| CIHR Institutes |
| III Home |
| About III |
| III Funding |
| III Partnerships |
| III Showcase |
| III Publications & Resources |
| III Calendar of Events |
| Contact III |
Executive Summary
Antibiotic Resistance
Antibiotic Development
The Research Challenge
Novel Alternatives to Antibiotics Workshop
The Recommendations
Path Forward
Resources
Workshop Report
Welcome and Introductions
Presentations
Break-out Sessions
Recommendations
Next Steps
Appendix 1 - Workshop Participants
Appendix 2 - Workshop Agenda
Appendix 3 - Biography of Keynote Speaker
Appendix 4 - Workshop Evaluation
Bacterial infections can strike anyone - the young, the old, the healthy and the chronically ill. Usually the body's immune system, which is designed to fight infection, defeats the invading bacteria. Sometimes however, the burden of infection proves too great, or the patient too weak perhaps because of a compromised immune system, (eg. people living with HIV/AIDS or receiving cancer treatment). In these situations infection can be fatal. For more than 50 years, antibiotics have come to the rescue by routinely producing rapid and long-lasting 'miracle cures'. However, from the beginning antibiotics have selected for resistance in the bacterial populations that they attack - resistance than can be easily transferred between bacteria. The more an antibiotic is used and the broader its spectrum, the more widespread resistance becomes. Because antibiotics have a rapid and long lasting effect and are relatively inexpensive, they have sometimes been overused or misused in clinical practice, often being prescribed for infections caused by viruses, or in response to a patient's request for a 'quick fix'. In addition, the widespread use of related classes of antibiotics as growth promoters and unnecessary therapeutics in agriculture has exacerbated the problem of resistance to the antibiotics used in human health. The consequence has been a gradual rise in antibiotic resistance and the selection of bacteria that are resistant to most, if not all, available classes of antibiotics. The situation is worse in some countries than others and although Canada does not see the same high rates of resistance as the United States, antibiotic resistance is not a problem we can afford to ignore.
Initially new drug development by the large pharmaceutical companies kept pace with rising rates of resistance, but recently the flow of new antibiotics onto the market has dramatically decreased. Increasingly, industry is turning its attention to more marketable drugs with bigger profit margins such as those used for the treatment of chronic diseases or life-style issues. We are now faced with a situation that has been compared to "a train coming down the track" - increasing drug resistance and no new drugs. There is concern that medicine could return to the pre-antibiotic days if we fail to preserve the efficacy of the antibiotics we still have, investigate new targets, screen the biologically active small molecules that exist in nature and in man-made chemical libraries, and explore novel alternatives to antibiotic use.
The Institute of Infection and Immunity (III) is one of the 13 virtual Institutes of the Canadian Institutes of Health Research (CIHR). Antibiotic resistance is one of the Institute's strategic research priorities. III is currently funding research on antibiotic resistance both in agriculture and human health and recently committed funds to a new CIHR health services research program to explore ways to reduce the need for antibiotics through improved infection control practices in acute and long-term health care facilities. Other health related organizations are engaged in antibiotic resistance surveillance, epidemiology studies and educational initiatives to encourage the prudent use of antibiotics. In 2004, Dr Brett Finlay, a member of the III Institute Advisory Board, identified a need for research into novel alternatives to antibiotics on the premise that not only will resistance always be generated by traditional antibiotics, but academia does not have the financial means to take new drugs to market. A small steering group was formed which, together with a number of partner organizations, identified a group of researchers known both for their research expertise and their ability to think creatively. These researchers were invited to an informal and interactive workshop entitled 'Novel Alternatives to Antibiotics', which took place in Vancouver on March 10th and 11th, 2005.
The Partners
The following organizations were engaged in the planning and support of the workshop and will continue to work together on the development of a research agenda:
| Alberta Heritage Foundation for Medical Research Association of Medical Microbiology and Infectious Disease Canada Canadian Committee on Antibiotic Resistance Canadian Foundation for Infectious Diseases Community and Hospital Infection Control Association Canadian Patient Safety Institute Fonds de la recherche en santé Québec National Research Council of Canada Public Health Agency of Canada |
The workshop combined an overview of antibiotic resistance with free ranging discussions on potential alternatives to antibiotics. The criteria used to identify topics included the originality of the approach, the feasibility of mounting a research initiative based on available research strengths, potential for rapid uptake of results (knowledge translation) and cost. Of the many alternatives that were suggested and discussed during the workshop several themes emerged consistently among the working groups. They were:
When viewed from the perspective of responsiveness to the goals of the workshop and 'readiness' for immediate development of a research initiative, three themes emerged as being of high priority:
Immune Systems
One function of the immune response is to kill bacteria. Modulation of the host immune response, either through vaccine delivery (therapeutic and preventive) or other mechanisms to increase innate immunity, holds considerable promise as a means to fight bacterial infection. A team approach was recommended to combine the strong Canadian research expertise in immunology and microbiology.
