Antibiotic Resistance: Current Practices and Strategies to Overcome this Growing Threat

 
 
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Biopharm Reports has carried two comprehensive market studies, covering bacterial molecular diagnostics and antibiotic resistance. These studies involved the participation of 1072 experienced researchers, clinicians and laboratory end-users and profiled current practices, developments, trends and plans over the next three years, as well as growth and opportunities across key sectors of these markets. These findings provide a wealth of market information on the current and evolving markets for bacterial molecular diagnostics and antibiotic resistance.

ANTIBIOTIC RESISTANCE

Clinical Laboratory
The top three therapeutic areas Purpose of participant’s research
lower respiratory tract, urethritis etc) Top associated therapeutic areas
Bacterial and viral infections Main activity
Current patients Antibiotic source
Preferred distinguishing tests Gram negative bacteria
Suppliers Gram positive bacteria
Test costs per patient Other bacteria
Test time Companion diagnostics
Distinguishing infections Companion diagnostics
Future patients Identification methods
Future tests and instrumentation Methods
Future preferred suppliers Preferred Products
Identifying causal bacteria Preferred supplier
Current patients Future identification methods
Laboratory identification methods Future methods
Preferred tests and instrumentation Preferred tests and instrumentation
Preferred suppliers Future suppliers
Test costs per patient Antibiotics against Gram -ve bacteria
Test time Antibiotics against Gram +ve bacteria
Future identification of bacterial types Antibiotics against other bacteria
Future patients Novel combinations
Future bacterial identification methods Combinations
Tests and instrumentation Single antibiotics or combinations
Preferred suppliers Integrated programmes
Antibiotic resistance genes Current programme
Current patients Future integrated programme
Preferred tests and instrumentation Name and location
Preferred suppliers Antimicrobial stewardship
Testing costs Name and location
Test time Future stewardship programmes
Future identification of resistance genes Name and location
Future patients Innovation
Antibiotic resistance gene tests Barriers
Future suppliers Initiatives
Integrated programmes    
Current programme    
Future integrated programme    
Name and location    
Antimicrobial stewardship    
Name and location    
Future stewardship programmes    
Name and location    
Gram negative bacteria    
Gram positive bacteria    
Other bacteria    
Antibiotics against Gram -ve bacteria    
Antibiotics against Gram +ve bacteria    
Antibiotics against other bacteria    
Treatment costs    
Single antibiotics or combinations    
Innovation    
Barriers    
Initiatives    
   
Diagnostics  
Therapeutic areas    
Main activity     
Source of antibiotics     
Gram negative bacteria     
Gram positive bacteria     
Other bacteria     
Companion diagnostics     
Companion diagnostics     
Bacterial and viral infections      
Future distinguishing tests     
Identifying causal bacteria     
laboratory identification methods   
Preferred tests / instrumentation 
Preferred suppliers     
Future identification of bacteria     
Future identification methods     
Tests and instrumentation     
Preferred suppliers    
Integrated programmes     
Current programme     
Future integrated programme     
Name and location     
Stewardship programmes     
Name and location     
Future stewardship programmes     
Name and location    
Innovation     
Barriers     
Initiatives     

BACTERIAL MOLECULAR DIAGNOSTICS

Current molecular techniques Current applications
Current growth Current bacterial tests
Future molecular  techniques Advantages
Future growth Associated therapeutic areas
Test costs Budget
Suppliers Disadvantages
Number of bacteria tested Future applications
Current suppliers Future bacterial tests
Future suppliers Future requirements
Main bacteria tested Purpose of work
Multiplex methods Samples
Automated methods Techniques being replaced
Automation suppliers  

BACTERIAL MOLECULAR DIAGNOSTICS

This study profiled 420 experienced clinicians and research scientists and investigated current practices, developments, trends and future plans over the next three years, as well as growth, shrinkage and opportunities across key areas of this market. Its findings provide suppliers with market information on the current and evolving use of bacterial molecular diagnostics. The study investigated 45 market areas covering current activities, recent developments and trends, anticipated future growth, shrinkage and opportunities. Its findings provide market information on the current and evolving use of bacterial molecular diagnostics and assist companies selling into these markets to respond to laboratory users’ current needs and their future plans.

Market studies carried out by Biopharm Reports are designed to assist laboratory suppliers to profile current and evolving market opportunities. All of our studies are carried out through specialist groups of experienced researchers and clinicians, and therefore findings are based on 'real world' market data. By providing new insights and a better understanding of end-user needs, our studies assist suppliers to sell into these markets, and support innovation, development and strategic planning.

Market areas

Growth in bacterial molecular diagnostics: Based on recent trends in the numbers of bacterial molecular diagnostic tests (i.e. number of assays) carried out in their laboratory, an estimate of by how much (% increase or % decrease) their laboratory's use of bacterial molecular diagnostics has changed (or not) over the last three years. Also, based on current trends in the numbers of bacterial molecular diagnostic tests (i.e. number of assays) carried out in their laboratory, as estimate of by how much (% increase or % decrease) they anticipate their use of bacterial molecular diagnostics will change (or not) over the next three years.

Diagnostic techniques: The main bacterial diagnostic techniques currently used, where the techniques considered included Agar plates, Amplification methods (e.g. PCR), Antigen tests (e.g. C difficile toxin), Biochemical tests (e.g. lactose fermentation), Blood culture, Culture and sensitivity, Differential staining (e.g. Gram positive), Fatty acid profiles, FISH, Flow cytometry (e.g. for Pseudomonas, Listeria), General Hybridization, Inflammatory markers (CRP), Mass Spectrometry (e.g. Maldi-TOF), Microarrays, Microscopic morphology (e.g. cocci, rods), Next-Generation Sequencing, Northern Blot, Nucleic Acid Tests, Nucleic Acid Tests (e.g. PCR), Phage typing, Plasmid fingerprinting, Sequencing (Sanger), Serology (e.g. Slid Agglutination), Southern Blot, Stool test, Strep A and any other. Also, based on recent trends in their work, the main bacterial diagnostic techniques they expect to be using in three years.

