Summary
COMBACTE-MAGNET focused on the most vulnerable category of patients: those who are critically ill and being treated in intensive-care units. It aimed to find new clinical options for those patients who are fighting infections by Gram-negative bacteria, increase our understanding of the needs of these patients and doctors and use that knowledge to advance the development of well-targeted, life-saving treatments.
The EPI-Net network set up under COMBACTE-MAGNET focused on strengthening our knowledge of the epidemiological nature of antimicrobial resistance as well as improving surveillance for outbreaks of infections in hospitals and healthcare settings. EPI-Net connected experts in epidemiological studies in infectious diseases, leading to a series of white papers that bridges the gaps between surveillance data, and antibiotic policy and stewardship. The network also developed a set of recommendations to support the alignment of surveillance strategies for AMR in Europe.
EPI-Net created a central data repository which is made up of 23 million strains, focused on 25 target pathogens and five targeted healthcare associations. The network’s website is regularly updated with information such as the prevalence of AMR in different countries, the presence of healthcare-associated infections in different countries, emerging resistance to antibiotics, antifungal studies and more. An online AMR Travel Tool helps international travellers, travel clinics and infectious disease experts to navigate AMR risks at various destinations and find ways to mitigate them.
Complicated urinary tract infections (cUTI) are among the most common health-care associated infections, but there is a wide variety in the presentation and severity of the disease, which makes it difficult to treat. Added to that, antimicrobial resistance is also a major hindrance to treatment. To increase our understanding of cUTIs, COMBACTE-MAGNET conducted an observational study called RESCUING that gathered data on approximately 1 000 cUTI patients based in southern Europe and Israel, where there is a high prevalence of the bacteria that cause these infections.
Following the study, the results of the clinical epidemiology, multidrug resistance and outcomes provided important information on the frequency of the different types of cUTI, particularly urinary catheter associated UTIs, and the impact on antimicrobial resistance. An important finding was that the survival rates of patients with cUTI were not affected by early appropriate empirical treatment. This is an important result that calls for caution until the causative pathogen is identified to avoid unnecessary antibiotic treatments and thereby reduce selective antibiotic pressure on multidrug-resistant bacteria.
The EVADE Phase II clinical trial investigated the monoclonal antibody gremubamab, for the prevention of ventilator-associated pneumonia caused by Pseudomonas aeruginosa (PA) in adult ICU-patients. This monoclonal antibody had two targets rather than one, however one finding of the study was that the picture is much more complex with Pseudomonas and more research will be needed to better understand what could work against infections caused by this pathogen. Overall, 188 subjects were randomised. Although the trial ended up not finding a reduction in the incidence of ventilator-associated pneumonia caused by Pseudomonas aeruginosa (PA), it demonstrated the ability to test such approaches and the capabilities of academic and industrial partners to work together towards common goals.
The results of COMBACTE-MAGNET proved to be pivotal in helping us to better understand and treat the growing threat of antimicrobial resistance, now and in years to come. Overall, the COMBACTE projects, which are part of IMI’s New Drugs for Bad Bugs programme, have contributed to a wealth of new information in the fight against antimicrobial resistance.
The work that COMBACTE-MAGNET, COMBACTE-NET and COMBACTE-CARE carried out will be continued by ECRAID, a non-profit foundation led by academic investigators that will continue to strengthen Europe’s capacity to fight antimicrobial resistance. EPI-NET and the other three networks fostered by COMBACTE form the pillarstones of this foundation, which is based in Utrecht, in the Netherlands, and has 80 employees at present. At the time of writing, ECRAID was involved in 11 international studies at 269 study sites in 24 EU countries. The network involves more than 250 primary care sites, more than 1200 hospital sites and 900 clinical laboratories.
Achievements & News
It is known that treating patients with antibiotics is associated with the emergence of resistance - and worse outcomes for patients. But how resistance emerges during infections remains poorly understood.
Now a study published in Nature Communications reports that rapid bacterial evolution interacts with host immunity to shape both the rise, and fall, of resistance during infection. ###This study was performed as part of the IMI COMBACTE-MAGNET project.