Phage Therapy
Phage therapy was largely abandoned by the western world when antibiotics were first discovered. However phage research continued in both Poland and Russia, where antibiotic resistant infections apparently continue to be successfully treated using live phage or phage products. Recently, increasing attention has been turned towards phage therapy as a potential alternative to antibiotics. Although there is some research expertise in the Canadian agriculture and biotechnology sectors, there is little academic research capacity in Canada for phage therapy in the health sector. Despite potential regulatory problems, particularly with phage cocktails, phage therapy offers an innovative approach, ideally suited to proof of concept studies. Partnership development both in Canada (with existing biotechnology companies and the agriculture sector) and internationally will be key in developing a strong research agenda in this area.
Physical Systems/ Biomaterials
This area of research includes modifications to the physical environment such as hyperbaric conditions and temperature control, and the application of technologies such as lasers and UV light to reduce the risk of infection in patients undergoing treatment or surgery. The area also includes the discovery and application of biomaterials designed to reduce or eliminate bacterial growth and biofilm formation. Examples would be the introduction of 'super smooth' surfaces on artificial joints and the development of biomaterials impregnated with anti-infective agents. Most of the existing research and development in physical systems and biomaterials occurs in small biotech companies and there is currently little capacity for applied health research. However there is enormous potential for partnership between the private sector and health sector and good opportunities for new product development and commercialization. This was considered an excellent area for innovative partnerships between CIHR, the Natural Sciences and Engineering Research Council (NSERC) and the National Research Council of Canada (NRC).
Additional Research Areas
The other identified themes were also considered to be important research areas. It was thought that some however needed further development (eg. probiotics), and would benefit from an additional small focused workshop to bring together experts from the health and agriculture sectors. In other areas such as bio-prospecting and novel target identification it was recognized that the translational research required was beyond the financial means of any single organization and that collaboration between CIHR, NRC, NSERC and private industry would be highly advantageous. Rapid diagnostics is an area that underpins all antibacterial therapies including traditional antibiotics. Point-of-care diagnosis would enable specific therapy and reduce the need for broad-spectrum antibiotics. However, this topic was not felt to be truly relevant to the mandate of the workshop and there are already many existing avenues of funding for diagnostic tool development.
It was recommended that a Request for Applications (RFA) be developed by III and partners for launch in 2005 and that the eligible research areas should include all the themes and topics discussed at the workshop and described in this report but with emphasis on the following three themes:
It was further recommended that applicants be required to clearly identify the innovative components of their research project, the contribution their results will make in reducing the problem of antibiotic resistance, expected milestones, and an explanation of the process by which research findings will be translated into clinical practice. It was suggested that several different funding models should be made be available including short term programs such as pilot projects and proof of principle studies, and longer term programs such as small team grants, randomized control trials and operating grants. An emphasis on multidisciplinary research will be a strong component of successful applications.
III staff, the partners, and members of the III Institute Advisory Board will be guided by the recommendations in this report when making their final decision on the type of research initiative to be launched.
The workshop was called to order by Dr. Judith Bray who explained the meeting logistics and informed participants that scheduled key-note speaker, Dr Jim Hutchinson would unfortunately be unable to attend the workshop as he was stranded in St John's as a result of poor weather conditions. J. Bray introduced the Scientific Director of the CIHR Institute of Infection and Immunity (III), Dr. Bhagirath Singh, who welcomed participants and gave a brief overview of III priorities and achievements over the last five years, including funded programs in the area of antibiotic resistance.
J. Bray introduced representatives of the nine partner organizations supporting the goals of the workshop. Each said a few words about their organization and their interest in the topic. They were, in alphabetical order:
| Organization | Representative |
| Alberta Heritage Foundation for Medical Research (provided funds in support of the workshop) | Jacques Magnan |
| Association of Medical Microbiology and Infectious Disease Canada | Mark Loeb |
| Canadian Committee on Antibiotic Resistance (provided funds in support of the workshop) | Rick Walter |
| Canadian Foundation for Infectious Diseases | Raphael Saginur |
| Community and Hospital Infection Control Association | Mary McNaughton |
| Canadian Patient Safety Institute | Joseph Gebran |
| Fonds de la recherche en santé du Québec | André Dascal |
| National Research Council of Canada | Jim Richards |
| Public Health Agency of Canada (provided funds in support of the workshop) | Mohammed Karmali |
Judith Bray also introduced the other members of the Steering Committee, Brett Finlay, Marc Ouellette, Chris Bleackley and Robert Brunham [representing the CIHR Institute of Population and Public health (IPPH)], and the III staff who helped to organize the workshop, Erik Blache and Amanda Devost.
This workshop was organized in response to the escalating problem of antibiotic resistance and the parallel decrease in antimicrobial research and development by large pharmaceutical companies. Of 89 new drugs approved in 2002, none were antibiotics and of over 400 new agents currently in development, only five are new anti-microbials, most of which are derivatives of existing drugs. Meanwhile, there are at least 12 anti-HIV drugs under development, plus five other anti-virals, five anti-parasitic drugs and three anti-fungal drugs.