Molecular diagnostic techniques: The main bacterial molecular diagnostic techniques they currently use, where the techniques considered were bDNA assays, Classical qualitative PCR, Cleavase-Invader Technology, Cycling Probe Technology, Degenerate Oligonucleotide PCR (DOP-PCR), Digital PCR (dPCR), DNA cloning, Dot Blot, General Hybridization, General Primers PCR, Helicase-Dependent Amplification, Hot start PCR, Hybrid Capture Assay, In Situ Hybridization, Inverse PCR, Isothermal PCR, Ligase Chain Reaction, Liquid Hybridization, Loop-mediated isothermal amplification (LAMP), Microarrays, Microsphere-Based Array, Nested PCR, Next-Generation Sequencing, Northern Blot, Panbacterial PCR, PCR array, PCR Restriction Fragment Length Polymorphism (PCR-RFLP), Quantitative PCR (qPCR), Restriction Fragment Length Polymorphism (RFLP), Reverse Transcription PCR (RT-PCR), Single Specific Primer-Polymerase Chain Reaction (SSP-PCR), Southern Blot, Strand Displacement Amplification, Taqman, Touchdown PCR, Transcription-Mediated Amplification (TMA) and any other. Also, based on recent trends in their work, the main bacterial molecular diagnostic techniques that they anticipate using in three years.

Suppliers: The main suppliers of bacterial molecular diagnostics (e.g. diagnostic kits, reagents) to their laboratory, where the companies considered were Abbott Molecular, AdvanDx, Appliedbiosystems, Atlas Genetics, AutoGenomics, BD, Biognost, BioGX, Biomerieux, Bio-Rad, Cepheid, Coris-Bio, ELITech Molecular, Euroimmun US, Focus Diagnostics, Gen-Probe, Hain Life Science, Hologic, Hylabs, Idaho Technology, IntelligentMDx, Invitrogen (Life Technologies), Life Technologies, Luminex, Merck, Meridian Bioscience, Nanosphere, Pathology, Inc., PrimeraDx, Qiagen, Quidel Corporation, R-Biopharm Inc, Roche Diagnostics, Seegene, Siemens Healthcare, Thermo Fisher and any other. Also, based on recent practices in their work, which companies they anticipate will be their main suppliers of bacterial molecular diagnostics (e.g. Kits, reagents), in three years.

Technique Replacement: The non-molecular bacterial diagnostic techniques that have been, or are being, replaced in their laboratory by bacterial molecular diagnostics, where the techniques considered were Agar plates, Antigen tests (e.g. C difficile toxin)., Biochemical tests (e.g. lactose fermentation), Blood culture, Culture and sensitivity, Differential staining (e.g. Gram positive), Fatty acid profiles, Flow cytometry (e.g. for Pseudomonas, Listeria), Inflammatory markers (CRP), Mass Spectrometry (e.g. Maldi-TOF), Microscopic morphology (e.g. cocci, rods), Phage typing, Plasmid fingerprinting, Serology (e.g. Slid Agglutination), Stool test, Strep A and any other.

Gram Negative bacteria: The main Gram negative bacteria with they work relating to all types of bacterial diagnostics, where the bacteria considered were Acinetobacter species, Actinobacillus species, Bacteroides fragilis, Bacteroides sp., Bordetella pertussis, Borrelia burgdorferi, Brucella abortus, Brucella canis, Brucella melitensis, Brucella suis, Campylobacter jejuni, Chlamydia pneumonia, Chlamydia trachomatis, Chlamydophila pneumonia, Chlamydophila psittaci, Chlymidia peumoniae, Cyanobacteria, Enterobacter, Erwinia species, Escherichia coli, Francisella tularensis, Fusobacterium nucleatum, Haemophilus influenza, Helicobacter pylori, Klebsiella pneumonia, Legionella pneumophila, Leptospira interrogans, Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitides, Pasteurella multocida, Proteus bacilli, Pseudomonas aeruginosa, Rickettsia rickettsia, Salmonella typhimurium, Serratia marcescens, Shigella sonnei, Treponema pallidum, Vibrio cholera, Yersinia pestis and any other. Also, based on recent trends in their work, the main Gram negative bacteria that they anticipate working with in three years from now.

Gram positive bacteria. The main Gram positive bacteria with they currently work, relating to all types of bacterial diagnostics, where the bacteria considered were Bacillus anthracis, Bacillus cereus, Bacillus subtilis, Clostridium botulinum, Clostridium difficile, Clostridium perfringens, Clostridium tetani, Corynebacterium diphtheria, Corynebacterium jeikeium, Enterococcos faecalis, Enterococcos faecium, Enterococcus faecalis, Lactobacillus species, Listeria monocytogenes, Listeria monocytogenes, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Streptococcus agalactiae, Streptococcus pneumonia, Streptococcus pyogenes, Streptococcus viridans and any other. Also, based on recent trends in their work, the main Gram positive bacteria that they anticipate working with in three years from now.

Other bacteria: The main other bacteria with which they currently work, relating to all types of bacterial diagnostics, where the other bacteria considered were Gardnerella vaginalis, Mycobacterium leprae, Mycobacterium tuberculosis, Mycobacterium ulcerans, Mycoplasma peumoniae, Mycoplasma pneumonia and any other. Also, based on recent trends in their work, the main other bacteria that they anticipate working with in three years from now.

Current multiplex methods:  the percentage of their bacterial molecular diagnostics assays that are based on multiplex methods. Also, Based on recent trends in their work, estimates of the percentage of their bacterial molecular diagnostics that you anticipate will be based on multiplex methods in three years from now.

Automation: The percentage of their current bacterial molecular diagnostics that are automated, together with the preferred suppliers of automated systems for bacterial molecular diagnostics.

Gram negative bacteria tested using molecular diagnostics: The main Gram negative bacteria currently tested for using molecular diagnostics, where the bacterial considered were Acinetobacter species, Actinobacillus species, Bacteroides fragilis, Bacteroides sp., Bordetella pertussis, Borrelia burgdorferi, Brucella abortus, Brucella canis, Brucella melitensis, Brucella suis, Campylobacter jejuni, Chlamydia pneumonia, Chlamydia trachomatis, Chlamydophila pneumonia, Chlamydophila psittaci, Chlymidia peumoniae, Cyanobacteria, Enterobacter, Erwinia species, Escherichia coli, Francisella tularensis, Fusobacterium nucleatum, Haemophilus influenza, Helicobacter pylori, Klebsiella pneumonia, Legionella pneumophila, Leptospira interrogans, Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitides, Pasteurella multocida, Proteus bacilli, Pseudomonas aeruginosa, Rickettsia rickettsia, Salmonella typhimurium, Serratia marcescens, Shigella sonnei, Treponema pallidum, Vibrio cholera, Yersinia pestis and any other. Also, based on recent trends in their work, the main Gram negative bacteria they anticipate testing using molecular diagnostics in three years.

