Managed to attend more talks today. The morning plenary was delivered by Prof Hsueh Po Ren from Taipei, Taiwan, who described in detail the escalating threat of antimicrobial resistance in the Asia-Pacific region.

Plenary lecture, 15th APCCMI Day 3 – delivered by Prof Hsueh PR

The quality of the photos is poor (taken using an iPhone 5!), given the dim lighting during the talks.

The subsequent keynote I attended (1 of 3 simultaneous sessions) was delivered by Prof Seto Wing Hong – a well known and respected infection control specialist who is currently director of the WHO Collaborating Centre for Infection Control in Hong Kong. Always entertaining, but I have heard his talks once too many times – even the jokes have become familiar! Nonetheless, the issue of infection control for multidrug-resistant bacteria in hospitals is an important one, even if no one is quite clear how to control the spread of antimicrobial resistance in Gram-negative bacteria.

Prof Seto Wing Hong discussing the global map of resistance, characterized by missing data from many countries.

Another of Prof Seto’s slides on the overview of antimicrobial resistance and control.

After a short tea break, I managed to catch Prof John Turnidge’s talk on polymyxin susceptibility testing. Polymyxins are currently the last-line antibiotics for the treatment of drug-resistant Gram-negative bacteria. These drugs were developed for clinical use in the 1960s, but abandoned because of low efficacy (compared to beta-lactam antibiotics) and how rates of adverse effects. They are now undergoing a “renaissance” because of the rise of multi- and extensively drug-resistant Gram-negative bacteria. According to Prof Turnidge, susceptibility testing for polymyxins is fraught with problems owing to the nature of the antibiotics (large positively charged molecule that diffuses poorly through agar media and which tends to adhere to the sides of plastic containers with a negative charge).

Prof John Turnidge on how the concentration of certain ions can influence the results of polymyxin susceptibility testing.

And Prof Xiao Yonghong from Zhejiang University, China, gave an overview of the problem of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. These enzymes are now entrenched in both the community and hospitals of many countries, and it does not look like they will be brought under control anytime in the near or distant future…

Prof Xiao about to begin his talk on ESBLs.

Overall, a well organized meeting that was a pleasure to attend.  A final photo at the airport before departure – it’s gratifying to see that this station has not seen frequent use!

Infection control station at the airport in Kuala Lumpur.