Stocktake Sale on now: wide range of books at up to 70% off!
Register      Login
Microbiology Australia Microbiology Australia Society
Microbiology Australia, bringing Microbiologists together
RESEARCH ARTICLE (Open Access)

The AMR Hub: a public–private partnership to overcome barriers to commercialisation and deliver antimicrobial stewardship innovations

Michelle Bonello A # , Tanya L. Applegate A # * , Steve Badman B , Catriona S. Bradshaw C D E , Alex Broom F , Paul Field G , Jane S. Hocking E , Wilhelmina M. Huston H , Fabian Kong E , Gerald L. Murray I J K , Elisa Mokany L , Shivani Pasricha M , Alison V. Todd L , David M. Whiley N O , Virginia Wiseman A P , Rebecca Guy A and on behalf of investigators and partner investigators of the AMR Hub
+ Author Affiliations
- Author Affiliations

A The Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia.

B Cepheid, Sunnyvale, CA, USA.

C Melbourne Sexual Health Centre, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic., Australia.

D The School of Translational Medicine, Monash University, Melbourne, Vic., Australia.

E Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia.

F Sydney Centre for Healthy Societies, Faculty of Arts and Social Sciences, School of Social and Political Sciences (SSPS), The University of Sydney, Sydney, NSW, Australia.

G Global Antibiotic Research and Development Partnership (GARDP), Geneva, Switzerland.

H Faculty of Sciences, University of Technology, Sydney, NSW 2007, Australia.

I Department of Obstetrics, Gynaecology and Newborn Health, The University of Melbourne, Melbourne, Vic., Australia.

J Murdoch Children’s Research Institute, Melbourne, Vic., Australia.

K The Royal Women’s Hospital, Melbourne, Vic., Australia.

L SpeeDx Pty Ltd, Eveleigh, Sydney, NSW, Australia.

M Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Vic., Australia.

N The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.

O Department of Microbiology, Pathology Queensland Central Laboratory, Brisbane, Qld, Australia.

P Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.




Dr Michelle Bonello (BSc(Hons), MPH, PhD) is Business Manager of the Industrial Transformation Research Hub to Combat AMR. She has a background is molecular biology and public health research.



Assoc. Prof. Tanya Applegate is Lead of the Diagnostics Innovations Group in the Surveillance Evaluation and Research Program at the Kirby Institute, UNSW Sydney. Tanya leads a multistakeholder, multidisciplinary diagnostics research program spanning all stages of the pipeline with over 20 years working in regulatory, hospital, private industry and academic environments. Her translational research aims to provide equitable access to healthcare for people who are marginalised or living in remote or resource limited settings.



Dr Steven Badman is Director of Medical and Scientific Affairs, Cepheid, for the Australia, New Zealand, Papua New Guinea and western Pacific region. Steve is a clinically trained public health researcher with 20+ years of international infectious disease research and public health implementation in several countries, including remote Australia, Indonesia, Malaysia, Thailand, Vanuatu, Papua New Guinea, Tuvalu, Kiribati and Myanmar.



Catriona S. Bradshaw is a professor at Monash University, Melbourne. Catriona heads a translational research programme to improve the diagnosis, treatment and control of drug-resistant and refractory sexually transmitted infections (STIs), with a focus on improving antimicrobial stewardship and AMR in STIs. Her programme includes interventions to achieve a vaginal microbiota associated with optimal reproductive health outcomes.



Alex Broom is Professor of Sociology and Director of the Sydney Centre for Healthy Societies, Faculty of Arts and Social Sciences, The University of Sydney.



Paul Field is the representative for the Global Antibiotic Research & Development Partnership (GARDP) in Australia. GARDP is developing and delivering new treatments for drug-resistant bacterial infections including zoliflodacin a first-in-class antibiotic against Neisseria gonorrohoeae.



Prof. Jane Hocking is an epidemiologist and implementation researcher whose research interests include the epidemiology and control of STIs, sexual health and the implementation and evaluation of primary care interventions. She is a Dame Kate Campbell Fellow, holds a NHMRC Investigator Grant (L2) and is the head of the Sexual Health Unit at the Melbourne School of Population and Global Health, University of Melbourne.



Prof. Wilhelmina Huston is a molecular microbiologist in the field of STIs based at the University of Technology—Sydney. Her research is focussed on chlamydial pathogenesis, but also host responses and interplay with microbiome factors in the context of both infection and disease pathologies. She is also a committed educator with research and academic development outcomes in higher education teaching and learning in Science.