Gram positive bacteria tested using molecular diagnostics: The main Gram positive bacteria currently tested using molecular diagnostics, where the bacteria considered were Bacillus anthracis, Bacillus cereus, Bacillus subtilis, Clostridium botulinum, Clostridium difficile, Clostridium perfringens, Clostridium tetani, Corynebacterium diphtheria, Corynebacterium jeikeium, Enterococcos faecalis, Enterococcos faecium, Enterococcus faecalis, Lactobacillus species, Listeria monocytogenes, Listeria monocytogenes, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Streptococcus agalactiae, Streptococcus pneumonia, Streptococcus pyogenes, Streptococcus viridans and any other. Also, based on recent trends in their work, the main Gram positive bacteria they anticipate testing using molecular diagnostics in three years from now.

Other bacteria tested using molecular diagnostics: The main other bacteria they currently test for, using molecular diagnostics, where the bacteria considered were Gardnerella vaginalis, Mycobacterium leprae, Mycobacterium tuberculosis, Mycobacterium ulcerans, Mycoplasma peumoniae, Mycoplasma pneumonia and any other. Also, based on recent trends in their work, the main other bacteria they anticipate testing in three years from now.

Samples: The main sample types tested, relating to bacterial diagnostics, where the samples considered were Amniotic fluid, Bone marrow, From broncho-alveolar lavage, Cadaveric Serum, Cell isolates, Cells, Cerebrospinal fluid, Cervical, Dried Blood Spot, Faecal, From genital ulcers, Leucocytes, Liver tissue, Lymphocytes, Microbiological materials, Muco-cutaneous samples, Placental and foetal, Plasma, Respiratory samples, Saliva, Serum, Skin lesions, Tumours, Urine, Warts biopsies, Whole blood and any other.

Current numbers of bacteria: the number of different bacterial types they currently typically (simultaneous) test in the same molecular diagnostic assay. Also, based on current trends in their work, the numbers of different bacteria they anticipate typically (simultaneously) testing for in the same molecular diagnostic assay in three years from now.

Current applications: The current main applications of bacterial molecular diagnostics used in their  laboratory, where the applications considered were Antibiotic Resistance, Bacterial Load, Bacterial Strains, Bacterial Sub Typing, Bacteria in antibiotic-treated patients, Fastidious species, Patient monitoring, Antibiotic prescribing decisions, Quantitation of Bacteria, Screening Patients, Uncultivable bacteria, Virulence traits and any other. Also, based on current trends in their work, their anticipated main applications of bacterial molecular diagnostics in their laboratory in three years from now.

Advantages and Disadvantages: The main advantages of bacterial molecular diagnostics in their work, compared to non-molecular bacterial diagnostics, where the potential advantages considered were Accuracy, As adjunctive tests, As alternative tests, Automation, Convenience, Cost, Detection of new resistant strains, Detection of non-culturable bacteria, Earlier detection of bacterial infections, Ease of use, For 'all clear' or cure decisions, Hard-to-detect bacteria, Identification of resistant bacteria, Laboratory throughput and productivity, Length of patient stays, Multiplexing, Personalised therapies, Quality control, Reproducibility, Results turnaround times, Sample handling and storage, Sample preparation or isolation requirements, Sample size requirements, Sensitivity, Specificity, Subjectivity factors, Universal Standardisation, Versatility and any other.

Future Requirements: The main areas where they would like to see future improvements in bacterial molecular diagnostics, where the potential future requirements were Accuracy, As adjunctive tests, As alternative tests, Automation, Convenience, Cost, Detection of new resistant strains, Detection of non-culturable bacteria, Earlier detection of bacterial infections, Ease of use, For 'all clear' or cure decisions, Hard-to-detect bacteria, Identification of resistant bacteria, Laboratory throughput and productivity, Length of patient stays, Multiplexing, Personalised therapies, Quality control, Reproducibility, Results turnaround times, Sample handling and storage, Sample preparation or isolation requirements, Sample size requirements, Sensitivity, Specificity, Subjectivity factors, Universal Standardisation, Versatility and any other.

Most tested bacteria: The bacteria that are most tested in their laboratory in terms of the numbers of bacterial molecular diagnostic tests carried out, where the bacteria considered were Acinetobacter species, Actinobacillus species, Bacteroides fragilis, Bacteroides sp., Bordetella pertussis, Borrelia burgdorferi, Brucella abortus, Brucella canis, Brucella melitensis, Brucella suis, Campylobacter jejuni, Chlamydia pneumonia, Chlamydia trachomatis, Chlamydophila pneumonia, Chlamydophila psittaci, Chlymidia peumoniae, Cyanobacteria, Enterobacter, Erwinia species, Escherichia coli, Francisella tularensis, Fusobacterium nucleatum, Haemophilus influenza, Helicobacter pylori, Klebsiella pneumonia, Legionella pneumophila, Leptospira interrogans, Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitides, Pasteurella multocida, Proteus bacilli, Pseudomonas aeruginosa, Rickettsia rickettsia, Salmonella typhimurium, Serratia marcescens, Shigella sonnei, Treponema pallidum, Vibrio cholera, Yersinia pestis, Bacillus anthracis, Bacillus cereus, Bacillus subtilis, Clostridium botulinum, Clostridium difficile, Clostridium perfringens, Clostridium tetani, Corynebacterium diphtheria, Corynebacterium jeikeium, Enterococcos faecalis, Enterococcos faecium, Enterococcus faecalis, Lactobacillus species, Listeria monocytogenes, Listeria monocytogenes, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Streptococcus agalactiae, Streptococcus pneumonia, Streptococcus pyogenes, Streptococcus viridans, Gardnerella vaginalis, Mycobacterium leprae, Mycobacterium tuberculosis, Mycobacterium ulcerans, Mycoplasma peumoniae, Mycoplasma pneumonia and any other.

