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Keeping global tabs on antimicrobial resistance
POLICY AND PEOPLE
Scottish basic science gets a boost spin-offs from the centre’s work will cottish biomedical science will attract biotechnology firms and boost receive a major boost next week the local economy. The influx of sciwith the official opening of a entists, from all over £13-million (US$22Europe and the USA, million) research centakes the total numtre at the University of ber of biomedical Dundee. More than workers in Dundee to 250 scientists, from 1500, and so far developmental biolohas brought more gists to experts in than £18 million in genetic regulation and research grants and molecular biology, fellowships. The city have been recruited to now has the highest the five-storey comconcentration of life plex of laboratories scientists in the UK which will focus on after Oxford and basic research related Cambridge. to cancer, diabetes, Programmes that inflammation, heart Cohen: seeing blue sky ahead are already under way disease, immune defispan the full gamut of biomedical ciency, and tropical infections. interest, including: development of a A £10-million donation from mednew class of cancer drug based on the ical-research charity the Wellcome body’s natural opioids, which are Trust has provided the bulk of funds now identified as key regulators of for building and equipping the cencell death; identification of enzymes tre, now named the Wellcome Trust that could disarm trypanosomes, Building. But money has also come such as those that cause African from the local council and business sleeping sickness and Chagas’ disinterests who have high hopes that Hilary Bower
S
Keeping global tabs on antimicrobial resistance
E
mergence of antimicrobialresistant nosocomial pathogens will be tracked by an international hospital-based surveillance system being developed by the US Centers For Disease Control and Prevention (CDC) and WHO. The system, part of the International Surveillance Program for Emerging Antimicrobial Resistance in Hospitals (INSPEAR), will be operative in 6–12 months, according to a CDC document released last week. CDC asserts that “the emergence of antimicrobial resistance is a global problem; no country is spared”. Drug-resistant pathogens of concern include: methicillinresistant Staphylococcus aureus; vancomycin-resistant enterococci; Klebsiella pneumoniae; Serratia marcescens; Pseudomonas aeruginosa; Acinetobacter baumannii; Enterobacter aerogenes; and Stenotrophomonas maltophilia. The medical community “may have problems isolating and identifying these organisms”, notes CDC. And too often, infection-control interventions are either not implemented or implemented too late so that “resistant organisms have
1264
become endemic, infection control strategies may not be effective and further transmission may occur”. INSPEAR is a collaborative effort of the agencies, with 73 individual hospitals and 12 hospital networks from 14 European nations, the USA, Bulgaria, Croatia, the Czech Republic, Lithuania, Morocco, Poland, Romania, Russia, Slovenia, and Tunisia. The new system will “facilitate rapid distribution of information about emerging multidrug-resistant organisms to hospitals worldwide” and serve as a model for the development and implementation of interventions to prevent emergence or transmission of such pathogens. According to CDC’s William Jarvis, there is a definite need for enhanced surveillance. “With international travel, it’s very easy for a patient to come into this country with a multidrug resistant strain”, he notes. “We need to make sure national and international parties work together to detect these strains through surveillance and alert one another to potential problems”.
ease, that are so damaging in the developing world; and studies into cell-adhesion molecules to aid understanding of inflammatory reactions. Director of the centre Philip Cohen believes that the expertise now in Dundee will make it an increasingly important international centre. “Some of the best science in Britain is now going on in the ‘Tartan Triangle’—Dundee, Edinburgh, and Glasgow—not just the ‘Golden Triangle’ of Oxford, Cambridge, and London”, he notes. Cohen also heads the adjoining Medical Research Council protein phosphorylation unit and makes no excuses for facilitating “blue sky” work at a time when there is so much pressure for targeted research. “So many things that have become important in medicine have come about because someone started looking at something just because they were interested in it. What we want is for all these people to be able to fulfil their potential and develop their science.” Hilary Bower
Drugs & devices Testing COX-2 inhibitors Cyclooxygenase-2 (COX-2) inhibitors might have fewer gastrointestinal side-effects than the related nonsteroidal anti-inflammatory drugs (NSAIDs). But an FDA advisory panel said last month that the FDA still considers COX-2 inhibitors to be NSAIDs. “The gastrointestinal toxicity template is a very important aspect of the label, which we are loathe to change unless we have good data”, said the FDA’s Michael Weintraub. The FDA reprimanded SmithKline Beecham for advertising its COX-2 inhibitor nabumetone (Relafen) as safer than conventional NSAIDs. And since COX-2 inhibitors may affect bone, kidneys, and reproductive organs, the panel also asked for more data in these areas. Two new Taxol uses US FDA advisers voted last month to approve Paclitaxel (Taxol) for use in advanced ovarian and non-smallcell lung cancer (NSCLC). The panel was more impressed with survival data on use in ovarian cancer than in NSCLC.
