Announcer

And now, from the University of Colorado in Boulder, the College of Engineering and Applied Science presents: On CUE.

Jonathan Raab

While the COVID-19 pandemic continues to be an international crisis, medical professionals and researchers are searching for ways to slow and ultimately stop the spread of this deadly virus. Prior to this pandemic, however, researchers at CU Boulder had been sounding the alarm on another potential threat, bacterial infections that are immune to current antibiotic treatments. Because bacteria change and evolve at an incredible pace, developing new effective treatments is a challenge. Anti-Microbial resistance or AMR is the ability of bacteria to resist antibiotic treatments. Bacteria develop AMR through repeated exposure to antimicrobials, which eliminate most but not all bacteria. The bacteria that survive replicate, thus creating new, more powerful strains. Antimicrobials are in widespread worldwide use, from hand sanitizer in your home to hospitals to industrial agriculture. Overuse of these treatments mean that we are rapidly reaching a point where bacterial infections may become untreatable. CU Boulder is ground zero for a new global movement to curb this existential threat. Born out of the labs of assistant professors Anushree Chatterjee and Prashant Nagpal and ARC Laboratories, the Anti-Microbial Resistance Mediation Outreach Program, or ARMOR, is a graduate student led international effort to develop public awareness of and research into new treatments to tackle a or bacteria. Professor Nagpal gave us some background on this research.

Prashant Nagpal

Right. So we've been hearing about antimicrobial resistance for a long time. In fact, even when I was a undergrad, you know, you could see all these articles about superbugs, how we do need to fill in this big gap of antibiotic innovation. Since 1970s, there's been no new class of antibiotics for negative pathogens, which ultimately has resulted now in sort of a perfect storm of superbugs. They're becoming smarter. We are so losing ground. And this is such a key technology, antibiotics, that it forms a bedrock of modern medicine. Any time we have a small cut while shaving, we wash hands, we have any surgery – all of it relies on the fact that anytime our last line of defense, the skin gets exposed, we rely on antibiotics. Otherwise there used to be a severe number of mortalities during surgeries. And so all of our modern medicine kind of relies on it. And so we are losing ground there. Now we are slowly entering post-antibiotic era, which would be a very frightening scenario. But more importantly, we decided that what's really required is this acceleration of taking pains from a bedside to a bedside, which is why last year in 2018 we formally kicked off the anti-microbial regeneration consortium, or ARC, because it's not a local problem, it's a global problem.

Raab

We then sat down with professor Chatterjee and our students to learn more about this innovative program.

Raab

What threat does anti-microbial resistant bacteria pose to us now and in the future? What's the scale of this threat?

Anushree Chatterjee

So anti-microbial resistance poses a major threat right now and it's only escalating into the future. Just to give you a perspective, you know, by 2050 it is projected that there'll be more than 10 million deaths caused due to drug resistant infections. And, you know, it's going to exceed cancer. And the problem is that we are not creating enough solutions right now to be able to, you know, not just catch up, but also solve the challenges that we're facing today in the hospitals. So it's a major issue. In fact, the United Nations released a report at the end of April, saying that if we don't take an urgent step right now within one generation, the effect will be catastrophic. So that just sums it up.

Raab

So what is ARMOR's mission and how did it initially form?

Chatterjee

So armor, which stands for anti-microbial resistance, mediation, outreach. So this is an outreach program. And it actually came alive under the Antimicrobial Regeneration Consortium initiative that was funded by myself and Prashant Nagpal. And that's an initiative which brings in labs across the globe to come together to bring in technologies and expertise so that we can accelerate development of antimicrobials and diagnostics. Even though ARC was focused on research, we thought that outreach was extremely important. So ARMOR is an effort to start a conversation between researchers and the medical community and the general community and take steps so that we can minimize an EMR.

Raab

How do students lead the armor efforts?

Chatterjee

The students are an extremely important component of ARMOR. It's actually totally a student led effort and I strongly believe that the younger generation needs to take charge of this problem. The younger generation needs to demand that it's not OK, that we don't have antibiotics, it's not OK that we have crops of superbugs. It's not OK that pharma is moving out of this. And I think the younger generation must demand that this problem be solved right now. So I really want to give this power to them to spread awareness across, you know, communities, across different states and hopefully across the globe, because, you know, when young minds come together to solve something, they can make leaps and bounds in very short periods of time. And, you know, already the students who are part of this effort, you know, I applaud their spirit. They've done so much with such, you know, so little resources. I admire it. And I am very confident that they'll do great things in the future.

Raab

Indeed, ARMOR as a student led program. They spoke to us about how they are building awareness of and encouraging action to mitigate the threat of AMR bacterial.

Colleen McCollum

Yeah. My name's Colleen McCollum. I'm a graduate student in the Chatterjee lab. I'm a first year PhD student and in terms of ARMOR, I am one of the founding members. I was one of the people who kind of got the CU chapter of this going through the CU organization groups. AMR is one of those things that it is a global problem. It is something that can affect anyone and does affect kind of everyone. It's this huge issue that we can't ignore anymore. And it's something that industry and academia aren't really spending enough time on right now, especially in the industry sphere. A lot of people are kind of leaving the area of antibiotics because it's not very profitable, it's not very efficient. And it's kind of at this point out to academia to step up and try to fill in those blanks there to make sure that this is a problem they get solved.

