With Christmas rapidly approaching I thought it would be seasonable to have some good news about AMR for a change, and two great things happened this week.

Firstly, Prof Beate Kampmann, Director of the LSHTM, Vaccine centre brought to my attention a paper in NEJM about a highly successful typhoid vaccine trial in Nepal. Prof Kampmann comments that “This vaccine could potentially change the game in typhoid- endemic countries such as Nepal, where there are also serious concerns about multi-drug resistant strains. The vaccine will certainly protect children from a serious infectious disease and could help us to prevent the spread of drug resistant strains.” She did caution though that “How long the very promising protection of over 80% lasts still has to be established in further studies but there is no doubt that this vaccine is highly immunogenic.“  While I am a strong believer in vaccines in the fight against AMR the current global measles increases show that there are still issues of accessibility and hesitancy to be dealt with but still excellent news.

The second started with a conversation with Prof Anthony Scott, former head of the LSHTM Vaccine Centre, that while AMR rates and rate increases are often reported what is often over looked is that in many places rates of infection, resistant or not, are generally going down. I have known for years working on MRSA and C. difficile that rates of these AMR bugs have been on the decline in the UK and in many HIC countries but Antony wasn’t talking about a HIC country but in Kenya where he works. The recent updated CDC report indicated that incidence of many of the infections had gone down since the original 2013 report, for instance Acinetobacter VRE and Drug-resistant Candida. OK, some infections had gone up such as ESBL-producing Enterobacteriaceae but it is still encouraging. This highlights another positive that is coming from the AMR ‘apocalypse’ is the improvement in surveillance so we can spot the good news and work out why and how things have improved to then implement where it is not so good. All in all, I am encouraged that progress is being made. Maybe it’s the season to be jolly and the fact that it is actually sunny outside but I go in to 2020 positive that we are beginning to go in the right direction.

Happy Christmas to all.