Dr Fabian Kong is a senior fellow and Deputy Head of the Sexual Health Unit at The University of Melbourne. Fabian comes from a clinical pharmacy background with expertise in evidence medicine and international health and has worked for the WHO, UNDP and The World Bank. He currently works as an epidemiologist to optimise treatments for STIs using pharmacokinetics and novel culture models, with a focus on multi-drug resistant gonorrhoea in the mouth.



Gerald Murray is a senior research officer in the department of Obstetrics and Gynaecology at The University of Melbourne, based at the Royal Women’s Hospital. His research interests include investigating mechanisms of AMR, studying the human microbiota in health and disease, and human papillomavirus (HPV).



Dr Elisa Mokany is a co-founder and the Chief Technology Officer at SpeeDx. Elisa is a strong advocate of SpeeDx’s goal of pioneering solutions to address the global problem of antibiotic resistance with the company’s lead first commercial test world-wide for detection of a STI that detects both the infectious agent together with markers of antibiotic resistance.



Shivani Pasricha is a microbiologist and laboratory head in the Department of Infectious Diseases, University of Melbourne. Using molecular and genomic approaches, her research aims to improve the detection, prevention and surveillance of STIs. Her current research includes developing cutting-edge CRISPR-diagnostics for the point-of-care detection of STIs and AMR.



Adj. Prof. Alison Todd is the Chief Scientific Officer and co-founder of SpeeDx. She is an elected Fellow of the Australian Academy of Technology and Engineering and awarded Member (AM) in the general division of the Order of Australia. Her commitment to deliver innovative clinical diagnostics to improve patient outcomes has contributed to the development of over 30 products, utilising her patented inventions from a portfolio of over 20 patent families.



Assoc. Prof. David Whiley is a principal research fellow at The University of Queensland Centre for Clinical Research (UQCCR) and a research scientist at Pathology Queensland. Antibiotic-resistant Neisseria gonorrhoeae is a particular research interest of his, including enhancing gonorrhoea AMR surveillance and treatment.



Virginia Wiseman is Professor of Health Economics (BEc(Hons), PhD) and Theme Director of Health Economics & Health Systems Research at the Kirby Institute, UNSW Sydney, with a dual appointment in the Department of Global Health and Development at the London School of Hygiene & Tropical Medicine. She has 24 years’ experience in translational research, evaluating the economic and health impacts of public health interventions in Australia, Africa and the Asia-Pacific. Virginia leads the Australian Centre for Stronger Investments in Infectious Diseases (STRIDE).



Prof. Rebecca Guy (BAppSc, MAppEpid, PhD) is a public health epidemiologist and Head of the Surveillance and Evaluation Research Program at the Kirby Institute, UNSW Sydney. Her research focuses on the epidemiology and prevention of infectious diseases, including HIV, STIs and respiratory tract infections. She has led national surveillance, cohort and data linkage studies, and cluster randomised trials of large-scale public initiatives, particularly among marginalised populations. This research has translated into policy and practice, including national strategies, national guidelines and WHO guidelines.

* Correspondence to: tapplegate@kirby.unsw.edu.au
# These authors contributed equally to this paper

Microbiology Australia https://doi.org/10.1071/MA24017
Submitted: 30 April 2024  Accepted: 6 May 2024  Published: 23 May 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the ASM. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY)

Abstract

Antimicrobial resistance (AMR) is recognised as one of the greatest scientific challenges of the 21st century, disproportionately affecting people living in low- and middle-income countries. With bacterial pathogens becoming increasingly resistant to antibiotics, there is an urgent need for innovative approaches to combat this growing threat. The World Health Organization has recognised this need and prioritised further research to enhance diagnostics, surveillance and our understanding the epidemiology and drivers of AMR. The Industrial Transformation Research Hub to Combat AMR, or the AMR Hub, is an Australian collaborative private–public research partnership involving over 20 organisations. It aims to foster multidisciplinary collaborations across sectors and develop wholistic solutions that address barriers to the commercialisation of tools to minimise the risks of AMR. The AMR Hub’s research is focusing on sexually transmitted infections, which are increasingly resistant to antibiotics and have few alternative candidates in the pipeline. Investigators are together developing novel diagnostics, optimising treatment, identifying tools to detect active bacterial infections, and engaging stakeholders to optimise AMR innovation. Through a multidisciplinary ecosystem across sectors, the AMR Hub seeks to fast-track the development of adaptable technologies, new antibiotics and stewardship innovations for prevention, while also addressing societal, economic and commercial aspects of AMR solutions.