Dana Stamo

So my name is Dana Stamo, I'm a first year PhD student studying biological engineering with Dr. Chatterjee. However, I have been working very closely with Dr. Chatterjee for the past year on many issues, focusing on how to resolve antimicrobial resistance in the world. So I always knew from a very young age I really wanted to go into medicine. And then as I was getting my degree here, I was learning about the pharmaceutical industry, getting progressively disenchanted with the field because of how they take advantage of a very vulnerable consumer population. And then I met Anushree and I saw how much passion she had for genuinely helping people and not just trying to make a profit off of a disease. And that inspired me so much and really pulled me into this this global crisis that no one has ever talked about. And yeah, it's as big as climate change, but people don't really know about it. Health is a shared resource. So a disease and one part of the world is a plane ride away from everywhere else. And that's terrifying. And it's really important to address. You know, I actually think that we stumbled upon this statistic suggesting that if antibiotic resistance goes unaddressed, it's going to kill more people than cancer does by 2050, which is terrifying and really soon. And despite that, it doesn't seem like anybody knows about AMR, but everybody knows about cancer. And so we started paying more attention. There's so many campaigns to bring awareness to cancer, to pull funding into cancer. And the really isn't it really isn't happening for AMR research or for AMR awareness in general. You still see people who don't finish their prescriptions. You still see meat in the supermarket that's treated with antibiotics. And all of that culminates into a culture that is irresponsible with their use of antimicrobials. And that's only going to further perpetuate the situation. Simultaneously, pharmaceutical companies don't want to keep investing in it because it's expensive and you will use that treatment for a couple weeks. They would rather invest in lifelong diseases that they're going to keep getting money from. Again, part of the reason why I was disenchanted with this field. But all that being said, we knew that our part in this as members of our community, we just need to bring awareness to it in a way that's more intense than has previously previously been done before. It's not just talking to your friends. It's going to the farmer's market and interacting with the people who are growing their own crops, learning about their perspectives on things. Drawing attention to people who do suffer from AMR  infections. All of these things are really important for raising that awareness. And so we knew that ARMOR was a really good way to sort of streamline that process.

Kristen Eller

My name is Kristen Eller and I'm a fourth year PhD student in the chemical engineering department and I'm currently working on utilizing some of our novel strategies for new antibiotics to treat specifically intracellular infections. So I was naive and had no idea actually really about the big issue that was antimicrobial resistance when I first joined the department and was looking into the various research opportunities. But when I spoke to Dr. Chatterjee, I quickly realized how prevalent this issue is. And once I understood what was going on, it was easy to see that small things that actually were happening day to day. And throughout the last four years, I've noticed many friends, family members who, for example, had infections and had to do various different antibiotics, not realizing them themselves, not realizing. And I probably would in the past have realized what that meant. And that meant that those treatments weren't working because the bugs were adapting and we weren't. I feel as if I'm starting armor. We really discuss a lot of different initiatives and programs that we wanted to put into place and in actually more than a few we already found that CU had taken that step, for example, which was fantastic. It really showed us one that, you know, CU and Boulder itself, the community really is probably an area that is already thinking at least probably a little bit farther ahead than a lot of other places in the world. And that's fantastic and really shows that this is a great place to start. It also means that some of these programs that we are working to start, for example, partnering with local farmers, looking to see if they use antibiotics. We also looked into seeing if, for example, the hand soaps that are used in all university buildings, if they have any kind of antimicrobials in them and they don't. And as well, we looked into the food that's provided at the dining hall, and I think almost all of them don't have done it.

Stamo

None of them, they don't use antibiotics at all in any of the food in the dining halls. And they brag about it. They have signs that say it. So they're aware of this issue and they're pointing it out, which is great.

Eller

No and it's fantastic for us at first we were like well, thats what we wanted to do. But it was great. It means that they care. And it also means that it provides this framework that we can go to them, say, how did you get this started? We want to be able to provide this framework for all other potential armor institutions or areas that may be thinking of putting these kind of things into place, but don't know how.

Jocelyn Campos

My name is Jocelyn Campos and I recently graduated with my Masters in Biochemistry, but I've had a very close relationship with doctor Chatterjee in the past couple of years, and I am now a staff scientist in her lab currently and I am tackling many of these similar problems dealing with antimicrobial resistance. It started out kind of as a very open conversation with doctor Chatterjee about what actions we need to do beyond lab, beyond research. And it kind of started out with, well, we have all these, you know, potential students who were interested. Why not read a chapter here in our own community, right? And, you know, it started as an open dialog. But then, you know, it started into wanting to become like an action, you know, moving forward with it. And that's kind of where I started helping Colleen or other fellow colleagues to get it going. This involvement with pre-med students, I think is going to help really tremendously for our future students because they are going to be the future clinicians that in the future, you know, physicians and to get that information down now and then moving forward with their own studies, I think is vital. And then secondly, I think I see ARMOR in a lot of other different institutions and kind of embedded in community hospitals. Hopefully, you know, we already have, you know, involvement with, at least an initiation with University of Denmark or Institution in Denmark and in India. Why not start more institutions here in the U.S. and across the board? So that's where I see it and I think naturally it'll be incorporated in a lot of many other schools and hospitals across the nation.

Announcer

ARMOR meets weekly currently over Zoom. You can email us at armor@colorado.edu that's armor@colorado.edu for the Zoom link and more information. We are on BuffConnect as well. Also, follow us on Instagram and Twitter using the handle @CU_ARMOR and like us on Facebook by searching for Global ARMOR.

This has been On CUE for more information, visit Colorado.edu/engineering.

Reporting and editing by Jonathan Raab, additional production support by Matthew Goodman.