Diagnostic test costs: The cost per molecular diagnostic test (including associated replicates and controls) of their most tested bacterium, together with the overall costs, the percentage (%) of their budget for the conduct of bacterial molecular diagnostic tests, that is associated with the single molecular diagnostic test previously indicated.

Preferred suppliers: Their preferred suppliers of their main bacterial molecular diagnostic (e.g. Test kit or reagents), indicated previously, where the companies considered were Abbott Molecular, AdvanDx, Appliedbiosystems, Atlas Genetics, AutoGenomics, BD, Biognost, BioGX, Biomerieux, Bio-Rad, Cepheid, Coris-Bio, ELITech Molecular, Euroimmun US, Focus Diagnostics, Gen-Probe, Hain Life Science, Hologic, Hylabs, Idaho Technology, IntelligentMDx, Invitrogen (Life Technologies), Life Technologies, Luminex, Merck, Meridian Bioscience, Nanosphere, Pathology, Inc., PrimeraDx, Qiagen, Quidel Corporation, R-Biopharm Inc, Roche Diagnostics, Seegene, Siemens Healthcare, Thermo Fisher and any other.

Participants: Participants provided background information on themselves and their activities including professional positions, activities, email address of the organisation (company, university etc.) to which their bacterial diagnostics activities relate, namely Regions (Europe, Asia, North America, South America, Africa (Sub-Saharan), Central America / Caribbean, Australia, New Zealand and Oceania and Middle East / North Africa / and Greater Arabia); Countries professional title; Years of experience in bacterial diagnostics; organisation type (Clinic, Government Organisation, Hospital, Large International Company, Medium Sized Company, Research Institute, Small Company, Teaching Hospital, University, Veterinary Organisation; Field (Human Medicine/Disease and Veterinary Medicine/Disease); Purpose of work in bacterial molecular diagnostic Clinical research, Routine diagnostics, Routine screening, Screening blood products, Disease biomarkers, Clinical trials, Patient treatment, Treatment monitoring, Diagnostics research, Disease research, Drug R&D, Drug targets, Toxicology or other); Role (Physician or Clinician, Laboratory Scientist (Clinical or Other), Laboratory or Clinical Manager, Veterinarian and Other) and; Activity (Disease research, Routine patient testing, Diagnostics research, Diagnostics development or others).

Therapeutic Areas: The main associated therapeutic areas relating to their bacterial diagnostics, where the areas considered were Aging, Arthritis, Autoimmune Diseases, Blood, Bone Metabolism, Cancer, Cardiovascular, Central Nervous System, Dermatology, Diabetes, Endocrine, Exercise, Gastrointestinal, Genito-urinary System, Haematology, Hearing, Hepatic, Immunology, Infections, Inflammation, Lung diseases, Mental diseases, Metabolic Disorders, Musculoskeletal Disorders, Nutrition, Obstetrics and Gynaecology, Ophthalmology, Pain, Parasitology, Regeneration, Renal, Reproduction, Respiratory, Toxicology and any other.

ANTIBIOTIC RESISTANCE

Market findings from this study are based on 'real world' laboratory data, provided by research scientists and clinicians who work routinely on the challenges posed by antibiotic resistance.

This study investigated 117 market areas covering current activities, recent developments and trends, anticipated future growth, shrinkage and opportunities. Its findings provide market information on current and developing activities to combat antibiotic resistance and assist companies selling into these markets to respond to laboratory users’ current needs and their future plans.

Biopharm Reports specialises in carrying out market studies of techniques and applications used in life science laboratories and clinics. All our studies involve the participation of scientists and clinicians and investigate in-depth, key areas of their current use of specialised laboratory techniques, and their plans for using these techniques over the next three years. The associated report provides a competitive market analysis of current practices and future developments across 25 key areas relating to antibiotic resistance. Examples include:

Diagnostics: Therapeutic areas, top Gram positives, Gram negatives and other pathogens; current and future development of companion diagnostics, tests to distinguish between bacterial and viral infections, the identification of causal bacterial pathogens, bacterial identification methods, preferred tests and instrumentation, preferred suppliers, integrated and antimicrobial stewardship programmes, requirements for innovation, new initiatives and barriers to success.
Clinical: Therapeutic areas, top infection types, the major Gram positives, Gram negatives and other pathogens; distinguishing bacterial and viral infections, test costs and test times per patient, the identification of causal bacterial, preferred methods and suppliers, the identification of antibiotic resistance genes, integrated and antimicrobial stewardship programmes, requirements for innovation, new initiatives, barriers to success and future plans in these areas
Suppliers: Who are the major company suppliers in the ‘antibiotic resistance’ market and who do diagnosticians and clinicians plan to purchase from over the next three years. Who are the top ten suppliers in this field, and what changes are predicted in three years from now.
Opportunities: The findings of this study are analysed to identify opportunities to suppliers in the ‘antibiotic resistance’ market, in each of the 'Diagnostics’, ‘Clinical’ and ‘Laboratory’ areas indicated below.

Overview


Threats posed by the global increase in antibiotic resistant bacterial strains continue to cause alarm, and some observers suggest that this problem is threatening to take societies back to a pre-antibiotic era. However, the last five years have seen important changes in practices, innovation and attitudes, in response to this growing threat. Biopharm Reports has recently carried out a global market study of antibiotic resistance, to identify the changing developments and management strategies that are taking place, and the opportunities these offer to developers in this field.

Biopharm Reports has carried out a global market study of antibiotics resistance, to identifying the changes that are taking place in the ‘antibiotic resistance market’ and the opportunities these present to developers in this field. This global study involved the participation of 652 clinicians, scientists, researchers and Government officials in 80 countries and provides a comprehensive overview of current and evolving practices, developments and strategies and their importance in the combating and management of antibiotic resistance.

This report provides a wealth of information for companies and Government departments working in this field, and through a detailed analysis of the study’s findings, identifies commercial opportunities and provides insights, which will help to guide decision-making in this challenging field. 

