Page 73 - SAMRC Annual Report 2023-24

PERFORMANCE INFORMATION

Centre for The Study of
Antimicrobial Resistance

Research Unit

Unit director:
Prof. Keertan Dheda

Prioritising responsive research the lower respiratory tract which correlated with
through impactful interventions exaggerated and dysfunctional immune responses
and accelerated death. This work improved our
The Centre for the Study of Antimicrobial Resistance understanding of COVID-19 immunopathogenesis
(CAMRA) collaborates with South African and and informs future treatment strategies. An editorial
international scientists and clinicians to conduct was written on this publication in the same journal.
research into TB and non-TB MDR pathogens. This We also published work highlighting potential
includes: (1) studies to investigate the relationship sources of MDR pathogens in hospital settings
between pharmacokinetic (PK) mismatch and and subsequent strategies to minimise nosocomial
drug resistance development, and subsequent spread (Dheda et al. Infec Drug Resist: 2023).
strategies to improve diagnostic readouts to detect
mismatch and newer approaches to drug delivery Equitable capacity development
including inhaled formulations of existing drugs (2) for empowering communities
to investigate treatment outcomes and transmission
dynamics of patients with drug-resistant TB, including We have developed a new sequencing facility
those receiving new and repurposed drugs such as (using funds from CAMRA and UCT) which includes
bedaquiline and linezolid (3) To investigate the organ- a new iSEQ 100 and ONT MinION sequencer and
specific viral kinetics and bioaerosol transmission a Tapestation 4150. This will be used to facilitate
dynamics of patients infected by COVID-19. These several of our CAMRA sequencing studies including
research activities aim to provide important insights (i) the T3 RCT to determine the impact of targeted
into mechanisms of drug resistance evolution (and sequencing for guiding individualised treatment
SARS-CoV2 immunopathogenesis and transmission) in patients with drug-resistant TB, (ii) the PAKMAN
and subsequently lead to better diagnostic and study which seeks to improve sputum-based
diagnostics for MDR-TB using targeted-sequencing
treatment strategies, transmission interruption approaches Several staff, including two females, are
strategies and to understand the epidemiology of being trained in sequencing techniques.
patients who fail treatment, especially those on new
and repurposed drugs. We also have several SAMRC-funded clinicians who
are undertaking PhDs in the field of drug resistance.
During the reporting period, we have made several Dr Suzette Oelofse is performing a prospective study
notable achievements. Firstly, we published on SARS- to determine treatment outcomes and transmission
CoV2 transmission in cough aerosols (Jaumdully et dynamics of MDR patients. Dr Alex Scott is looking
al, Nature Comm 2024; IF=16) showing the presence at the utility of CAD CXR in identifying undiagnosed
of culturable SARS-CoV2 in cough aerosols and TB cases in the community. Dr Ali Esmail recently
emphasising the need for public health strategies to submitted his PhD on novel sputum and non-
interrupt transmission. We also published on SARS- sputum-based diagnostics for TB. We also have a
CoV2 organ-specific viral kinetics (Tomasicchio et al. prospective black African MSc student joining the
Amer Jour Resp Crit Care 2024; IF=24). This work unit to examine immune responses in the lungs of
showed the presence of culturable SARS CoV2 in drug-resistant TB patients.

SAMRC ANNUAL REPOR T 2023-24 71