COMBACTE-MAGNET is working to find new approaches to combat antibiotic resistance. This new study highlights the need to understand better how our immune system works with antibiotics to suppress bacterial infections.
The research described in the article is part of the ASPIRE-ICU study, which stands for Advanced understanding of Staphylococcus aureus and Pseudomonas aeruginosa Infections in EuRopE – Intensive Care Units.
Find out more
- Read the article in full
Antimicrobial resistance (AMR) project COMBACTE-MAGNET has launched a new, freely accessible online tool that allows healthcare professionals and the public to assess the risk of international travellers acquiring (and spreading) antimicrobial-resistant bacteria.###
Travel plays a major role in the spread of AMR, and the new AMR Travel Tool will make it easier for healthcare professionals to evaluate patients’ travel history and associated AMR risk factors. The healthcare professional’s section of the website highlights differences in resistance levels between the travel destination and the host country, for example.
Meanwhile, travellers can enter their travel destination and receive general advice on infection control as well as pathogen-specific advice on the infection risks related to their destination (and tips on how to avoid them).
Find out more
- Visit the AMR Travel Tool
COMBACTE projects have launched a unique European platform that allows users to explore and visualise data on antibiotic resistant infections in humans and animals across Europe. The website, which is freely accessible, brings together epidemiology data from 32 European countries on the priority list of pathogens released by the World health Organization in 2017.### It also includes data on more recent outbreaks and emerging cases of resistance to newly-developed antibiotics. Data is displayed via colour-schemed maps that allow users to easily track things like the setting, resistance rates, sample sizes and data sources. If users register, they can also select and download data. In a statement, the project explains: ‘The goal is to give industry, policy makers, and public an easy tool to use in order to understand the trends and the epidemiology of antimicrobial resistant infections across Europe using a One Health approach. The platform provides an interactive space, which combines multiple sources and allows to overcome language barriers.’
Antibiotic resistance is a big global public health problem. Of particular concern are multidrug-resistant Gram-negative bacteria, which are among the leading causes of serious, debilitating and life threatening healthcare-associated infections. There is an urgent need for new therapies to treat or prevent infections caused by these bacteria in hospitalised patients. IMI’s COMBACTE-MAGNET project is developing new antibacterial treatments for vulnerable patients, especially the critically ill in intensive care units. ###It is doing this by promoting collaborations between scientific experts. ‘I think the creation of an effective public-private consortium like COMBACTE-MAGNET in itself is a major achievement,’ says project coordinator Hasan Jafri of MedImmune, the global biologics research and development arm of AstraZeneca. ‘The project brings together top researchers and clinicians from five pharmaceutical companies – AstraZeneca, AiCuris, GSK, Basilea Pharmaceutica, and Sanofi – and more than 30 leading academic medical centres from 10 European countries.’ To date, the COMBACTE-MAGNET consortium has established a Pan-European platform called EPI-Net to access epidemiological data; is publishing the first results from an epidemiology study; and is designing innovative clinical trials to advance development of novel molecules against multidrug-resistant Gram-negative bacteria.
- Read the entire story
The Antibacterial Resistance Leadership Group (ARLG) has become the first US consortium to take part in clinical studies run by IMI’s COMBACTE programme on antimicrobial resistance. In a statement, the project described the news as a ‘major milestone’ that ‘clearly demonstrates the benefits of public-private collaboration and international collaboration between COMBACTE and ARLG’. ###The ARLG is joining two studies on treatments design to prevent pneumonia in people in intensive care who require a ventilator to help them breathe. The SAATELLITE study focuses on pneumonia caused by Staphylococcus aureus, while EVADE focuses on infections caused by Pseudomonas aeruginosa. Currently, 15 US sites are slated to participate in the trials; the first, in Detroit, was activated in January. ‘It is becoming increasingly common for hospitalised patients—especially those with weakened immune systems—to develop severe, hard-to-treat bacterial infections,’ said Anthony S. Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID) which is supporting the ARLG’s participation in the studies. ‘These clinical trials […] are part of a global collaborative effort to explore innovative ways to mitigate the threat of antimicrobial resistance.’ Meanwhile COMBACTE-NET coordinator Hasan Jafri of MedImmune said: ‘We believe collaboration with world-renowned experts, such as those within COMBACTE and the ARLG, is one of the best models to advance development in this area, and bring novel and effective anti-infectives to patients.’