Background


While the emergence of MRSA has embodied concerns over the rise of antibiotic resistance, other trends are becoming increasingly problematic. An example is the emergence of carbapenem resistance in K. pneumonia, due to a lack of alternative treatment options. Reports from the US suggest that 50–60% of all hospital-acquired infections are caused by antibiotic resistant bacteria, illustrating the human and financial impact of antibiotic resistance.  In 2009, the World Health Organisation reported that in Europe 25,000 people die every year from drug-resistant infections. In the same year there were 440,000 new cases of MDR tuberculosis, in 69 countries.

Although the use of antibiotics has soared in recent decades, the approval of new antibiotics in the US fell by 60% from 30 during the decade 1983 to 1992, to just 12 over the period 1998 to 2009. Although recent years have seen a significant growth in the numbers and novelty of new pipeline antibiotics, it is evident that the health threats posed by antibiotic resistance need to be tackled urgently, and in many different ways.

The last five years have seen important changes in practices, innovation and attitudes in response to these growing threats. These are driving innovation in drug discovery and diagnostics, but more importantly, in clinical practices and the ways in which antibiotics are being used. There is also increasing local and international surveillance to monitor the emergence and spread of antibiotic resistant strains, and local integrated practices, antimicrobial stewardship programs and more effective diagnostic methods are being pushed forward, in an effort to ensure the most appropriate and effective use of antibiotics. These developments offer new opportunities for developers in this field, both in drug discovery and in diagnostics. This market study is summarised below:

Diagnostics


1. Therapeutic areas: Participants top three (associated) therapeutic areas relating to their work with bacterial diagnostics (general bacterial infections, infections associated with autoimmune disease etc). Options: arthritis, autoimmune diseases, general bacterial infections, bone metabolism, cancer, cardiovascular, central nervous system, dermatology, endocrine, gastrointestinal, genitourinary system, haematology, inflammation, metabolic disorders, musculoskeletal disorders, nutrition, obstetrics and gynaecology, ophthalmology, pain, respiratory, viral infections or other.
2. Main activity: Participants main activity relating to antibiotics and/or antibiotic resistance. Options: The development of bacterial (identification) diagnostic tests;
bacterial diagnostic research; differentiating between bacterial infections and viral infections; other
3. Source of antibiotics: Participants’ disclosures on the main source of antibiotics (those targeting pathogens of interest to them) that relate to their work on bacterial antibiotics. Options: natural, semisynthetic, synthetic or other.
4. Gram negative bacteria: Participants’ disclosures on the top three gram negative bacteria, relating to their work in bacterial diagnostics Options: Acinetobacter species, Actinobacillus species, Bacteroides fragilis, Bacteroides sp., Bordetella pertussis, Borrelia burgdorferi, Brucella abortus, Brucella canis, Brucella melitensis, Brucella suis, Campylobacter jejuni, Chlamydia pneumoniae, Chlamydia trachomatis, Chlamydophila pneumoniae, Chlamydophila psittaci, Chlymidia peumoniae, Cyanobacteria, Enterobacter, Erwinia species, Escherichia coli, Francisella tularensis, Fusobacterium nucleatum, Haemophilus influenzae, Helicobacter pylori, Klebsiella pneumoniae, Legionella pneumophila, Leptospira interrogans, Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Proteus bacilli, Pseudomonas aeruginosa, Rickettsia rickettsii, Salmonella typhimurium, Serratia marcescens, Shigella sonnei, Treponema pallidum, Vibrio cholerae, Yersinia pestis or other.
5. Gram positive bacteria: Participants’ disclosures on the top three gram positive bacteria, relating to their work in bacterial diagnostics Options. Options: Bacillus anthracis, Bacillus cereus, Bacillus subtilis, Clostridium botulinum, Clostridium difficile, Clostridium perfringens, Clostridium tetani, Corynebacterium Diphtheriae, Corynebacterium jeikeium, Enterococcos faecalis, Enterococcos faecium, Enterococcus faecalis, Lactobacillus species, Listeria monocytogenes, Listeria monocytogenes, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, other.
6. Other bacteria: Participants’ disclosures on the top three other bacteria, relating to their work in bacterial diagnostics Options: Options: Gardnerella vaginalis, Mycobacterium leprae, Mycobacterium tuberculosis, Mycobacterium ulcerans, Mycoplasma peumoniae, Mycoplasma pneumoniae, other.
7. Companion diagnostics: Participants’ disclosures on their work in bacterial diagnostics, relating to the use (or not) of companion diagnostic tests.
8. Companion diagnostics: For those participants who answered ‘yes’ to question 7 – participants description of the companion diagnostic
9. Bacterial and viral infections: Participants’ disclosures on their development of laboratory tests to distinguish between bacterial and viral infections, prior to antibiotic use. [this refers to tests that are able to distinguish between bacterial and viral infections as a basis for prescribing antibiotics (in cases where a bacterial infection is confirmed) or not (in cases where a viral infection is confirmed).
10. Future tests for distinguishing bacterial and viral infections: For those participants who answered ‘no’ to question 10 – participants expectations to in their work three years from now, to research, work on or developing tests to distinguish between bacterial and viral infections, prior to antibiotic use. bacterial infection is confirmed) or not (in cases where a viral infection is confirmed).
