On a quest for transformative solutions against Antimicrobial Resistance

What is AMR?

Antimicrobial Resistance (AMR) occurs when microbes that can cause diseases become resistant to antimicrobials used in standard treatment protocols. Poor infection prevention and control measures have added to the burden of AMR, thus there is an urgent need to identify, develop and scale newer interventions and strategies which are aligned to the evolving nature of the pathogens, and data-driven prioritization of surveillance efforts. The spiralling rate at which AMR cases have increased in the past few years has made this top global agenda, not just due to health security threats but also due to the impending severe economic consequences.

Interventions are urgently required across preventatives (vaccines), diagnostics and therapeutics (antibiotics/drugs) against AMR. Concerted efforts are needed to identify, validate and integrate these interventions to reduce the burden of AMR.

C-CAMP — The Centre for Cellular and Molecular Platforms is one of India’s most exciting Life Science innovation and entrepreneurship ecosystems.

Recognising the need to build a robust pipeline for new approaches and treatments to prevent, detect and treat bacterial infections, C-CAMP conceptualised and launched the C-CAMP AMR Quest, a nation-wide search for transformative solutions against AMR.

AMR Quest Launch

C-CAMP AMR Quest

The mandate of the C-CAMP AMR Quest, run jointly by C-CAMP and CARB-X, a global non-profit partnership led by Boston University dedicated to accelerating antibacterial research to tackle the global rising threat of drug-resistant bacteria, is to attract, identify, reward and foster innovators that are working towards the development of solutions to tackle antimicrobial resistance. The winning innovations are awarded with opportunities for mentoring by industry experts, networking, funding, showcasing and commercialisation through the three-month C-CAMP AMR Accelerator. Additionally, the innovators get the opportunity to present at prominent international conferences. This collectively opens up avenues for fast tracking these innovations not just to the market but to further scale up faster and contribute in reducing the threat of AMR globally. Past winners of the C-CAMP AMR Quest have gone on to set up their own enterprise and raised grant funding, post their time in the C-CAMP AMR Accelerator.

In this context, the first two editions of the AMR Quest (2020 and 2021) focused on interventions across the domains of prevention, diagnostics and therapeutics.

These included those for broad spectrum of microbes as well as an emphasis on the ESKAPE Pathogens, a group of six highly virulent and antibiotic resistant bacteriae-Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp, that are the primary pathogens in hospital acquired infections (HAIs), and escape commonly used antibiotics.

Preventatives, including vaccines, preventative antibodies and fragments, and microbiome products, can potentially reduce the rate of disease morbidity in the population and the demand for antimicrobials. In diagnostics, the ability to reliably identify the infecting pathogen and its antibiotic susceptibility profile in the most time efficient way can markedly impact guided treatment regimens and unnecessary use of antibiotics. Due to a lack of development of new drugs and a dry pipeline for antibiotics, it is imperative to explore other therapeutic options like direct acting small molecules, preferably target new targets on the pathogen. Non-traditional therapeutics that hold promise include the indirect acting small molecules (eg; potentiators, BLI combinations, etc), direct and indirect acting large molecules (eg; peptides, phage, microbiome and nucleic acid), and finally drug conjugates (ADC, other dual acting drug conjugates).

AMR Quest 2020 Grand Finale with Chief Guest, Dr Renu Swarup, Secretary, Department of Biotechnology, Govt of India and Chairperson, BIRAC

Pan-India Spectrum of Innovations for AMR

The C-CAMP AMR Quest has seen applications coming in from all parts of the country, with Karnataka, Tamil Nadu, Maharashtra, Uttar Pradesh, Delhi, Telangana and Kerala leading in terms of number of applications received. Representation from states like Jammu & Kashmir, Himachal Pradesh, Jharkhand and Meghalaya has also gained traction.

The AMR Quest is open to anyone with an idea or technology, be they start-ups, SMEs large companies, innovators, researchers, scientists, post docs or academicians.