There are many ways to address the problem of antibiotic resistance including enhanced education of both health care workers and the lay public, changes in prescribing practices, reduction or elimination of antibiotics as growth promoters or unnecessary therapeutics in agriculture, and improved infection control procedures. There is little doubt that more prudent use of antibiotics will extend their life and slow the progression of resistance. However, resistance will ultimately always occur either through de-novo generation or horizontal transfer and so we would be wise to consider alternatives to traditional antibiotics in the continuing battle against infectious diseases.
In 2004, the Institute Advisory Board of III made the proactive decision to tackle the problem of antibiotic resistance from the perspective of novel alternatives to antibiotics. As a first step, a steering committee was formed comprised of III IAB members (Brett Finlay, Marc Ouellette, Chris Bleackley), III staff (Judy Bray) and a representative of the IAB of the CIHR Institute of Population and Public Health (Robert Brunham).Workshop participants selected by this steering committee, in consultation with the supporting partner organizations, were chosen not only on the basis of their successful research careers but also for their capacity to think beyond their traditional disciplines and areas of research to discuss far reaching questions about antibiotic therapeutics (See Participant List, Appendix 1). The workshop was planned to be highly interactive, with a focus on brainstorming and discussion to produce innovative ideas for novel research initiatives (See Agenda, Appendix 2). The ultimate goal of the workshop was to provide III and the partner organizations with recommendations for a joint research initiative that will capitalize on Canadian research strengths and provide alternative therapies to replace or complement the use of traditional antibiotics in medical practice.
As one of Canada's leading experts in the field of antibiotic resistance Dr. Davies was well-placed to give participants a comprehensive overview of the current situation in Canada and abroad, based on his many years of experience dating back almost to the original discovery of penicillin in the 1940's. His talk was followed by a lively question and answer period that covered many areas of antibiotic resistance, from both a scientific and philosophical perspective and addressed some of the problems encountered with new drug discovery and regulatory issues.
The presentation began with a philosophical quote from Charles Darwin, which is as true today as it was when it was made in 1882, "It is not the strongest of species that survive, nor the most intelligent, but the ones most responsive to change". In the natural evolutionary competition for survival there is nothing that guarantees that the human species will be the survivor in our ongoing war against pathogenic bacteria. There is still much that we don't know about the natural world of microbes and the biologically active small molecules that they produce, a small percentage of which have antibiotic properties. The average streptomycete, for example, has the genetic capacity to produce about 30 complex small molecules, and there are more than 500 species of streptomyces alone. After a flurry of discovery in the 1940's, 50's and early 60's antibiotic discovery tailed off rapidly. There are a number of reasons why large pharmaceutical companies have essentially stopped research and development on new antibiotics including:
Antibiotic resistance has always been present and the biochemical mechanisms involved are well understood. These mechanisms include target modification, by-pass, repair and amplification, decreased influx and increased efflux, enzymatic inactivation, sequestration, intracellular localization, and biofilm formation. Despite this knowledge however, resistance continues to be an increasing problem that has been exacerbated by the widespread use of antibiotics in agriculture. Recently, there has been a dramatic increase in research in this field, as measured by publications over the last two years, signaling an acknowledgment by the scientific research community that antibiotic resistance is becoming a serious health threat. Although Canada currently enjoys a lower rate of antibiotic resistance than the United States, this situation could soon change if we continue to ignore the warning signs and do not take better care of those effective antibiotics that we have. Possible solutions include:
There is no question that the discovery of antibiotics has had a major impact on public health and the control of infectious diseases caused by bacterial pathogens. Because antibiotics are easy to administer, act quickly and effectively, have limited side effects, are relatively inexpensive and can be assayed for activity, physicians have come to rely heavily upon them. It is incumbent on us to take the issue of antibiotic resistance seriously, act to mitigate its effects and provide clinicians with alternative approaches in the treatment of bacterial infections.
Participants were divided into four groups, each facilitated by a member of the steering committee. Groups were provided with the following questions to guide their discussions:
Following the break-out sessions, the whole group re-convened and each working group presented an overview of their alternative approaches followed by a more detailed account of their discussions for each topic. As each topic was presented, the entire group was invited to contribute information and suggestions. By the end of the session we had a summary of all the possible alternatives proposed by the participants. Working group presentations were summarized on flip charts in point form:
Immune Systems:
Immune modulation, Vaccines - therapeutic and preventive
Enhancement of innate immune response;
Anti-microbial peptides eg. defensins;
Antibody therapy
Microbial Ecology:
Prebiotics - food , eg. non-digestible carbohydrate ingested by organism, not host
Probiotics - live microorganisms, health benefit, bacterial interference, competitive agents
Alteration of bacterial flora, changes during disease
Bio-Prospecting:
Phage Therapy:
Novel Targets:
Physical Sciences:
Hyperbaric; Laser; Heat; UV
Bio-Materials:
Prevent infection; Positive impact; Positive capacity; Positive mechanistic
Rapid Diagnostics:
Following a brief summary of the points raised during the break-out sessions on Day 1, an open discussion was held with the whole group to further develop the ideas presented. The group referred to the following questions as a guide to discussion:
It was decided that although bacterial diseases such as tuberculosis have a huge global impact they are not currently a big problem in Canada. Given the limited availability of funds, participants were advised to focus on antibacterial resistance from the Canadian perspective initially with a view to partnership in the international arena at a later stage. It was agreed that, in Canada, we are often out of synchronization with the research we fund relative to the actual disease burden and that we need better methods to track disease and define disease burden. This kind of information would be important to engage the interest of the Public Health Agency of Canada and Industry Canada but falls outside the mandate of this workshop. It was also decided that rapid diagnostics, although an important area of research and one that underpins the success of many alternative therapies, was not the focus of this workshop. There are already several existing funding avenues for this kind of research eg. CIHR operating grants.