11. Identifying causal bacteria: Participants practices on the use of laboratory tests to identify the specific causal bacteria associated with infections, in their work relating to bacterial diagnostics [this refers to tests that are able to identify the specific or major causal bacterium or subtype in a particular patient infection, prior to the clinical selection of an antibiotic to treat that infection].
12. laboratory identification methods: For those participants who answered ‘yes’ to question 9 – participants’ top three laboratory tests used to identify the specific causal bacteria associated with infections, relating to bacterial diagnostics. Options: microscopic morphological characteristics (e.g. cocci, rods), differential staining (e.g. gram positive, acid fast stain), biochemical tests (e.g. lactose fermentation), serology (e.g. slid agglutination, serological testing), phage typing, fatty acid profiles, flow cytometry (e.g. for pseudomonas, listeria), plasmid fingerprinting, nucleic acid hybridisation, polymerase chain reaction (pcr) microarray or other.
13. Preferred tests and instrumentation: For those participants who answered ‘yes’ to question 9 – participants’ preferred laboratory tests to allow the identification of the specific causal bacteria associated with infections.
14. Preferred suppliers: For those participants who answered ‘yes’ to question 9 – participants’ preferred company suppliers of laboratory tests and instrumentation to allow them to identify the specific causal bacteria associated with infections.
15. Future identification of causal bacterial types: For those participants who answered ‘no’ to question 9 – participants’ anticipated use of laboratory tests three years from now to identify the specific causal bacteria associated with infections [this refers to tests that are able to identify the specific or major causal bacterium or subtype in a particular patient infection, prior to the clinical selection of an antibiotic to treat that infection] Options: yes, possibly, don't know, probably not, no, other
16. Future bacterial identification methods: For those participants who answered ‘yes’ to question 15 – participants’ top three laboratory tests three years from now, that they anticipate using to identify the specific causal bacteria associated with infections, prior to antibiotic use. Options: microscopic morphological characteristics (e.g. cocci, rods), differential staining (e.g. gram positive, acid fast stain), biochemical tests (e.g. lactose fermentation), serology (e.g. slid agglutination, serological testing), phage typing, fatty acid profiles, flow cytometry (e.g. for pseudomonas, listeria), plasmid fingerprinting, nucleic acid hybridisation, polymerase chain reaction (pcr) microarray or other.
17. Tests and instrumentation: For those participants who answered ‘yes’ to question 15 – participants’ anticipated preferred laboratory tests, three years from now, to identify the specific causal bacteria associated with infections prior to antibiotic use.
18. Preferred suppliers: For those participants who answered ‘yes’ to question 15 – participants’ anticipated preferred company suppliers, three years from now, of laboratory tests to identify the specific bacteria associated with infections in prior to antibiotic use.
19. Integrated programmes: Participants work with integrated programmes which give access to information on resistant or susceptible bacterial pathogens in their community, prevalent or emerging antibiotic resistance genes or any other 'surveillance-related' information, to support decisions on the use of specific antibiotics. Options: yes/no
20. Current programme: For those participants who answered ‘yes’ to question 19 – participants disclosures on name of the programme and the geographic area in which it operates.
21. Future integrated programme: For those participants who answered ‘no’ to question 19 – participants disclosures on whether they anticipate working with, in three years from now, any integrated programmes that gives access to information on resistant or susceptible bacterial pathogens in their community, prevalent or emerging antibiotic resistance genes or any other 'surveillance-related' information, to support decisions on the use of specific antibiotics.
22. Name and location: For those participants who answered ‘yes’ to question 21 – participants disclosures in the name and geographic location of the integrated programme.
23. Antimicrobial stewardship programmes: Participant disclosures on whether their work is associated with an antimicrobial stewardship programme. [antimicrobial stewardship refers to coordinated interventions designed to improve and measure the appropriate use of antimicrobials - The Infectious Diseases Society of America (IDSA)].
24. Name and location: For those participants who answered ‘yes’ to question 21 – participants disclosures on the name and geographic location of the antimicrobial stewardship programme.
25. Future antimicrobial stewardship programmes: For those participants who answered ‘no’ to question 23 – participants anticipated activities in three years from now, on whether their work will be linked to or associated with, an antimicrobial stewardship programme.
26. Name and location: For those participants who answered ‘yes’ to question 25 – participants disclosures on the name and geographic location of the antimicrobial stewardship programme
27. Innovation: In their own field, participants disclosures on what they believe to be the areas of greatest need in terms of innovation or change, to more effectively deal with and manage antibiotic resistance.
28. Barriers: In their own field, participants disclosures on what they believe are the greatest barriers to more effectively dealing with or managing antibiotic resistance.
29. Initiatives: In their own field, participants opinions on what new initiatives government departments can promote, to more effectively deal with or manage antibiotic

