The rapid advancement of artificial intelligence (AI) has already had wide-ranging implications and applications in health and medical innovation, advancing areas including personalized medicine, predictive health analytics, and data interoperability. One recent, potentially game-changing use case for AI in medicine is its ability to identify drug-resistant infections swiftly.
CEO, TAXIS Pharmaceuticals
As demonstrated in a study by Cambridge University scientists, AI can now identify drug-resistant typhoid-like infections from microscopy images within hours, showcasing a powerful tool in the fight against antimicrobial resistance (AMR).1 The technology helps overcome a longstanding challenge: the inability to distinguish rapidly between organisms that can be treated with first-line drugs and those that are resistant to treatment. Conventional testing “can take several days, requiring bacteria to be cultured, tested against various antimicrobial treatments, and analyzed by a laboratory technician or by machine,” a delay that “often results in patients being treated with an inappropriate drug, which can lead to more serious outcomes and, potentially, further drive drug resistance.” 1
And while this innovation shows strong potential for combating the growing epidemic of AMR by treating hospital-acquired infections early and with medications that will be effective, thereby improving health outcomes, this application of AI is not without its challenges. Concerns regarding the accuracy, reliability, and ethical implications of AI in healthcare must be addressed to fully leverage its capacity. So, this is not a magic bullet.
And, quite frankly, when it comes to the complex, global threat of AMR, shiny new AI tools simply won’t be enough.
Scope of the crisis
Despite the many technological and med- ical advances of the past several decades, AMR remains a formidable global threat, posing severe risks to both public health and economic stability. The World Health Organization (WHO) recently named AMR one of the top global public health and development threats. The WHO has also pointed out that AMR puts many of the gains of modern medicine at risk and makes infections harder to treat, and that it makes other medical procedures and treatments—such as surgery, cesarian sections, and cancer chemotherapy—much riskier.2
AMR has been a persistent challenge since the discovery of antibiotics. Bacterial cells evolve sophisticated mechanisms and structural defenses to survive exposure to antibiotics, leading to the development of drug-resistant strains over time. This evolutionary process has been accelerated by the overuse and misuse of antibiotics in both medical and agricultural settings, as some bacterial infections that had been treatable with antibiotics in the past are now becoming resistant, a process that poses an ever-growing threat.3
Currently, a significant percentage of antibiotics are no longer effective, and the pipeline for new antibiotics has dried up, creating a dire situation. Antibiotic resistance directly causes the deaths of 1.27 million people (and contributes to the deaths of 5 million) globally each year, and projections indicate that by 2050, AMR could cause 10 million deaths.4
Beyond the human and clinical cost of AMR, the financial impact is staggering. The effects of AMR permeate into productivity and economic stability, as individuals suffer from prolonged illnesses and healthcare systems become strained. Cost projections show that by 2050, AMR infections could result in an economic burden of up to $100 trillion globally.5
A health crisis of this magnitude demands innovative solutions that address the root causes of bacterial resistance, rather than relying on temporary fixes. Understanding the fundamental structures and functions of bacterial cells is key to developing these solutions.
By deciphering how bacteria evolve resistance mechanisms, scientists can pinpoint vulnerabilities and develop new therapies that restore the effectiveness of existing antibiotics. These efforts not only show potential to mitigate the immediate threat of drug-resistant infections, but also offer a sustainable path forward by reducing the overreliance on antibiotics and promoting responsible use. Such comprehensive strategies are essential to safeguarding public health as well as ensuring robust economic resilience in the face of this escalating global health challenge.
Scientific advances
The urgency of addressing AMR cannot be overstated, but thankfully, researchers are developing new treatments that target the core mechanisms of resistance. Current approaches in various stages of preclinical and clinical investigation include:
• Disrupt bacterial cell division. Certain investigational com- pounds specifically target filamenting temperature-sensitive mutant Z (FtsZ), a critical bacterial protein that plays a pivotal role in the process of bacterial cell division. By inhibiting FtsZ function, these compounds have the potential to effectively prevent bacteria from dividing and proliferating.