As one function of the immune system is to protect the host from infection, there was general agreement that modulation and enhancement of the host immune response would be a viable alternative to antibiotics either as an adjunct to controlled antibiotic use or in place of standard therapies. Participants were reminded that bacterial infections are not usually an acute life threatening event as in sepsis. More often, infections are chronic as in the case of wound infections, otitis and diarrhea and the window of opportunity for treatment can be several days or weeks, rather than hours. For example immunosuppressed cancer patients may respond over several days to growth factors given to stimulate neutrophil production and boost the immune response. To prevent post-surgical infections it might be possible to boost the immune response prior to surgery.
It was generally agreed that Canada has great strength in both immunology and microbiology but that the challenge is to get the two disciplines together. There were not many immunologists at the workshop although many were invited. The feeling was that they did not see the topic of the workshop as relevant to their area of research, but saw antibiotic resistance as being solely in the domain of the microbiologists. There is no shortage of potential interest and projects if the immunologists and microbiologists would work together.
Recommendations:
Proof of principle already exists in the vaccine area and there is already experience in therapeutic vaccines for cancer and more recently in dialysis and burn patients. There is even some evidence in early French literature for vaccines against S. aureus. More recently there has been research on an anti-toxin vaccine against C. difficile. There is also some evidence in mouse models for the efficacy of therapeutic vaccines and the discovery of new adjuvants may improve the effectiveness of experimental vaccines. However, there have been few studies relating specifically to vaccines against the handful of antibiotic resistant organisms.
Recommendations:
Although Canada has significant research strength in microbial ecology, including expertise in biofilms and microbial genetics, there is little collaboration between researchers working with pathogens and those working with non-pathogens. Also little is known about the composition of natural flora occurring in the gut or vagina. It is therefore difficult to asses the effects of probiotics on natural flora. To fully explore these interactions, high throughput methods will be required to investigate the entire response. Therefore a team approach involving microbial ecologists, immunologists, microbiologists and probiotics experts will be required. Currently most of the Canadian expertise in probiotics resides in the agriculture sector, although probiotics have been used recently in the treatment of C.difficile infections in humans. One problem is the lack of standardization of probiotic products and regulatory constraints in administering probiotics to humans. One area of current research, pioneered at the University of Texas, involves the study of eukaryotic cells capable of producing of antibiotics that modulate the normal flora. Although traditionally associated with modulation of gut flora, probiotics may also have a role in the modulation of immune responses in the vagina and topically in superficial wound sites.
Recommendation:
Antibiotics have been the biggest therapeutic success in history and continue to save millions of lives, but resistance has and always will be a problem with any new antibiotic. Discussion arose around the role of CIHR and other research funding agencies in the discovery and development of new small molecules with antibiotic activity. There are many failed leads in the archives of large pharmaceutical companies and the issue was raised as to whether it was a feasible role for academia to asses some of these undeveloped molecules. It was noted that the advice of the chemistry community would be needed to determine the value in pursuing this avenue of thought. It was suggested that a partnership between CIHR, NRC, NSERC and private industry would be most advantageous in exploring the diversity and efficacy of new small molecules from both existing libraries and new molecules discovered in the natural environment, eg. soil and oceans. It was noted that the NIH has made a large financial investment in the creation of chemical libraries.
Recommendations:
It was acknowledged that there is little academic research in Canada on phage therapy although there are at least three Canadian biotechnology companies working in his area. Phage therapy was largely abandoned as a treatment for bacterial infection following the discovery of modern day antibiotics except in certain strongholds in Russia and Poland where phage therapy is reported to still be an accepted form of treatment for many infections. Recently, interest has been renewed in this largely abandoned area of research and with the increasing rise in antibiotic resistance, phage therapy may present a real alternative. Participants agreed that the scientific base in Canada is extremely weak and that the first task would be to build capacity and form collaborations with scientists from other countries such as Russia, Poland and to a lesser extent, the US. It was also acknowledged that given the increasing interest in phages as potential alternatives to antibiotics and the lack of current research capacity in Canada, this could represent an area where the fastest gains might occur, particularly in proof of concept studies eg. clinical trials. Development of this research area could be helped by collaboration with the agriculture sector which already has several successful models of using phage to treat infection in animals. It was noted that one reason why phage therapy has not been adopted by private industry is the lack of potential for IP development. Discussion arose around the regulatory problems when using phage for human therapy especially if cocktails of many different phage are required. The point was made that viruses have already been approved for cancer treatment in certain circumstances so the regulatory hurdles could probably be overcome if the science was sound.
