Objectives of the course

The objectives are to give the students a thorough understanding of antimicrobials and antimicrobial resistance, the significance of AMR in a one-health perspective, surveillance programs, and to give a practical training of measurement of AMR.

Learning outcomes and competences

After the course, the student will 

• Know what antimicrobials are, including classes, mechanisms of action, and spectrum
• Understand what antimicrobial resistance (AMR) is, including the genetic background for various types of AMR: resistance genes, mobile genetic elements and mutations
• Be aware of the societal impact of AMR and consequences in terms of animal health and one-health
• Understand the rationale for treatment guidelines
• Have overview over surveillance programmes and action plans, nationally and internationally (EFSA, ECDC, FAO, GLASS)
• Have an understanding of important legal aspects, such as the “yellow card” limits for use of antibiotics for animals
• Have hands-on experience in measurement of AMR, i.e., perform susceptibility tests: – MIC determination, disc diffusion, E-test
• Have an understanding of how to interpret test results: when is a bacterium resistant, understand the terms epidemiological cut-off values and clinical breakpoints
• Have knowledge of sequencing and bioinformatics tools to search for resistance genes and mutations and predict AMR

Compulsory programme

Active participation in both theoretical part and the practical exercises is anticipated and necessary for getting credit for participation.

Content

The course includes a mixture of lectures, laboratory exercises and theoretical exercises. In the lectures, we will cover the topics specified in the learning outcomes above

 

• A thorough description of different antibiotics and classes of antibiotics, and how they work
• A description of antimicrobial resistance (AMR), and how AMR is encoded on the chromosome or on plasmids
• We will go through the consequences of AMR when it comes to treatment of infections in both animals and humans
• We will explain how the best treatment of animals and humans is secured from knowledge of pharmacokinetics and pharmacodynamics
• We will explain the surveillance of AMR in humans, animals and food through the various surveillance programmes, EARS, EARS-Vet and others
• We will go through legislation – national and international - and action plans for limitation of antimicrobial use
• The course participants will perform susceptibility test from beginning to end using both the disc diffusion test and determination of minimum inhibitory concentration (MIC)
• We will explain how knowledge of inhibition zone diameters and MIC values is interpreted into prediction of clinical success of treatment
• This is achieved through explanation of the terms epidemiological cut-off values and clinical breakpoints
• Finally, we will explain how whole genome sequencing can be used to obtain knowledge of presence of antimicrobial resistance genes and mutations, and how bioinformatics can predict AMR

Prerequisites

The course is intended for PhD students and other researchers working on projects in microbiology and/or antimicrobial resistance. Knowledge of microbiology is therefore required.