WEBVTT

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So this is Nick Thomson
whose lab does research

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on the genomics of AMR.

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What is Antimicrobial
Resistance?

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So we use antimicrobials
therapeutically

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to kill and to treat infections.

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And when a microbe or bacteria
is no longer sensitive,

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it's no longer killed by an
antibiotic, by definition,

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it's resistant to
the antibiotic.

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Why do bacteria become
resistant to antibiotics?

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It's because we are
reliant on antibiotics

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to treat infections,
therefore we use lots of them.

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They're used all over the world.

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There are multiple
different types,

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and we don't always tailor
the amount of antibiotic

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we take to the size of person.

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For example, everyone
gets a standard dose.

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And so just by sheer
size, the doses

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of the antibiotic that circulate
within our body are different.

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When you take an antibiotic
for a specific infection,

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the antibiotic can even
be sweated in your skin.

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So everything every bacteria
in your guts, on your skin,

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everywhere is exposed to
the antibiotic regardless

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of whether that's the bacterium
causing the infection or not.

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So the reason that we get
resistance is through exposure.

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We take antibiotics we expose
bacteria to antibiotics.

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Those that are
resistant survive.

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Those that are sensitive don't.

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And so we select for resistant.

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We hear about AMR all
the time on the news.

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Why should we be
worried about it?

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It's a problem,
because antibiotics are

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very important for treatment.

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And reverting or
going back to a time

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where we had no antibiotics
mean that very common illnesses

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become real life threatening.

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And it's not just
through infections.

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It's everything where we
break the skin barrier.

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So for operations, for
hip, knee operations,

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anything where bacteria
can enter the body

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and cause an infection, if
we don't have antibiotics

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to treat those infections,
then those infections

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can become life threatening.

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Is this a problem
all over the world?

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It's a problem all
over the world.

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Resistance is spreading.

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So these resistant bacteria
are able to spread not just

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locally, nationally,
but globally.

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We carry them on our skin.

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And so there are
many ways for them

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to spread and within our bodies.

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And so anywhere where
we've overused antibiotics

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or that resistance
has developed,

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it's a problem and
that, at the moment,

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because of our
reliance on antibiotics

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is most of the world.

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So what can genomics do to help
us tackle the problem of AMR?

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So that we know there
are different ways

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to become resistant.

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You can be naturally
truly resistant.

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You can acquire
genes that confer,

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allow you to be resistant,
a bacterium that is.

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And we also have
bacteria which we know

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are more resistant than others.

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And so genomics
allows us to identify

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all of those possibilities.

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It allows us to look at
highly-resistant bacteria

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and how they're spreading.

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It allows us to understand
whether that gene is

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able to spread to other
bacteria or is confined

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to that single bacterium,
or whether the mechanism

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of resistance is a threat
in terms of other bacteria.

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It could spread
to other bacteria

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and confer resistance
more broadly.

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So really what it
does is to allow

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us to estimate the
risk of not only

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the bacteria that is
resistant but the genes that

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confer resistance
pose to human health.

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So could you give us an example
from your research where you've

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used genomics in
the context of AMR

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to help us understand
more about it?

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We had a very unusual
example of disease in Africa.

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It was a bacteria that's
familiar to many, salmonella,

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Salmonella typhimurium.

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In the UK, for example,
where I'm based,

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you would mostly
associate salmonella food

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with food poisoning,
so with food.

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In Africa, it wasn't
associated with food at all.

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And it also didn't necessarily
generate the symptoms

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that we'd be familiar
with here, so diarrhoea.

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It caused a fever, so
an invasive illness

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that led to a fever,
a very high fever.

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It was life threatening and
treated with antibiotics.

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The recommended antibiotic
for Salmonella in that setting

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wasn't working.

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And so when we
sequenced the bug,

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the first thing we
found out was that these

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were a very specialised
form of the Salmonella

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that we would have in the
UK, but different and that

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explained why they were causing
a fever, an invasive disease.

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We also found that
they carried the genes

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not just for one antibiotic, but
for five different antibiotics

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that conferred resistance
to those antibiotics, which

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explained why treatment
was failing to limit

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the severity of the infection.

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And in actual fact,
as a result, there

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was extremely high
mortality rate.

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And so we were able
to not only define

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this organism and
its resistance,

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we were able to say how
far that had spread.

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And it actually spread
right across Africa.

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And so therefore,
you can alert anyone

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who wants to treat these
types of infections

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to the presence of
an organism that

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will not respond to the
recommended antimicrobials.

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OK.

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Thank you very much, Nick.

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