Recommmendations:
Participants felt that Canada already has strong expertise in the identification of new targets and that programs already exist for the adequate funding of research in this area, eg. through the CIHR operating grants competition and Proof of Principle program. What is really needed is a process to screen and develop potential new compounds with activity against specific novel targets, once identified. It is the translational piece that is missing.
Recommendation:
Physical science refers to changes and modifications in the physical environment that may act to reduce the risk of bacterial infection or directly inhibit the growth of bacterial pathogens. This area includes advances in biomaterials research that may further reduce the risk of infection and need for pre- and post-operative antibiotics. Much of the activity in this area resides in small biotechnology companies as a relatively untapped resource. Examples range from raising patient (or environmental) temperature during surgery to reduce the risk of infection (syphilis was first cured by giving the patient malaria which raised their body temperature sufficiently to kill the syphilis bacterium!), to using UV light for water or surface sterilization. There are many promising technologies that are currently making few inroads into Canada
The development of biomaterials with built-in antibacterial activity is a huge and growing area that involves a host of different materials for different functions such as antiseptics, heavy metals, surfactants, anti-infective cement for implants, and ultra smooth materials for stitches and catheters that resist biofilm formation and eventually dissolve. There is already some limited expertise in Canada, but this area of research represents a field that is ripe for development and offers enormous potential for rapid commercialization of successful products. The area would be highly suitable for a partnership between CIHR, the NRC and NSERC.
Recommendation:
It was decided that as there are funds available immediately to support new research in this area (approximately $1 million per year for 5 years from III, plus contributions from partners), it would be possible to launch a request for applications (RFA) in the next six months to a year. There was support for a general approach that would not eliminate good ideas. The three main areas of research that emerged from the discussions as being of high priority and ready to be further developed were:
It was felt that other areas such as probiotics and bio-prospecting would benefit from further discussion with experts and researchers from other disciplines. However, the group did not want to eliminate these areas from an RFA. It was suggested that the wording of the RFA should read, "areas of research including but not limited to immune modulation, phage therapy and physical sciences/biomaterials research". The RFA should list all the areas discussed during the workshop and should be linked to this workshop report.
It was agreed that the RFA should offer a variety of research funding tools, eg, short term programs such as Pilot Projects and Proof of Principle grants and longer term programs such as Team Grants and Randomized Control Trials (RCTs). The suggestion was also made that III could post a priority announcement in this area that applied to several of CIHR's open competitions eg. Operating Grants and RCTs
There was strong support for a Letter of Intent (LOI) process on all grant applications, to ensure an acceptable success rate at the full application stage. It was recommended that in order to attract innovative and imaginative applications, applicants should be encouraged to state clearly in the LOI, how their research is novel and what the expected milestones are in both the short and long term. Applicants should also address the issue of knowledge translation and clearly state the expected outcomes of their research and how these outcomes will be moved into practice. Partnership will be strongly encouraged both between researchers with complementary expertise and between researchers and the private sector.
Participants were asked to complete a two-page workshop evaluation form before leaving the meeting. The results are given in Appendix 4.
The meeting was adjourned at noon and was followed by a two-hour meeting of the partner organizations to discuss opportunities for collaboration in the development of a Canadian research agenda on novel alternatives to antibiotics.
