DT News - India - How AI is fighting Antimicrobial Resistance (AMR)

Dr Rewant Chauhan

Tue. 26 November 2024

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The crisis of antimicrobial resistance (AMR) stems largely from the widespread misuse and overprescription of antibiotics across various sectors, including healthcare, agriculture, and the environment. However, the rapid advancements in artificial intelligence (AI) offer transformative solutions, enabling significant progress in early diagnosis, enhanced surveillance systems, and accelerated drug discovery processes.

Introduction
Antibiotics have been a critical public health tool since the discovery of penicillin in 1928, saving the lives of millions of people around the world. Today, however, the emergence of drug resistance in bacteria is reversing the gains of the past eighty years, with many important drug choices for the treatment of bacterial infections becoming increasingly limited, expensive, and, in some cases, nonexistent. The Centers for Disease Control and Prevention (CDC) estimates that each year at least two million illnesses and 23,000 deaths are caused by drug-resistant bacteria in the United States alone. AMR demands urgent action as it poses an undeniable threat to global health, modern medicine, and the stability of economies worldwide. The World Health Organization (WHO) has identified AMR as one of the top ten public health threats, projecting that it could lead to a catastrophic 10 million deaths annually by 2050.¹ This crisis is rooted in the reckless misuse and overprescription of antibiotics across healthcare, agriculture, and environmental sectors. Fortunately, advancements in AI technologies present indispensable solutions that can revolutionize early diagnosis, improve surveillance, and expedite drug discovery.

Global efforts to address AMR
The escalating threat of AMR has taken back international policymakers and researchers into immediate collective action. The WHO’s Global Antimicrobial Resistance and Use Surveillance System (GLASS) is a crucial initiative that empowers nations to systematically track and analyze resistance patterns.¹ The G20 has already declared AMR a priority, demanding increased research funding and robust public-private partnerships to drive the development of next-generation antibiotics and groundbreaking diagnostics.² Furthermore, regional initiatives such as the European Union's Joint Programming Initiative on AMR are effectively aligning research efforts to tackle resistance head-on.³

Artificial intelligence technologies are not just optional tools but game changers in the fight against AMR. Pioneering models like AlphaFold from DeepMind have reshaped structural biology by enabling the prediction of protein structures essential for identifying antibiotic targets.⁴ Tools like Pathogenwatch harness the power of AI to analyze microbial genomes, pinpoint resistance genes, and track their global spread with remarkable precision.⁵ Additionally, SyntheMol’s application of AI for in silico screening of new antimicrobial compounds accelerates development timelines and curtails costs.⁶

In clinical environments, AI's significance is equally undeniable. IBM Watson for Precision Medicine personalizes treatment plans based on detailed patient profiles, ensuring antibiotics are prescribed only when necessary.⁷ AI-enhanced diagnostics, such as the Karius Test, effectively distinguish between bacterial and viral infections, dramatically reducing inappropriate antibiotic prescriptions (Karius, 2022).⁸

AMR: A world lens
At the World Health Assembly in 2015, all Member States, including the US, Canada, UK, and Australia endorsed a global action plan to tackle AMR. All member states were urged to have national action plans in place by 2017.⁹ The United States already has a “first national action plan” for combating antibiotic-resistant bacteria implemented. CIHR Canada and NHS UK developed a new AMR 5-year national action plan, ‘Confronting antimicrobial resistance,’ which builds on the achievements and lessons from the first national action plan.

Other Asian nations, including India, China, and Japan, are already implementing strong AMR stewardship programs and enhancing their surveillance systems. The Asia-Pacific AMR Network is fostering unprecedented collaboration among countries, driving home the critical role of education and technology-driven solutions in combating AMR challenges (Asia-Pacific AMR Report, 2021).¹⁰ The integration of AI technologies in India is not just promising; it is transformative, with initiatives like Genome India using genomic insights to directly confront resistance.¹¹

Implications for dentistry
Dentistry is a key player in the fight against AMR and cannot be overlooked. Dental infections are major contributors to antibiotic prescriptions, often issued unnecessarily.¹² AI-driven diagnostic systems empower dentists to make accurate diagnoses and minimize reliance on broad-spectrum antibiotics. Additionally, predictive tools can identify patients at high risk for infections, enabling proactive measures. Education platforms, such as Teledentistry AI, are essential for training dentists on rigorous, evidence-based prescribing practices.¹³

Conclusion
To effectively combat AMR, it is imperative for global and regional collaborations to prioritize:

Investing decisively in AI technologies that enhance research, strengthen surveillance, and improve diagnostics.
Enforcing robust regulatory frameworks to curtail the misuse of antibiotics, use 5 pillars of WHO guidelines on tackling AMR.
Boosting public awareness campaigns, particularly in low- and middle-income countries (LMICs).
Supporting AI-driven educational platforms aimed at profoundly enriching healthcare provider knowledge.
Establishing strong public-private partnerships to innovate in the field of antibiotics.

AMR is a silent pandemic that demands unwavering and immediate action from the global community. The transformative power of AI can and must accelerate solutions, from predicting resistance genes to optimizing antibiotic use. Dentists, as pivotal members of the healthcare continuum, must adopt AI-driven tools that enhance stewardship efforts. A unified approach that uses technology and collective action is not just desirable; it is essential for protecting global health and ensuring a sustainable future for medicine.

References

World Health Organization. "Antimicrobial Resistance Fact Sheets." 2023, www.who.int/amr.
GLASS (Global Antimicrobial Resistance and Use Surveillance System). https://www.who.int/initiatives/glass
European Commission. 2022. "Joint Programming Initiative on AMR." https://research-and-innovation.ec.europa.eu/research-area/health/antimicrobial-drug-resistance-amr_en
Jumper, J., et al. "Highly Accurate Protein Structure Prediction with AlphaFold." Nature, vol. 596, no. 7873, 2021, pp. 583-589.
Pathogenwatch. 2023. "AI-Powered Genomic Analysis for AMR." https://pathogen.watch/
SyntheMol. 2023. "AI Applications in Antimicrobial Drug Discovery." https://github.com/swansonk14/SyntheMol
IBM Watson Healthcare. 2021. "Precision Medicine Applications." https://www.ibm.com/industries/healthcare
Park SY, Chang EJ, Ledeboer N, Messacar K, Lindner MS, Venkatasubrahmanyam S, Wilber JC, Vaughn ML, Bercovici S, Perkins BA, Nolte FS. Plasma Microbial Cell-Free DNA Sequencing from over 15,000 Patients Identified a Broad Spectrum of Pathogens. J Clin Microbiol. 2023 Aug 23;61(8):e0185522. doi: 10.1128/jcm.01855-22. Epub 2023 Jul 13. PMID: 37439686; PMCID: PMC10446866.
U.S. Actions & Events to Combat Antimicrobial Resistance. https://www.cdc.gov/antimicrobial-resistance/programs/AR-actions-events.html
GenomeIndia. 2023. "Addressing Antimicrobial Resistance through Genomics." https://genomeindia.in/
Asia-Pacific AMR Report. 2021. "Regional Collaborations in Combating Antimicrobial Resistance." https://rr-asia.woah.org/en/projects/antimicrobial-resistance/
Contaldo, Maria et al. “Antibiotics in Dentistry: A Narrative Review of the Evidence beyond the Myth.” International journal of environmental research and public health vol. 20,11 6025. 1 Jun. 2023, doi:10.3390/ijerph20116025
Teledentistry AI. 2022. "Training Dental Professionals for AMR Stewardship."