Five essential elements to achieve effective prevention
The concept of the PILGRIM research is based on five elements/approaches which are essential in order to achieve timely application of measures and effective prevention.
1. PILGRIM focuses on one strain, the MRSA ST398, an animal-adapted, zoonotic, resistant pathogen that causes colonisation and infection in humans in community and health care settings. MRSA ST398 is the most relevant strain to study because it is animal-adapted allowing PILGRIM to use animal models and it is able to infect humans offering a unique opportunity to investigate colonisation, host range and virulence factors. As MRSA ST398 occurs in the community as well as in hospitals with a high potential for further spread in countries with approved prevalence and emergence throughout Europe timely action is required to prevent a major public health impact and to comply with the Community Strategy against Antimicrobial Resistance and Optimising the Delivery of Health Care to European Citizens of the European Commission.
2. PILGRIM undertakes epidemiological and physiological studies of MRS ST398 not only using conventional observational studies and strain typing but also using well comparable animal models in order to better understand the specific ecology of zoonotic resistant bacteria.
3. Based on these longitudinal studies the PILGRIM consortium will be able to
- characterise isolated MRSA ST398 strains;
- investigate the biological relevance of molecular characteristics in an in-vivo colonisationmodel using human volunteer studies and an animal model with gnotobiotic piglets;
- establish genetic differences between adhesive and non-adhesive strains as well as differences between ST398 and other MRSA of both human and animal origin using a specifically developed micro-array;
- identify specific genes for the development of new rapid tests to identify specific MRSAstrains and potentially for bed-side testing;
- develop novel intervention instruments targeted at decolonisation and environmentalsanitation using photocatalysis and electrochemically generated charged metal ion solutions;
- propose novel control strategies and measures to policy makers, and practitioners. provide a testing environment, the Technology Testing Platform, available to companies,especially for SMEs for cost-intensive validation of their existing and new solutions understandardised and realistic conditions.
4. MRSA ST398 is seen as a model to enhance our understanding of other MRSA and the ecology of resistant zoonotic pathogens in general. Indeed, the majority of emerging infectious diseases originate from an animal reservoir. Similarly, MRSA is not the only resistant zoonotic bacterial clone. In order to investigate the complex issue of its antimicrobial resistance and transmission from animal to and within human populations, co-operation and knowledge transfer between experts from different ecosystems.
5. The PILGRIM consortium includes the necessary clinical, genetic, microbiological and public health partners from 6 European countries who are internationally renowned for their expertise in complementary ecosystems research. In order to ensure the maximum dissemination and exploitation of results, the two SME partners will foster the use of the Technology Testing Platform by external companies committed to validate their solutions for cost-effective prevention and eradication of community and nosocomial infections.