Lisa Putman
THE LANCET • Vol 351 • April 25, 1998
Scottish basic science gets a boost spin-offs from the centre’s work will cottish biomedical science will attract biotechnology firms and boost receive a major boost next week the local economy. The influx of sciwith the official opening of a entists, from all over £13-million (US$22Europe and the USA, million) research centakes the total numtre at the University of ber of biomedical Dundee. More than workers in Dundee to 250 scientists, from 1500, and so far developmental biolohas brought more gists to experts in than £18 million in genetic regulation and research grants and molecular biology, fellowships. The city have been recruited to now has the highest the five-storey comconcentration of life plex of laboratories scientists in the UK which will focus on after Oxford and basic research related Cambridge. to cancer, diabetes, Programmes that inflammation, heart Cohen: seeing blue sky ahead are already under way disease, immune defispan the full gamut of biomedical ciency, and tropical infections. interest, including: development of a A £10-million donation from mednew class of cancer drug based on the ical-research charity the Wellcome body’s natural opioids, which are Trust has provided the bulk of funds now identified as key regulators of for building and equipping the cencell death; identification of enzymes tre, now named the Wellcome Trust that could disarm trypanosomes, Building. But money has also come such as those that cause African from the local council and business sleeping sickness and Chagas’ disinterests who have high hopes that Hilary Bower
S
Keeping global tabs on antimicrobial resistance
E
mergence of antimicrobialresistant nosocomial pathogens will be tracked by an international hospital-based surveillance system being developed by the US Centers For Disease Control and Prevention (CDC) and WHO. The system, part of the International Surveillance Program for Emerging Antimicrobial Resistance in Hospitals (INSPEAR), will be operative in 6–12 months, according to a CDC document released last week. CDC asserts that “the emergence of antimicrobial resistance is a global problem; no country is spared”. Drug-resistant pathogens of concern include: methicillinresistant Staphylococcus aureus; vancomycin-resistant enterococci; Klebsiella pneumoniae; Serratia marcescens; Pseudomonas aeruginosa; Acinetobacter baumannii; Enterobacter aerogenes; and Stenotrophomonas maltophilia. The medical community “may have problems isolating and identifying these organisms”, notes CDC. And too often, infection-control interventions are either not implemented or implemented too late so that “resistant organisms have
1264
become endemic, infection control strategies may not be effective and further transmission may occur”. INSPEAR is a collaborative effort of the agencies, with 73 individual hospitals and 12 hospital networks from 14 European nations, the USA, Bulgaria, Croatia, the Czech Republic, Lithuania, Morocco, Poland, Romania, Russia, Slovenia, and Tunisia. The new system will “facilitate rapid distribution of information about emerging multidrug-resistant organisms to hospitals worldwide” and serve as a model for the development and implementation of interventions to prevent emergence or transmission of such pathogens. According to CDC’s William Jarvis, there is a definite need for enhanced surveillance. “With international travel, it’s very easy for a patient to come into this country with a multidrug resistant strain”, he notes. “We need to make sure national and international parties work together to detect these strains through surveillance and alert one another to potential problems”.
ease, that are so damaging in the developing world; and studies into cell-adhesion molecules to aid understanding of inflammatory reactions. Director of the centre Philip Cohen believes that the expertise now in Dundee will make it an increasingly important international centre. “Some of the best science in Britain is now going on in the ‘Tartan Triangle’—Dundee, Edinburgh, and Glasgow—not just the ‘Golden Triangle’ of Oxford, Cambridge, and London”, he notes. Cohen also heads the adjoining Medical Research Council protein phosphorylation unit and makes no excuses for facilitating “blue sky” work at a time when there is so much pressure for targeted research. “So many things that have become important in medicine have come about because someone started looking at something just because they were interested in it. What we want is for all these people to be able to fulfil their potential and develop their science.” Hilary Bower
Drugs & devices Testing COX-2 inhibitors Cyclooxygenase-2 (COX-2) inhibitors might have fewer gastrointestinal side-effects than the related nonsteroidal anti-inflammatory drugs (NSAIDs). But an FDA advisory panel said last month that the FDA still considers COX-2 inhibitors to be NSAIDs. “The gastrointestinal toxicity template is a very important aspect of the label, which we are loathe to change unless we have good data”, said the FDA’s Michael Weintraub. The FDA reprimanded SmithKline Beecham for advertising its COX-2 inhibitor nabumetone (Relafen) as safer than conventional NSAIDs. And since COX-2 inhibitors may affect bone, kidneys, and reproductive organs, the panel also asked for more data in these areas. Two new Taxol uses US FDA advisers voted last month to approve Paclitaxel (Taxol) for use in advanced ovarian and non-smallcell lung cancer (NSCLC). The panel was more impressed with survival data on use in ovarian cancer than in NSCLC.
Lisa Putman
THE LANCET • Vol 351 • April 25, 1998