Blog

Feature Image Credit: Slide by Sara Vernam, Associate Programme Officer, The Bill & Melinda Gates Foundation: BMGF & BARNARDS- Perspectives on Antimicrobial Resistance. May 12th 2017 The BARNARDS workshop 2017, Kigali.

We would like to take this opportunity to again thank all delegates for your attendance and contribution to the BARNARDS workshop last week.

It was a pleasure to meet those of you we haven’t previously met and to reconnect with those we have.

We hope the workshop strengthened the bonds between the global network that is being established to meet the aims of the BARNARDS project.

We would like to wish our Rwandan hosts a special thank you. Our tour around Kabgayi Hospital was one of the highlights of the week. We were very fortunate to see so much of the truly beautiful country that is Rwanda and experience the welcoming and friendly culture.

We would like to offer a warm welcome to all partners and delegates to the BARNARDS 2017 workshop!

We are extremely pleased to bring BARNARDS team members together from all participating countries for the BARNARDS annual conference, this year hosted in Kigali, Rwanda. We are looking forward to a week of reviewing project progress, success stories and discussion of key issues surrounding infection control, antibiotic resistance and neonatal sepsis.

We are extremely pleased to announce the launch of the BARNARDS website!

The BARNARDS project is an international collaborative of research into the Burden of Antibiotic Resistance in Neonates in Developing Societies, with researchers and medical staff across the UK, Africa and South Asia working together to combat neonatal mortality and morbidity in low-middle income countries (LMICs) as the result of sepsis causing antibiotic resistant bacteria.

Antimicrobial resistance (AMR) is fast becoming one of the largest and fastest growing threats to human health. With increasing globalisation, bacteria can rapidly develop resistance mechanisms that render front-line and last-resort antibiotics ineffective. Multi-drug resistance (MDR) is particularly problematic with MDR bacteria being tolerant to a range of antimicrobial treatments.

BARNARDS is particularly focused on multi-drug resistant Gram-negative bacteria (MDR GNB) carrying the resistance genes bla_CTX-M, bla_OXA-48-like, bla_NDM and bla_KPC, indicative of the presence of extended-spectrum β-lactamases and carbapenemases producing bacteria. These enzymes confer resistance to β-lactam antibiotics, the most widely used drugs to combat clinical and community infections caused by GNB. Particularly, the presence of carbapenemases is greatly concerning as they render the host bacteria resistant to carbapenems, which are last-resort antibiotics.

With developing countries accounting for 99% of the worlds neonatal mortality from sepsis, BARNARDS aims to:

• Provide the means, support, network and tools to understand the impact of antibiotic resistance on neonatal morbidity and mortality and identify possible solutions to minimize its impact.

• Blend clinical and molecular epidemiology from LMICs with respect to neonatal Gram-negative infections using a range of microbiological and molecular/genomics techniques

• Monitor and improve mother and infant wellbeing by exploring the impact of infection control interventions.

• Determine the prevalence of multi-drug resistant Gram-negative bacteria (MDR_GNB) carried as the mother’s normal micriobiota that causes neonatal sepsis and identify any contributing risk factors for sepsis within sociodemographic traits, living and sanitary conditions and the clinical histories and outcomes for the mothers and their babies.

• To create a genomics platform amongst partner countries, housing over 4000 bacterial isolates, establishing a comprehensive international neonatal Gram-negative sepsis database – the first of its type worldwide.

• To support participating clinical centers in uniform and excellent microbiology, molecular/genomic practices.

• To use the data generated to inform local, national and international health bodies.

From all in the BARNARDS group, we hope that this website serves as a portal where everyone can follow the work done in this project, the stories shared by the BARNARDS team members and where all can learn about the global problem of AMR.

A touching story from our Nigerian BARNARDS Project Coordinator that encapsulates the heart of BARNARDS, aiming to reduce neonatal mortality in developing societies as a result of sepsis caused by antimicrobial resistant bacteria.

“When we were at the neonatal ward, I noticed a young mother staring at her baby silently while her baby lay still and motionless. She did not utter a word. The ward was so busy and all the staff were preoccupied. I called the attention of the doctors, who then began to resuscitate an already dead baby on the makeshift resuscitare (a cold brown table). After a couple of minutes the baby was wrapped up in a cloth and the nurse called out for the mum. The baby’s grandma came up and carried the baby in her arms silently. I watched them leave without uttering a sound, without shedding a tear, it was almost like nothing happened but I could see their silent pain. The doctors swiftly moved on to the next patient…”

-Zahra Modibbo, June 2016