Page 86 - SAMRC AnnualReport 2025-26

Centre for the Study of
Antimicrobial Resistance
Research Unit

UNIT DIRECTOR:
Prof. Keertan Dheda
Keertan.dheda@uct.ac.za

Overview of the Research Unit antimicrobial therapies for TB and other difficult-to-
treat respiratory infections. By integrating discovery
Antimicrobial resistance (AMR) is one of the greatest
global public health threats, with multidrug-resistant science with translational and clinical research,
(MDR) pathogens increasingly causing untreatable CAMRA aims to deliver new approaches for
infections in hospitals and communities. Key MDR diagnosing, treating, and preventing antimicrobial-
organisms include Acinetobacter, Klebsiella and resistant infections.
Pseudomonas species, while the emergence and
spread of drug-resistant tuberculosis (DR-TB) Key Milestones and Achievements
remains a major challenge in South Africa, where Major CAMRA research in the 2025/2026 year
TB is a leading cause of death. The World Health includes:
Organization has identified AMR as a critical threat
to progress in controlling communicable diseases, Improving DR-TB treatment strategies: The UFO
and global economic losses attributable to AMR are project retrospectively analyses and prospectively
projected to approach US$100 trillion by 2050. monitors treatment outcomes and transmission
dynamics in patients receiving bedaquiline-
To address this challenge, the Centre for the Study of and linezolid-containing regimens. Findings
Antimicrobial Resistance (CAMRA) was established in demonstrating the impact of linezolid interruption
2018 as a multidisciplinary research unit, comprising and re-challenge on treatment outcomes were
multiple national and international collaborators, published in Lancet Global Health (Oelofse et al.,
focused on understanding, detecting, and 2026), presented at the 2025 Union Conference
combating antimicrobial resistance across bacterial on Lung Health and the 2026 South African TB
pathogens. CAMRA integrates expertise spanning Conference. The work also informed the South
microbiology, immunology, clinical medicine, African Department of Health National Essential
pharmacology, genomics, bioinformatics and Medicines List Committee report. As linezolid is
translational science to accelerate the development a key but highly toxic drug in DR-TB treatment
of innovative diagnostics and therapeutic strategies. regimens, these findings will help optimise its use
by maximising efficacy while minimising toxicity.
The Unit's research spans three major areas: (i) Additional analyses evaluating the effectiveness of
understanding mechanisms of pathogenesis and the BPaL-M regimen and the long-term outcomes of
resistance amplification at the site of disease, bedaquiline-based therapy are ongoing.
including pharmacokinetic mismatch; (ii) developing
highly sensitive molecular approaches, including Developing innovative approaches to diagnose
targeted deep sequencing, to rapidly detect drug- and monitor drug resistance. CAMRA continued
resistance and micro-hetero-resistant bacterial studies investigating the pharmacokinetic
populations in clinical samples that are missed by mismatch, in which inadequate drug penetration
conventional diagnostics; and (iii) developing and into diseased lung tissue drives resistance despite
evaluating interventions to reduce AMR, including adequate plasma concentrations. Methodology
facility-based interventions and novel inhaled for measuring antimicrobial concentrations in lung

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