Clinical


1. The top three therapeutic areas: relating to participants work with antibiotics or antibiotic resistance (e.g. general bacterial infections, infections associated with autoimmune disease etc). Options: arthritis, autoimmune diseases, general bacterial infections, bone metabolism, cancer, cardiovascular, central nervous system, dermatology, endocrine, gastrointestinal, genitourinary system, haematology, inflammation, metabolic disorders, musculoskeletal disorders, nutrition, obstetrics and gynaecology, ophthalmology, pain, respiratory, viral infections or other.
2. Top three infection types (e.g. lower respiratory tract, urethritis etc): with which clinicians and other participants work.
3. Bacterial and viral infections: Participant’s current use of laboratory tests to distinguish between bacterial and viral infections, prior to antibiotic use. [this refers to tests that are able to distinguish between bacterial and viral infections as a basis for prescribing antibiotics (in cases where a bacterial infection is confirmed) or not (in cases where a viral infection is confirmed).
4. Current patients: For those participants who answered ‘yes’ to question 3, participants estimates of the percentage of (infection) patient cases in which laboratory tests are used to distinguish between bacterial and viral infections, prior to antibiotic use.
5. Preferred distinguishing tests and instrumentation: For those participants who answered ‘yes’ to question 3 - participants’ preferred laboratory tests and instrumentation for distinguishing between bacterial and viral infections, prior to antibiotic use.
6. Suppliers: For those participants who answered ‘yes’ to question 3 - participants’ preferred company suppliers of laboratory tests to allow the distinction between bacterial and viral infections, prior to antibiotic use.
7. Test costs per patient: For those participants who answered ‘yes’ to question 3 - participants’ estimates of average test costs per patient, for distinguishing between bacterial and viral infections, prior to antibiotic use.
8. Test time: For those participants who answered ‘yes’ to question 3 - participants’ estimates of the average test time (from sample taking, to the time results are available) for distinguishing between bacterial infections and viral infections, prior to antibiotic use.
9. Future distinction between bacterial and viral infections: For those participants who answered ‘no’ to question 3 – participants expectation of using laboratory tests three years from now to distinguish between bacterial and viral infections, prior to antibiotic use. [this question refers to tests that are able to distinguish between bacterial and viral infections as a basis for prescribing antibiotics (in cases where a bacterial infection is confirmed) or not (in cases where a viral infection is confirmed).
10. Future patients: For those participants who answered ‘yes’ to question 9 – participants estimate of the percentage of (infection) patient cases in which laboratory tests three years from now, to distinguish between bacterial and viral infections, prior to antibiotic use.
11. Future tests and instrumentation: For those participants who answered ‘yes’ to question 9 – participants (anticipated) preferred laboratory tests and instrumentation three years from now, for distinguishing between bacterial and viral infections, prior to antibiotic use.
12 Future preferred suppliers: For those participants who answered ‘yes’ to question 9 – participants (anticipated) preferred company suppliers three years from now, of laboratory tests to allow them to distinguish between bacterial and viral infections, prior to antibiotic use.
13. Identifying causal bacteria: Participants practices on the use of laboratory tests to identify the specific causal bacteria associated with infections, prior to antibiotic use. [this refers to tests that are able to identify the specific or major causal bacterium or subtype in a particular patient infection, prior to the clinical selection of an antibiotic to treat that infection].
14. Current patients: For those participants who answered ‘yes’ to question 13 – participants’ estimates of the current percentage (%) of (infection) patient cases in which they use laboratory tests to identify the specific causal bacteria associated with infections, prior to antibiotic use.
15. Laboratory identification methods: For those participants who answered ‘yes’ to question 13 – participants’ top three laboratory tests used to identify the specific causal bacteria associated with infections, prior to antibiotic use: Options: microscopic morphological characteristics (e.g. cocci, rods), differential staining (e.g. gram positive, acid fast stain), biochemical tests (e.g. lactose fermentation), serology (e.g. slid agglutination, serological testing), phage typing, fatty acid profiles, flow cytometry (e.g. for pseudomonas, listeria), plasmid fingerprinting, nucleic acid hybridisation, polymerase chain reaction (pcr) microarray or other.
16. Preferred tests and instrumentation: For those participants who answered ‘yes’ to question 13 – participants’ preferred laboratory tests to allow the identification of the specific causal bacteria associated with infections, prior to antibiotic use.
17. Preferred suppliers: For those participants who answered ‘yes’ to question 13 – participants’ preferred company suppliers of laboratory tests and instrumentation to allow you to identify the specific causal bacteria associated with infections, prior to antibiotic use.
18. Test costs per patient: For those participants who answered ‘yes’ to question 13 – participants’ estimates of the average test costs per patient, to identify the specific causal bacteria associated with infections, prior to antibiotic use.
19. Test time: For those participants who answered ‘yes’ to question 13 – participants’ estimates of the average test time (from sample taking, to the time results are available) to identify the specific causal bacteria associated with infections, prior to antibiotic use.
20. Future identification of causal bacterial types: For those participants who answered ‘no’ to question 13 – participants’ anticipated use of laboratory tests three years from now to identify the specific causal bacteria associated with infections, prior to antibiotic use. [this refers to tests that are able to identify the specific or major causal bacterium or subtype in a particular patient infection, prior to the clinical selection of an antibiotic to treat that infection]
21. Future patients: For those participants who answered ‘yes’ to question 20 – participants’ estimates of the percentage (%) of their (infection) patient cases three years from now, in which they expect to use laboratory tests to identify the specific causal bacteria associated with infections prior to antibiotic use.
22. Future bacterial identification methods: For those participants who answered ‘yes’ to question 20 – participants’ top three laboratory tests three years from now, that they anticipate using to identify the specific causal bacteria associated with infections, prior to antibiotic use. Options: microscopic morphological characteristics (e.g. cocci, rods), differential staining (e.g. gram positive, acid fast stain), biochemical tests (e.g. lactose fermentation), serology (e.g. slid agglutination, serological testing), phage typing, fatty acid profiles, flow cytometry (e.g. for pseudomonas, listeria), plasmid fingerprinting, nucleic acid hybridisation, polymerase chain reaction (pcr) microarray or other.
23. Tests and instrumentation: For those participants who answered ‘yes’ to question 20 – participants’ anticipated preferred laboratory tests three years from now, to identify the specific causal bacteria associated with infections prior to antibiotic use.
24. Preferred suppliers: For those participants who answered ‘yes’ to question 20 – participants’ anticipated preferred company suppliers three years from now, of laboratory tests to identify the specific bacteria associated with infections in prior to antibiotic use.
25. Antibiotic resistance genes: Participants’ current use laboratory tests to identify antibiotic resistance genes in patient samples, prior to antibiotic use.
26. Current patients: For those participants who answered ‘yes’ to question 25 – participants’ estimates of the current percentage (%) of (infection) patient cases in which they use laboratory tests to identify antibiotic resistance genes in patient samples, prior to antibiotic use.
27. Preferred tests and instrumentation: For those participants who answered ‘yes’ to question 25 – participants’ preferred laboratory tests to identify antibiotic resistance genes in patient samples, prior to antibiotic use.
28. Preferred suppliers: For those participants who answered ‘yes’ to question 25– participants’ preferred company suppliers of laboratory tests to identify antibiotic resistance genes in patient samples, prior to antibiotic use.