Keywords: antimicrobial resistance, antimicrobial stewardship, antimicrobials, diagnostics, multidisciplinary, Mycoplasma genitalium, Neisseria gonorrhoeae, pre-commercialisation barriers, private–public partnership, sexually transmitted infections.

Biographies

MA24017_B1.gif

Dr Michelle Bonello (BSc(Hons), MPH, PhD) is Business Manager of the Industrial Transformation Research Hub to Combat AMR. She has a background is molecular biology and public health research.

MA24017_B2.gif

Assoc. Prof. Tanya Applegate is Lead of the Diagnostics Innovations Group in the Surveillance Evaluation and Research Program at the Kirby Institute, UNSW Sydney. Tanya leads a multistakeholder, multidisciplinary diagnostics research program spanning all stages of the pipeline with over 20 years working in regulatory, hospital, private industry and academic environments. Her translational research aims to provide equitable access to healthcare for people who are marginalised or living in remote or resource limited settings.

MA24017_B3.gif

Dr Steven Badman is Director of Medical and Scientific Affairs, Cepheid, for the Australia, New Zealand, Papua New Guinea and western Pacific region. Steve is a clinically trained public health researcher with 20+ years of international infectious disease research and public health implementation in several countries, including remote Australia, Indonesia, Malaysia, Thailand, Vanuatu, Papua New Guinea, Tuvalu, Kiribati and Myanmar.

MA24017_B4.gif

Catriona S. Bradshaw is a professor at Monash University, Melbourne. Catriona heads a translational research programme to improve the diagnosis, treatment and control of drug-resistant and refractory sexually transmitted infections (STIs), with a focus on improving antimicrobial stewardship and AMR in STIs. Her programme includes interventions to achieve a vaginal microbiota associated with optimal reproductive health outcomes.

MA24017_B5.gif

Alex Broom is Professor of Sociology and Director of the Sydney Centre for Healthy Societies, Faculty of Arts and Social Sciences, The University of Sydney.

MA24017_B6.gif

Paul Field is the representative for the Global Antibiotic Research & Development Partnership (GARDP) in Australia. GARDP is developing and delivering new treatments for drug-resistant bacterial infections including zoliflodacin a first-in-class antibiotic against Neisseria gonorrohoeae.

MA24017_B7.gif

Prof. Jane Hocking is an epidemiologist and implementation researcher whose research interests include the epidemiology and control of STIs, sexual health and the implementation and evaluation of primary care interventions. She is a Dame Kate Campbell Fellow, holds a NHMRC Investigator Grant (L2) and is the head of the Sexual Health Unit at the Melbourne School of Population and Global Health, University of Melbourne.

MA24017_B8.gif

Prof. Wilhelmina Huston is a molecular microbiologist in the field of STIs based at the University of Technology—Sydney. Her research is focussed on chlamydial pathogenesis, but also host responses and interplay with microbiome factors in the context of both infection and disease pathologies. She is also a committed educator with research and academic development outcomes in higher education teaching and learning in Science.

MA24017_B9.gif

Dr Fabian Kong is a senior fellow and Deputy Head of the Sexual Health Unit at The University of Melbourne. Fabian comes from a clinical pharmacy background with expertise in evidence medicine and international health and has worked for the WHO, UNDP and The World Bank. He currently works as an epidemiologist to optimise treatments for STIs using pharmacokinetics and novel culture models, with a focus on multi-drug resistant gonorrhoea in the mouth.

MA24017_B10.gif

Gerald Murray is a senior research officer in the department of Obstetrics and Gynaecology at The University of Melbourne, based at the Royal Women’s Hospital. His research interests include investigating mechanisms of AMR, studying the human microbiota in health and disease, and human papillomavirus (HPV).

MA24017_B11.gif

Dr Elisa Mokany is a co-founder and the Chief Technology Officer at SpeeDx. Elisa is a strong advocate of SpeeDx’s goal of pioneering solutions to address the global problem of antibiotic resistance with the company’s lead first commercial test world-wide for detection of a STI that detects both the infectious agent together with markers of antibiotic resistance.

MA24017_B12.gif

Shivani Pasricha is a microbiologist and laboratory head in the Department of Infectious Diseases, University of Melbourne. Using molecular and genomic approaches, her research aims to improve the detection, prevention and surveillance of STIs. Her current research includes developing cutting-edge CRISPR-diagnostics for the point-of-care detection of STIs and AMR.