Scientists from IMI’s antimicrobial resistance project COMBACTE-MAGNET have launched a clinical study of a promising antibiotic called AIC499. Developed by German company AiCuris, the drug appears to be effective against a range of multi-drug resistant bacteria in complicated urinary tract infections and intra-abdominal infections.### A phase I trial to evaluate the safety of AIC499 in healthy volunteers is now underway at the Medical University of Vienna in Austria. AIC499 is designed to tackle so-called Gram-negative bacteria, which are surrounded by a tough cell wall that forms a solid defence against many antibiotics. ‘Gram-negative pathogens are considered to be amongst the most serious threats to public health and a major unmet medical need,’ said AiCuris CEO Holger Zimmermann. ‘We are convinced that, with its unique profile and extensive coverage, AIC499 has the potential to become a highly effective antibiotic for patients with severe infections including those caused by multi-resistant pathogens.’ The first results from this Phase I study should be available in mid-2017.
Meet COMBACTE at ECCMID!
IMI’s COMBACTE family of antimicrobial resistance projects will have a stand at the exhibition of the 27th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) in Vienna, Austria on 22-25 April. ###The project team will be at booth 29 at the exhibition. Partners in the COMBACTE-MAGNET project will also present results from their RESCUING study at the conference. RESCUING gathered observational data on the treatment of some 1 000 patients with complicated urinary tract infections in 8 countries where the prevalence of multidrug-resistant Gram-negative bacteria is seen to be high. That includes Bulgaria, Greece, Hungary, Israel, Italy, Romania, Turkey and Spain. In a blog post on the COMBACTE website, COMBACTE-NET’s Bruno François explains why COMBACTE is going to ECCMID: ‘Since ECCMID is one of the biggest, most important microbiology and infectious diseases congresses, I would say it is really ‘the place to be’ for our project. Without a doubt it also creates more visibility. Next to that, the event itself fits with the purpose of COMBACTE.’
(March 2017)
COMBACTE-MAGNET project gets underway
The COMBACTE-MAGNET project has got underway with the goal of contributing to efforts to tackle certain types of drug-resistant infections. Specifically, the 7 year, €167 million project will investigate a new approach to preventing respiratory infections in patients in intensive care units and new treatment options for patients with life-threatening infections caused by multi-drug resistant bacteria. ###The project will also trial two new medicines: MedImmune’s MED3902 and AiCuris’s AIC499. More broadly, the project will build on the clinical trial and laboratory networks established by COMBACTE and set up a new network called EPI-Net. EPI-Net will map and draw on existing surveillance systems in Europe to optimally describe the epidemiology of antibiotic resistance and healthcare associated infections.