| Yossef AV-GAY University of British Columbia Division of Infectious Diseases Room 440D HP East, 2733 Heather Street Vancouver, BC V5Z 3J5 Tel: (604) 875-4329 Fax: (604) 875-4013 Email: yossi@interchange.ubc.ca |
Erik BLACHE - Steering Committee Member Canadian Institutes of Health Research Institute of Infection and Immunity 160 Elgin Street, Room 97 Ottawa, ON K1A 0W9 Tel: (613) 941-4329 Fax: (613) 954-1800 Email: eblache@cihr-irsc.gc.ca |
| Chris BLEACKLEY - Steering Committee Member University of Alberta Department of Biochemistry 474 Medical Sciences Building Edmonton, Alberta T6G 2H7 Tel: (780) 492-3968 Fax: (780) 492-0886 Email: chris.bleackley@ualberta.ca |
Edith BLONDEL-HILL BC Children's Hospital Department of Pathology and Laboratory Medicine Room 2G5, 4500 Oak Street Vancouver, BC V6H 3N1 Tel: (604) 875-2345 ext. 7649 Fax: (604) 875-3777 Email: ebhill@cw.bc.ca |
| Judith BRAY - Steering Committee Member Canadian Institutes of Health Research Institute of Infection and Immunity 160 Elgin Street, Room 97 Ottawa, ON K1A 0W9 Tel: (613) 954-7223 Fax: (613) 954-1800 Email: jbray@cihr-irsc.gc.ca |
Eric BROWN McMaster University Dept. of Biochemistry and Biomedical Sciences 1200 Main Street West Hamilton, ON L8N 3Z5 Tel: (905) 525-9140 ext. 22392 Fax: (905) 522-9033 Email: ebrown@mcmaster.ca |
| Robert C. BRUNHAM - Steering Committee Member University of British Columbia Centre for Disease Control 655 West 12th Avenue Vancouver, BC V5Z 4R4 Tel: (604) 660-2626 Fax: (604) 660-6066 Email: robert.brunham@bccdc.ca |
John CONLY University of Calgary Centre for Antimicrobial Resistance 930, 9th floor, North Tower, 1403-29th Street NW Calgary, Alberta T2N 2T9 Tel: (403) 944-8222 Fax: (403) 944-1095 Email: jconly@ucalgary.ca |
| André DASCAL (FRSQ) - Partner Dept. of Microbiology and Infectious Disease SMBD-Jewish General Hospital 3755 Cote Ste-Catherine Rd., Rm. G-140 Montreal, Quebec H3Z 2E9 Tel: (514) 340-8294 Fax: (514) 340-7578 Email: andre.dascal@mcgill.ca |
Julian DAVIES University of British Columbia Department of Microbiology and Immunology 300 - 6174 University Blvd. Vancouver, BC V6T 1Z3 Tel: (604) 822-5856 Fax: (604) 822-6041 Email: julian.davies@ubc.ca |
| Amanda DEVOST - Steering Committee Member Canadian Institutes of Health Research Institute of Infection and Immunity 160 Elgin Street, Room 97 Ottawa, ON K1A 0W9 Tel: (613) 941-0997 Fax: (613) 954-1800 Email: adevost@cihr-irsc.gc.ca |
Brett FINLAY - Steering Committee Member University of British Columbia Biotechnology Laboratory 237-6174 University Boulevard Vancouver, BC V6T 1Z3 Tel: (604) 822-2210 Fax: (604) 822-9830 Email: bfinlay@interchange.ubc.ca |
| Joseph GEBRAN (CPSI) - Partner Canadian Patient Safety Institute Corporate Services 10235 - 101 Street, Suite 1414 Edmonton, Alberta T5J 3G1 Tel: (780) 409-8090 Fax: (780) 409-8098 Email: jgebran@cpsi-icsp.ca |
Scott GRAY-OWEN University of Toronto Department of Medical Genetics and Microbiology Room 4381, Medical Sciences Building 1 King's College Circle Toronto, ON M5S 1A8 Tel: (416) 946-5307 Fax: (416) 978-6885 Email: scott.gray.owen@utoronto.ca |
| Phil HIETER University of British Columbia Biotechnology Laboratory 237 Wesbrook Bldg., 6174 University Blvd. Vancouver, British Columbia V6T 1Z3 Tel: (604) 822-5115 Fax: (604) 822-2114 Email: hieter@cmmt.ubc.ca |
Kevin KAIN Toronto General Hospital McLaughlin Center for Molecular Medicine 200 Elizabeth Street Eaton South 9-412 Toronto, ON M5G 2C4 Tel: (416) 340-3535 Fax: (416) 595-5826 Email: kevin.kain@uhn.on.ca |
| Mohammed KARMALI (PHAC) - Partner Public Health Agency of Canada Laboratory for Foodborne Zoonoses 110 Stone Road West Guelph, Ontario N1G 3W4 Tel: (519) 822-3300 ext. 235 Fax: (519) 822-2280 Email: mohamed_karmali@phac-aspc.gc.ca |
Andrew KROPINSKI Queen's University Department of Microbiology Botterell Hall, Room 741 Kingston, Ontario K7L 3N6 Tel: (613) 533-6796 Fax: (613) 533-2459 Email: kropinsk@post.queensu.ca |
| Paul KUBES University of Calgary Department of Physiology & Biophysics 3330 Hospital Drive NW Calgary, Alberta T2N 4N1 Tel: (403) 220-8558 Fax: (403) 270-7516 Email: pkubes@ucalgary.ca |
Mark LOEB (AMMI) - Partner McMaster University Department of Pathology and Molecular Medicine 1200 Main St. W., MDCL 3200 Hamilton, Ontario, L8N 3Z5 Tel: (905) 525-9140 ext. 26066 Fax: (905) 389-5822 Email: loebm@mcmaster.ca |
| Marie LOUIE University of Calgary Provincial Laboratory for Public Health 3030 Hospital Drive Calgary, Alberta T2N 4W4 Tel: (403) 944-2493 Fax: (403) 944-3491 Email: m.louie@provlab.ab.ca |
Roger MACKENZIE National Research Council Institute for Biological Sciences 100 Sussex Drive Ottawa, ON K1A 0R6 Tel: (613) 990-0833 Fax: (613) 952-9092 Email: roger.mackenzie@nrc-cnrc.gc.ca |