MA24017_B13.gif

Adj. Prof. Alison Todd is the Chief Scientific Officer and co-founder of SpeeDx. She is an elected Fellow of the Australian Academy of Technology and Engineering and awarded Member (AM) in the general division of the Order of Australia. Her commitment to deliver innovative clinical diagnostics to improve patient outcomes has contributed to the development of over 30 products, utilising her patented inventions from a portfolio of over 20 patent families.

MA24017_B14.gif

Assoc. Prof. David Whiley is a principal research fellow at The University of Queensland Centre for Clinical Research (UQCCR) and a research scientist at Pathology Queensland. Antibiotic-resistant Neisseria gonorrhoeae is a particular research interest of his, including enhancing gonorrhoea AMR surveillance and treatment.

MA24017_B15.gif

Virginia Wiseman is Professor of Health Economics (BEc(Hons), PhD) and Theme Director of Health Economics & Health Systems Research at the Kirby Institute, UNSW Sydney, with a dual appointment in the Department of Global Health and Development at the London School of Hygiene & Tropical Medicine. She has 24 years’ experience in translational research, evaluating the economic and health impacts of public health interventions in Australia, Africa and the Asia-Pacific. Virginia leads the Australian Centre for Stronger Investments in Infectious Diseases (STRIDE).

MA24017_B16.gif

Prof. Rebecca Guy (BAppSc, MAppEpid, PhD) is a public health epidemiologist and Head of the Surveillance and Evaluation Research Program at the Kirby Institute, UNSW Sydney. Her research focuses on the epidemiology and prevention of infectious diseases, including HIV, STIs and respiratory tract infections. She has led national surveillance, cohort and data linkage studies, and cluster randomised trials of large-scale public initiatives, particularly among marginalised populations. This research has translated into policy and practice, including national strategies, national guidelines and WHO guidelines.

References

Tacconelli E, et al. (2017) Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics. World Health Organization, Geneva, Switzerland. https://remed.org/wp-content/uploads/2017/03/lobal-priority-list-of-antibiotic-resistant-bacteria-2017.pdf

Murray C et al. (2022) Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet 399, 629-655.
| Crossref | Google Scholar |

MTPConnect (2022) Australian Antimicrobial Resistance Network (AAMRNet): 2022–2023 Pre-Budget Submission. January 2022. Report for the Australian Government Department of Industry, Science, Energy and Resources. MTPConnect, Melbourne, Vic., Australia. https://treasury.gov.au/sites/default/files/2022-03/258735_mtpconnect.pdf

Alividza V et al. (2018) Investigating the impact of poverty on colonization and infection with drug-resistant organisms in humans: a systematic review. Infect Dis Poverty 7, 76.
| Crossref | Google Scholar |

Australian Medical Association (2022) Antimicrobial resistance: the silent global pandemic. AMA Ltd. https://www.ama.com.au/antimicrobial-resistance

World Health Organization (2023) Global research agenda for antimicrobial resistance in human health. Policy brief. WHO, Geneva, Switzerland. https://www.who.int/publications/m/item/global-research-agenda-for-antimicrobial-resistance-in-human-health

Jensen JS, Unemo M (2024) Antimicrobial treatment and resistance in sexually transmitted bacterial infections. Nat Rev Microbiol
| Crossref | Google Scholar |

Trembizki E et al. (2021) Enhanced molecular surveillance in response to the detection of extensively resistant gonorrhoea in Australia. J Antimicrob Chemother 76, 270-271.
| Crossref | Google Scholar | PubMed |

Kong FYS et al. (2020) Treatment efficacy for pharyngeal Neisseria gonorrhoeae: a systematic review and meta-analysis of randomized controlled trials. J Antimicrob Chemother 75, 3109-3119.
| Crossref | Google Scholar | PubMed |

10  Kong FYS, Hocking JS (2022) Treating pharyngeal gonorrhoea continues to remain a challenge. Lancet Infect Dis 22, 573-574.
| Crossref | Google Scholar | PubMed |

11  Ertl NG et al. (2024) Concurrent parC and gyrA fluoroquinolone resistance mutations and associated strains in Mycoplasma genitalium in Queensland, Australia. J Antimicrob Chemother 79, 467-469.
| Crossref | Google Scholar | PubMed |

12  Murray GL et al. (2023) gyrA Mutations in Mycoplasma genitalium and their contribution to moxifloxacin failure: time for the next generation of resistance-guided therapy. Clin Infect Dis 76, 2187-2195.
| Crossref | Google Scholar | PubMed |