(February 2015)
Participants
Show participants on mapEFPIA companies
- Aicuris Anti-Infective Cures AG, Wuppertal, Germany
- Astrazeneca AB, Sodertaelje, Sweden
- Basilea Pharmaceutica International AG, Basel, Switzerland
- Glaxosmithkline Research & Development Limited, London, United Kingdom
- Sanofi-Aventis Recherche & Developpement, Gentilly, France
Universities, research organisations, public bodies, non-profit groups
- Academisch Medisch Centrum Bij De Universiteit Van Amsterdam, Amsterdam, Netherlands
- Assistance Publique Hopitaux De Paris, Paris, France
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
- Centre hospitalier universitaire de Limoges, Limoges, France
- Cliniques Universitaires Saint-Luc Asbl, Bruxelles / Brussel, Belgium
- Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain
- Eberhard Karls Universitaet Tuebingen, Tuebingen, Germany
- Erasmus Universitair Medisch Centrum Rotterdam, Rotterdam, Netherlands
- Fondation Cardiometabolisme Nutrition, Paris, France
- Fondazione PENTA - for the treatment and care of children with HIV-ONLUS, Padova, Italy
- Institut Catala De La Salut, Barcelona, Spain
- Institut National De La Sante Et De La Recherche Medicale, Paris, France
- Medizinische Universitaet Wien, Wien, Austria
- North Bristol National Health Service Trust, Bristol, United Kingdom
- Servicio Andaluz De La Salud, Sevilla, Spain
- Stichting Radboud Universiteit, Nijmegen, Netherlands
- Tel Aviv University, Tel Aviv, Israel
- The University Of Liverpool, Liverpool, United Kingdom
- Universita Degli Studi Di Verona, Verona, Italy
- Universitaet Ulm, Ulm, Germany
- Universitaetsklinikum Freiburg, Freiburg, Germany
- Universitair Medisch Centrum Utrecht, Utrecht, Netherlands
- Universitat Zurich, Zurich, Switzerland
- Universite De Geneve, Geneve, Switzerland
- Universiteit Antwerpen, Antwerpen, Belgium
- University College London, London, United Kingdom
- University Of The West Of England, Bristol, Bristol, United Kingdom
- University of Oxford, Oxford, United Kingdom
Small and medium-sized enterprises (SMEs)
- TranScrip Partners LLP, Reading, United Kingdom
- Ursula Theuretzbacher, Wien, Austria
Third parties
- Hospital Clinico Y Provincial De Barcelona, Barcelona, Spain
- Universite Paris Cite, Paris, France
Non EFPIA companies
- European Forum For Good Clinical Practice, Bruxelles / Brussel, Belgium
- Royal Liverpool And Broadgreen University Hospitals Nhs Trust, Liverpool, United Kingdom
- Servei De Salut De Les Illes Balears, Palma De Mallorca, Spain
- Servicio Madrileno De Salud, Madrid, Spain
Participants | |
---|---|
Name | EU funding in € |
Academisch Medisch Centrum Bij De Universiteit Van Amsterdam | 843 750 |
Assistance Publique Hopitaux De Paris | 184 608 |
Centre hospitalier universitaire de Limoges | 25 056 814 |
Centre Hospitalier Universitaire Vaudois | 157 800 |
Cliniques Universitaires Saint-Luc Asbl | 542 997 |
Consorci Institut D'Investigacions Biomediques August Pi I Sunyer | 281 462 |
Eberhard Karls Universitaet Tuebingen | 1 173 200 |
Erasmus Universitair Medisch Centrum Rotterdam | 29 971 |
European Forum For Good Clinical Practice | 120 000 |
Fondation Cardiometabolisme Nutrition | 346 900 |
Fondazione PENTA - for the treatment and care of children with HIV-ONLUS | 418 665 |
Institut Catala De La Salut | 195 529 |
Institut National De La Sante Et De La Recherche Medicale | 196 500 |
Medizinische Universitaet Wien | 234 672 |
North Bristol National Health Service Trust | 1 150 484 |
Royal Liverpool And Broadgreen University Hospitals Nhs Trust | 3 820 |
Servei De Salut De Les Illes Balears | 375 000 |
Servicio Andaluz De La Salud | 1 054 884 |
Servicio Madrileno De Salud | 133 997 |
Stichting Radboud Universiteit | 776 911 |
Tel Aviv University | 73 514 |
The University Of Liverpool | 166 886 |
TranScrip Partners LLP | 8 522 |
Universita Degli Studi Di Verona | 1 998 925 |
Universitaet Ulm | 188 550 |
Universitaetsklinikum Freiburg | 543 600 |
Universitair Medisch Centrum Utrecht | 5 807 588 |
Universitat Zurich | 148 050 |
Universite De Geneve | 622 761 |
Universiteit Antwerpen | 2 865 250 |
University College London | 27 435 |
University of Oxford | 232 500 |
University Of The West Of England, Bristol | 343 466 |
Ursula Theuretzbacher | 88 681 |
Third parties | |
Name | Funding in € |
Hospital Clinico Y Provincial De Barcelona | 174 338 |
Universite Paris Cite | 157 500 |
Total Cost | 46 725 530 |