| Jacques MAGNAN (AHFMR) - Partner Alberta Heritage Foundation for Medical Research Programs Suite 1500, 10104 - 103 Avenue Edmonton, AB T5J 4A7 Tel: (780) 423-5727 Fax: (780) 429-3509 Email: jacques.magnan@ahfmr.ab.ca |
François MALOUIN Université de Sherbrooke Faculte des sciences, Dept. de biologie 2500 boul. université Sherbrooke, Quebec J1K 2R1 Tel: (819) 821-8000 ext. 1202 Fax: (819) 821-8049 Email: francois.malouin@usherbrooke.ca |
| W. Robert MCMASTER University of British Columbia Jack Bell Research Centre 2660 Oak Street Vancouver, British Columbia V6H 3Z6 Tel: (604) 875-3488 Fax: (604) 875-5606 Email: robm@interchange.ubc.ca |
Mary MCNAUGHTON (CHICA) - Partner Providence Health Care 1190 Hornby Street Vancouver, BC V6Z 2K5 Tel: (604) 806-8187 Fax: (604) 806-8661 Email: mmcnaughton@providencehealth.bc.ca |
| Mark MILLER Sir Mortimer B. Davis Jewish General Hospital Department of Microbiology Suite G-139, 3755 Côte Ste-Catherine Road Montreal, Quebec H3T 1E2 Tel: (514) 340-8294 Fax: (514) 340-7546 Email: mmiller@lab.jgh.mcgill.ca |
Mike MULVEY Public Health Agency of Canada National Microbiology Laboratory 1015 Arlington Street Winnipeg, Manitoba R3E 3R2 Tel: (204) 789-2133 Fax: (204) 789-5020 Email: Michael_mulvey@phac-aspc.gc.ca |
| Lindsay NICOLLE University of Manitoba Health Sciences Centre Room GG443, 820 Sherbrook Street Winnipeg, Manitoba R3A 1R9 Tel: (204) 787-7030 Fax: (204) 787-4826 Email: lnicolle@exchange.hsc.mb.ca |
Marc OUELLETTE - Steering Committee Member Centre de recherche en infectiologie CHUQ-pavillon CHUL 2705 boul. Laurier Québec, QC G1V 4G2 Tel: (418) 654-2705 Fax: (418) 654-2715 Email: marc.ouellette@crchul.ulaval.ca |
| Diane TAYLOR University of Alberta Dept. of Medical Microbiology & Immunology 1-28 Medical Sciences Building, 112th Street Edmonton, Alberta T6G 2H7 Tel: (780) 492-4777 Fax: (780) 492-7521 Email: diane.taylor@ualberta.ca |
David PATRICK B.C. Centre for Disease Control 655 West 12th Avenue, Room 2104 Vancouver, British Columbia V5Z 4R4 Tel: (604) 660-3199 Fax: (604) 660-0197 Email: david.patrick@bccdc.ca |
| Jean-Pierre PERREAULT Université de Sherbrooke Département de biochimie 3001, 12e avenue nord - Pièce 5440 Sherbrooke, Quebec J1H 5N4 Tel: (819) 564-5310 Fax: (819) 564-5340 Email: jean-pierre.perreault@usherbrooke.ca |
Andy POTTER Vaccine and Infectious Disease Organization University of Saskatchewan 120 Veterinary Road Saskatoon, Saskatchewan S7N 5E3 Tel: (306) 966-7484 Fax: (306) 966-7478 Email: potter@sask.usask.ca |
| Babak POURBOHLOUL B.C. Centre for Disease Control 655 West 12th Avenue Vancouver, British Columbia V5Z 4R4 Tel: (604) 660-2000 Fax: (604) 660-6066 Email: babak.pourbohloul@bccdc.ca |
Martine RAYMOND Institut de recherche cliniques de Montréal Lab. de biologie moléculaire des levures 110, Avenue des Pins Ouest Montreal, Quebec H2W 1R7 Tel: (514) 987-5770 Fax: (514) 987-5764 Email: martine.raymond@ircm.qc.ca |
| Gregor REID Lawson Research Institute 268 Grosvenor Street London, Ontario N6A 4V2 Tel: (519) 824-4120 ext. 52689 Fax: (519) 646-6031 Email: gregor@uwo.ca |
Jim RICHARDS (NRC) - Partner National Research Council Institute for Biological Sciences 100 Sussex Drive Ottawa, Ontario K1A 0R6 Tel: (613) 990-0854 Fax: (613) 941-1327 Email: jim.richards@nrc-cnrc.gc.ca |
| Paul H. ROY Centre de recherche en infectiologie CHUQ, Pavillon CHUL, Suite RC-709 2705, boulevard Laurier Sainte-Foy, Quebec G1V 4G2 Tel: (418) 654-2705 Fax: (418) 654-2715 Email: paul.roy@crchul.ulaval.ca |
Raphaël SAGINUR (CFID) - Partner Ottawa Hospital - Civic Campus CPC 470, 1053 Carling Avenue Ottawa, Ontario K1Y 4E9 Tel: (613) 761-5555 ext. 14155 Fax: (613) 761-5340 Email: rsaginur@ottawahospital.on.ca |
| Bhagirath SINGH (CIHR) - Partner CIHR - Institute of Infection and Immunity Siebens-Drake Research Institute Suite 214, 1400 Western Road The University of Western Ontario London ON N6G 2V4 Tel: (519) 661-3228 Fax: (519) 661-4226 Email: bsingh@uwo.ca |
Curtis SUTTLE University of British Columbia Earth & Oc/Botany/Microbiology Science 6270 University Boulevard, Lab Room 1321 Vancouver, BC V6T 1Z3 Tel: (604) 822-9652 Fax: (604) 822-2273 Email: csuttle@eos.ubc.ca |
| Rick WALTER (CCAR) - Partner Canadian Committee on Antibiotic Resistance 3806 West 33rd Avenue Vancouver, BC V6N 2H6 Tel: (604) 263-4520 Fax: (604) 263-7074 Email: ccar@shaw.ca |
Chris WHITFIELD University of Guelph Department of Molecular and Cellular Biology Room 211, 50 Stone Road East Guelph, Ontario N1G 2W1 Tel: (519) 824-4120 ext. 3478 Fax: (519) 837-1802 Email: cwhitfie@uoguelph.ca |
