire Gorrie), ‘Rapid emergence of highly-resistant Salmonella enterica serovar 4,[5],12:i:- in Australia’ (Danielle Ingle), ‘Emergence of a hypervirulent clone of serogroup W Neisseria meningitidis in Victoria with reduced susceptibility to penicillin’ (Jason Kwong), ‘Prevalence of colistin resistance in carbapenemase-producing Enterobacteriaceae (CPE) in Victoria 2017’ (Kerrie Stevens), ‘Update to combined epidemiological and genomic surveillance of carbapenemase-producing Enterobacteriaceae in Victoria, Australia’ (Courtney Lane), ‘Controlling the Hospital Environment as a Source of AMR’ (Rhonda Stuart), ‘Building Scientific Careers in the Medical Laboratory’ (Susan Ballard), ‘The Year in Antimicrobial Stewardship’ (Kirsty Buising), and ‘Whole Genome Sequencing in the Clinical Microbiology Laboratory’ (Norelle Sherry).

We look forward to next year’s ASA conference in Sydney.