• Keep antibiotics inside bacterial cells. Efflux pumps act as bilge pumps inside bacterial cells, expelling antibiotics and rendering them ineffective. By inhibiting these pumps with investigational compounds called efflux pump inhibitors, researchers aim to keep the antibiotics inside the bacterial cells to ensure their efficacy. The National Institute of Allergy and Infectious Disease, a division of the National Institutes of Health, recently awarded a $2.67 million grant to further R&D efforts in this area.6
• Halt bacterial replication and growth. Dihydrofolate reductase inhibitors are intended to block the activity of an enzyme crucial for DNA and RNA production in bacteria, effectively halting bacterial replication and growth.
Through research efforts like these, we may be able to develop new treatments that are more effective and sustainable and that restore the efficacy of Food and Drug Administration–approved antibiotics, providing a much-needed edge in the ongoing battle against drug-resistant infections.
A collective vision
In addition to the R&D efforts of many pharma and biotech companies, deliberations in Congress are focusing on the AMR crisis. The House Budget Committee recently held a bipartisan roundtable, Threats to Modern Medicine: Examining the Budgetary Effects of Antimicrobial Resistance and the Broken Antibiotic Development Pipeline.7 And there has been renewed support for the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act. The bill is intended “to encourage innovative antimicrobial drug development.” 7 If passed, the bill “would commit $6 billion to purchasing new drugs to treat drug-resistant bacteria and fungi that federal officials designate as critically important targets.” 8 It would also establish a committee that would determine which treatments the federal government should purchase, making those medications available at no cost for Medicare and Medicaid recipients and those who receive health benefits from the Department of Veterans Affairs.8
COVID-19 set a precedent for the U.S. government purchasing medications on a large scale to help reign in national and global health threats, and seeing a similar effort in the face of widespread AMR is a strong step in the right direction.
The rising tide of drug-resistant infections threatens to undermine decades of medical progress, transforming once-treatable infections into deadly threats. Yet despite these daunting challenges, recent developments offer hope. These developments include AI applications to identify drug-resistant infections, research to restore antibiotic efficacy, and congressional actions to spur innovation.
Global collaboration and the pursuit of innovative solutions are now more critical than ever. By fostering a collective vision of a future where common bacterial infections are no longer life threatening, we can inspire action and ensure a healthier, more resilient world for generations to come.
Greg Mario is CEO of TAXIS Pharmaceuticals.
References
1. Brierley C. AI able to identify drug-resistant typhoid-like infection from microscopy images in matter of hours [press release]. University of Cambridge. Published online July 8, 2024. Accessed August 5, 2024.
2. Antimicrobial Resistance. World Health Organization. Published online November 21, 2023. Accessed August 5, 2024.
3. Antibiotic Resistance. Baylor College of Medicine, Molecular Virology and Microbiology, Baylor College of Medicine. Accessed August 5, 2024.
4. Political Declaration of the High-Level Meeting on Antimicrobial Resistance. United Nations. May 20, 2024. Accessed August 5, 2024.
5. Vaccines could avert half a million deaths associated with antimicrobial resistance a year [press release]. World Health Organization. Published online July 28, 2023. Accessed July 19, 2024.
6. Taxis Pharmaceuticals Announces $2.67 Million NIH Grant to Advance Research and Development of Combination Therapy to Combat Antibiotic-Resistant Pneumonia [press release]. Taxis Pharmaceuticals. Published online May 1, 2024. Accessed August 5, 2024.
7. House Budget Committee Examines Budgetary Effects of Antimicrobial Resistance and the Broken Antibiotic Development Pipeline [press release]. House Budget Committee. Published online. July 25, 2024. Accessed August 5, 2024.
8. Mosbergen D. Congress Considers Paying Developers of New Antibiotics. Wall Street Journal. Published online July 29, 2024. Accessed August 5, 2024.