13  Murray GL et al. (2022) parC Variants in Mycoplasma genitalium: trends over time and association with moxifloxacin failure. Antimicrob Agents Chemother 66, e0027822.
| Crossref | Google Scholar | PubMed |

14  Chua TP et al. (2022) Impact of 16S rRNA single nucleotide polymorphisms on Mycoplasma genitalium organism load with doxycycline treatment. Antimicrob Agents Chemother 66, e0024322.
| Crossref | Google Scholar | PubMed |

15  Sweeney EL et al. (2022) Mycoplasma genitalium: enhanced management using expanded resistance-guided treatment strategies. Sex Health 19, 248-254.
| Crossref | Google Scholar | PubMed |

16  Tickner JA et al. (2022) Novel probe-based melting curve assays for the characterization of fluoroquinolone resistance in Mycoplasma genitalium. J Antimicrob Chemother 77, 1592-1599.
| Crossref | Google Scholar | PubMed |

17  Sweeney EL et al. (2022) Individualised treatment of Mycoplasma genitalium infection-incorporation of fluoroquinolone resistance testing into clinical care. Lancet Infect Dis 22, e267-e270.
| Crossref | Google Scholar | PubMed |

18  Vodstrcil LA et al. (2022) Combination therapy for Mycoplasma genitalium, and new insights into the utility of parC mutant detection to improve cure. Clin Infect Dis 75, 813-823.
| Crossref | Google Scholar | PubMed |

19  Tickner JA et al. (2022) The need for a commercial test using the penA60 allele to identify ceftriaxone-resistant Neisseria gonorrhoeae. Lancet Infect Dis 22, 1271-1272.
| Crossref | Google Scholar | PubMed |

20  Bell SFE et al. (2023) Antimicrobial susceptibility assays for Neisseria gonorrhoeae: a proof-of-principle population-based retrospective analysis. Lancet Microbe 4, 544-551.
| Crossref | Google Scholar | PubMed |

21  Lee DYJ et al. (2021) Reflex detection of ciprofloxacin resistance in Neisseria gonorrhoeae by use of the SpeeDx ResistancePlus GC assay. J Clin Microbiol 59, 10.1128/jcm.00089-21.
| Crossref | Google Scholar | PubMed |

22  Read TRH et al. (2019) Outcomes of resistance-guided sequential treatment of Mycoplasma genitalium infections: a prospective evaluation. Clin Infect Dis 68, 554-560.
| Crossref | Google Scholar | PubMed |

23  Vodstrcil LA et al. (2024) Near-to-patient-testing to inform targeted antibiotic use for sexually transmitted infections in a public sexual health clinic: the NEPTUNE cohort study. Lancet Reg Health West Pac 44, 101005.
| Crossref | Google Scholar | PubMed |

24  Fairley CK et al. (2019) Models of gonorrhoea transmission from the mouth and saliva. Lancet Infect Dis 19, e360-e366.
| Crossref | Google Scholar |

25  Moran JS (1995) Treating uncomplicated Neisseria gonorrhoeae infections: is the anatomic site of infection important? Sex Transm Dis 22, 39-47.
| Crossref | Google Scholar | PubMed |

26  Goytia M et al. (2021) Antimicrobial resistance profiles of human commensal Neisseria species. Antibiotics 10, 538.
| Crossref | Google Scholar | PubMed |

27  Gaspari V et al. (2023) Non-pathogenic Neisseria species of the oropharynx as a reservoir of antimicrobial resistance: a cross-sectional study. Front Cell Infect Microbiol 13, 1308550.
| Crossref | Google Scholar | PubMed |

28  Kong FYS et al. (2022) Optimisation of treatments for oral Neisseria gonorrhoeae infection: Pharmacokinetics Study (STI-PK project) – study protocol for non-randomised clinical trial. BMJ Open 12, e064782.
| Crossref | Google Scholar | PubMed |

29  Kong FYS et al. (2017) Pharmacokinetics of a single 1 g dose of azithromycin in rectal tissue in men. PLoS ONE 12, e0174372.
| Crossref | Google Scholar |

30  Lima N et al. (2019) P070. Determination of antibiotic susceptibility and efficacy by VITA-PCR. Sex Transm Infect 95, A106 [Poster presentation abstract].
| Crossref | Google Scholar |

31  Broom A et al. (2023) Sex, drugs and superbugs: the rise of drug resistant STIs. SSM Qual Res Health 4, 100310.
| Crossref | Google Scholar |

32  Broom AP et al. (2022) Vulnerability and antimicrobial resistance. Crit Public Health 308-317.
| Crossref | Google Scholar |