This enables entries with proven proof of concept, on one end to nascent stage ideas, on the other and ensures visibility to promising solutions at different stages of the developmental pipeline.

Online reviews — 2021

Winning Innovations of the C-CAMP AMR Quest

The Winners of the C-CAMP AMR Quest are selected through multiple levels of screening by an expert Jury Panel from Government, industry, and academia to assess the scientific credibility of the proposed innovations. The most promising applications present at The Finale, presided over by the Grand Jury who are stalwarts in the AMR field. They are assessed for novelty and applicability of the solution, strength of validation data, commercialization potential, clarity in articulation, etc.

Eight promising innovations were identified through the two editions of the C-CAMP AMR Quest. Six of these were startups, whereas two were individual innovators.

Diagnostics:

· Adiuvo Diagnostics is developing a rapid phenotypic device using Autofluorescence and Machine Learning for antibiotics sensitivity testing (AST) under 1 hour.

The novel strategy utilizes changes in autofluorescence intensity and lifetime of biomarkers present in pathogens when encountered with antibiotic stress to develop a rapid phenotypic AST device.

· Rapiddx’s novel microfluidics-based r-PASA (Rapid Personalized Antibiotic Susceptibility Assay) in a self-contained test device can analyse directly from the clinical sample and generates result the same day. The test can be conducted within 6 hours against a panel of 20 antibiotics.

· Achira Labs’ BugCheck is a rapid molecular diagnostics platform for identification of microbial species and antimicrobial resistance genes directly from the urine of the patient suffering from urinary tract infection.

· Ampligene’s AmpEZ is an ultra-rapid and sensitive real time AMR test panel which allows rapid screening within minutes either from culture samples or direct from clinical specimen.

Therapeutics:

· Pepthera Laboratories proposed programmable Biomolecules for Combating Antimicrobial-Resistance in maintenance of personal hygiene. The concept emerges from the fact that peptides can be reverse -engineered with sequence alterations to have broad spectrum antimicrobial activity against different microbial species.

· Dr Geetika Dhanda of JNCASR proposed small molecular adjuvants to repurpose and rehabilitate antibiotics against Gram-negative Superbugs.

Their design enables optimum membrane-perturbation, thereby making these adjuvants non-active and extremely non-toxic on their own. This overcomes the limitations of antimicrobial peptide (AMP) mimics which are extremely toxic.

· Foundation for Neglected Disease Research (FNDR) is working on a low molecular weight small molecule broad spectrum antibiotic against Gram-positive/Gram-negative pathogens with desirable physico-chemical properties.

· Mr Tanay Bhatt of inStem proposed next generation antimicrobial peptides, that can be used as switch for on-demand controlled release of peptides and can thus provide a formidable new line of defence against the growing list of pathogens that are resistant to antibiotics.

In addition, 7 innovations received special mention by the Jury.

AMR Quest 2020 Winners
AMR Quest 2021 Winners and their innovations

C-CAMP AMR Accelerator

The C-CAMP AMR Quest has been a medium to reach the innovators and identify some of the most promising interventions in the domain. As a logical next step, the C-CAMP AMR Accelerator was conceived and actioned after recognizing the need for expert advice and mentoring for these innovations to reach their full potential. The winners of the AMR Quest are taken through a deep-dive 3 months Accelerator program that gives them the requisite mentorship from industry and academic experts on scientific aspects, regulatory affairs and IP laws, and at the same time enables them to fine tune their business strategy and fund-raising potential. This comprehensive value-addition enables fast-tracking the innovations towards commercialisation.

Integrating Innovations for Impact

For these innovations to reach the market and deliver impact, several enabling factors have to be in place —

funding for antibiotic/AMR research, a clearly defined regulatory pathway, access and market-models that are financially viable, incentives for pharma companies, etc.

In conclusion, aligning with the broad mandate conferred by Global Action Plan (GAP) and the National Action Plan (NAP), enabling policies, and a strong collaborative network will be required to orchestrate the expansion of these AMR interventions that can contribute to successful AMR governance.