| George ZHANEL University of Manitoba Health Sciences Centre 820 Sherbrook Street, MS-673 Microbiology Winnipeg, Manitoba R3A 1R9 Tel: (204) 787-4902 Fax: (204) 787-4699 Email: ggzhanel@pcs.mb.ca |
| Time | Item | Location |
| 07:45 | Bus departs from hotel | Westin Bayshore front lobby |
| 08:30 | Registration / Breakfast | Michael Smith Laboritories Room 101 |
| 09:00 | Welcoming remarks on behalf of CIHR - III - B. Singh | Michael Smith Laboritories Lecture Theatre (MSL 102) |
| 09:10 | "Partnerships" - J. Bray | Michael Smith Laboritories Lecture Theatre (MSL 102) |
| 09:25 | "Why we are all here?" - B. Finlay | Michael Smith Laboritories Lecture Theatre (MSL 102) |
| 09:45 | "Where are all the Antibiotics When You Really Need Them?: - J. Davies | Michael Smith Laboritories Lecture Theatre (MSL 102) |
| 10:30 | Health Break | MSL 101 |
| 10:45 | "Changing the Rules - Eccentric Approaches to the Problem of Antimicrobial Resistance" - CANCELLED - J. Hutchinson | Michael Smith Laboritories Lecture Theatre (MSL 102) |
| 11:45 | An overview of possibilities / logistics and expectations of the breakout sessions - B. Finlay / J. Bray | Michael Smith Laboritories Lecture Theatre (MSL 102) |
| 12:00 | Lunch | MSL 101 |
| 13:00 |
Breakout session:
|
Group A - MSL 201 |
| 14:30 | Health Break | MSL 101 |
| 15:00 | Group re-convenes Group Presentations (15 min. each) Discussion |
Michael Smith Laboritories Lecture Theatre (MSL 102) |
| 16:30 | Bus departs for hotel | Lobby |
| 18:30 | Dinner |
Shabusen Yakiniku House |
| Time | Item | Location |
| 8:00 | Breakfast | Oak Room |
| 8:30 | Summary of Day 1 - J. Bray / B. Finlay | Oak Room |
| 8:45 | Open discussion (whole group):
|
Oak Room |
| 10:00 | Health Break | Oak Room |
| 10:30 |
Discussion (continued) |
Oak Room |
| noon | Meeting ends - hotel check-out | - |
| 12:30 to 14:00 | Partners' meeting "How can we best work together to implement the workshop recommendations?" |
Fir Room |
Dr. Julian Davies
Department of Microbiology and Immunology
University of British Columbia
Dr. Julian Davies is Emeritus Professor of Microbiology and Immunology and Executive Vice President, Technology Development of Cubist Pharmaceuticals, Inc. Trained as an organic chemist, he switched to molecular microbiology in 1962 when he joined Harvard Medical School. Subsequently, he held academic positions at the University of Wisconsin, University of Geneva, and Institut Pasteur before joining the University of British Columbia as Head of Microbiology and Immunology in 1992. Davies was Research Director and President of of Biogen (Geneva) from 1980-1985 and founded TerraGen Discovery Inc (Vancouver) in 1996. He is a Fellow of the Royal Society (London) and the Royal Society of Canada. He is past President of the American Society for Microbiology. Dr. Davies' interests concern
various aspects of microbial ecology. In particular, he has studied the origins and mechanisms of antibiotic resistance in bacteria, with special reference to gene capture and horizontal gene transfer. He is also studying the degradation pathways of xenobiotics and lignin-derived products by streptomycetes. The focus of work at Cubist Pharmaceuticals, Inc. (formerly TerraGen Discovery Inc.) is the study of microbes in the environment with special reference to the predominant non-cultivable species. Molecular techniques are being used to isolate genes for antibiotic biosynthetic pathways to study their expression in surrogate hosts with the goal of isolating novel secondary metabolites for pharmaceutical application.
Prior to leaving on Day 2, participants were asked to fill in a two-page workshop evaluation form. More than 90% of Day 2 participants returned their forms for a total of 32 completed evaluations.
Fig. 1 Results of Workshop Evaluation: Program
Overall, participants were satisfied or highly satisfied with all aspects of the workshop (see Fig. 1):
One identified area of weakness was the background information provided to participants prior to the workshop, as many felt that it would have been helpful to have received information on some of the potential alternatives to antibiotics such as probiotics and bacteriophages. However, the steering committee made a conscious decision not to provide this information to avoid influencing the direction of the discussions by pre-identifying specific alternatives. It was anticipated that workshop participants holding expertise in a specific area would share this expertise during group discussions, which did in fact seem to be the case in most instances.