29. Testing costs: For those participants who answered ‘yes’ to question 25 – participants’ estimates of the average test costs per patient, for identifying antibiotic resistance genes in patient samples, prior to antibiotic use.
30. Test time: For those participants who answered ‘yes’ to question 25 – participants’ estimates of the average test time (from sample taking, to the time results are available) for identifying antibiotic resistance genes in patient samples, prior to antibiotic use.
31. Future identification of resistance genes: For those participants who answered ‘no’ to question 25 – participant’s anticipated use of laboratory tests three years from now, to identify antibiotic resistance genes in patient samples, prior to antibiotic use.
32. Future patients: For those participants who answered ‘yes’ to question 31 – participants’ estimates of the percentage (%) of their (infection) patient cases three years from now, in which they expect to identify antibiotic resistance genes in patient samples, prior to antibiotic use.
33. Antibiotic resistance gene tests and instrumentation: For those participants who answered ‘yes’ to question 31 – participants’ anticipated preferred laboratory tests and instrumentation three years from now, for identifying antibiotic resistance genes in patient samples, prior to antibiotic use.
34. Future suppliers: For those participants who answered ‘yes’ to question 31 – participants anticipated preferred company suppliers three years from now, of laboratory tests to allow them to identify antibiotic resistance genes in patient samples, prior to antibiotic use.
35. Integrated programmes: Participants work with integrated programmes which give access to information on resistant or susceptible bacterial pathogens in their community, prevalent or emerging antibiotic resistance genes or any other 'surveillance-related' information, to support decisions on the use of specific antibiotics. Options: yes/no
36 Current programme: For those participants who answered ‘yes’ to question 35 – participants disclosures on name of the programme and the geographic area in which it operates.
37. Future integrated programme: For those participants who answered ‘no’ to question 35 – participants disclosures on whether they anticipate working with, in three years from now, any integrated programmes that gives access to information on resistant or susceptible bacterial pathogens in your community, prevalent or emerging antibiotic resistance genes or any other 'surveillance-related' information, to support decisions on the use of specific antibiotics.
38. Name and location: For those participants who answered ‘yes’ to question 37 – participants disclosures in the name and geographic location of the integrated programme.
39. Antimicrobial stewardship programmes: Participant disclosures on whether their work is associated with an antimicrobial stewardship programme. [** antimicrobial stewardship refers to coordinated interventions designed to improve and measure the appropriate use of antimicrobials - The Infectious Diseases Society of America (IDSA)].
40. Name and location: For those participants who answered ‘yes’ to question 39 – participants disclosures on the name and geographic location of the antimicrobial stewardship programme.
41. Future antimicrobial stewardship programmes: For those participants who answered ‘no’ to question 39 – participants anticipated activities in three years from now, on whether their work will be linked to or associated with, an antimicrobial stewardship programme.
42. Name and location: For those participants who answered ‘yes’ to question 41 – participants disclosures on the name and geographic location of the antimicrobial stewardship programme.
43. Gram negative bacteria: Participants’ disclosures on the top three gram negative bacteria (where their identities are known or strongly suspected) that are associated with the infections treated in hospitals or clinics. Options: Acinetobacter species, Actinobacillus species, Bacteroides fragilis, Bacteroides sp., Bordetella pertussis, Borrelia burgdorferi, Brucella abortus, Brucella canis, Brucella melitensis, Brucella suis, Campylobacter jejuni, Chlamydia pneumoniae, Chlamydia trachomatis, Chlamydophila pneumoniae, Chlamydophila psittaci, Chlymidia peumoniae, Cyanobacteria, Enterobacter, Erwinia species, Escherichia coli, Francisella tularensis, Fusobacterium nucleatum, Haemophilus influenzae, Helicobacter pylori, Klebsiella pneumoniae, Legionella pneumophila, Leptospira interrogans, Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Proteus bacilli, Pseudomonas aeruginosa, Rickettsia rickettsii, Salmonella typhimurium, Serratia marcescens, Shigella sonnei, Treponema pallidum, Vibrio cholerae, Yersinia pestis or other.
44. Gram positive bacteria: Participants’ disclosures on the top three gram positive bacteria (where their identities are known or strongly suspected) that are associated with the infections treated in hospitals or clinics. Options: Bacillus anthracis, Bacillus cereus, Bacillus subtilis, Clostridium botulinum, Clostridium difficile, Clostridium perfringens, Clostridium tetani, Corynebacterium Diphtheriae, Corynebacterium jeikeium, Enterococcos faecalis, Enterococcos faecium, Enterococcus faecalis, Lactobacillus species, Listeria monocytogenes, Listeria monocytogenes, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, other.
45. Other bacteria: Participants’ disclosures on the top three other bacteria please (where their identities are known or strongly suspected) that are associated with the infections treated in hospitals or clinics. Options: Gardnerella vaginalis, Mycobacterium leprae, Mycobacterium tuberculosis, Mycobacterium ulcerans, Mycoplasma peumoniae, Mycoplasma pneumoniae, other
46. Antibiotics against Gram negative bacteria: Participants’ disclosures on the top three antibiotic classes that are most commonly prescribed to treat gram negative bacteria, in hospitals or clinics. Options: aminocyclitols, aminoglycosides, carbapenems, cephalosporins, monobactams, penicillins, cyclic lipopeptides, folate antagonists, fluoroquinolones, glycopeptides, immunomodulators, ketolides, lincosamides, macrocyclics, macrolides, mycobacterials, nitrofurans, oxazolidinones, peptides, pleuromutilins, polypeptides, pyridopyrimidines, quinolones, streptogramins, sulphonamides, tetracycline, other.
47. Antibiotics against Gram positive bacteria: Participants’ disclosures on the top three please indicate the top three antibiotic classes that are most commonly prescribed to treat gram positive bacteria, in hospitals or clinics. Options: aminocyclitols, aminoglycosides, carbapenems, cephalosporins, monobactams, penicillins, cyclic lipopeptides, folate antagonists, fluoroquinolones, glycopeptides, immunomodulators, ketolides, lincosamides, macrocyclics, macrolides, mycobacterials, nitrofurans, oxazolidinones, peptides, pleuromutilins, polypeptides, pyridopyrimidines, quinolones, streptogramins, sulphonamides, tetracycline, other.
48. Antibiotics against other bacteria: Participants’ disclosures on the top three antibiotic classes that are most commonly prescribed to treat other bacteria, in hospitals or clinics. Options: aminocyclitols, aminoglycosides, carbapenems, cephalosporins, monobactams, penicillins, cyclic lipopeptides, folate antagonists, fluoroquinolones, glycopeptides, immunomodulators, ketolides, lincosamides, macrocyclics, macrolides, mycobacterials, nitrofurans, oxazolidinones, peptides, pleuromutilins, polypeptides, pyridopyrimidines, quinolones, streptogramins, sulphonamides, tetracycline, other
49. Treatment costs: Participants’ disclosures on the average costs for antibiotics per patient, to treat bacterial infections in their hospital or clinic:
50. Single antibiotics or combinations: Participants disclosures on the percentage (%) of their patients who are treated with one, two, three or more than three antibiotics at the same time (enhancers such as lactamase inhibitors are not included). Options1: one antibiotic, two antibiotics together, three antibiotics together, more then three antibiotics, other.
Innovation: In their own field, participants disclosures on what they believe to be the areas of greatest need in terms of innovation or change, to more effectively deal with and manage antibiotic resistance.
51. Barriers: In their own field, participants disclosures on what they believe are the greatest barriers to more effectively dealing with or managing antibiotic resistance.
52. Initiatives: In their own field, participants opinions on what new initiatives government departments can promote, to more effectively deal with or manage antibiotic resistance.

Laboratory


1. Main purpose of participant’s research work: Options: clinical research, routine diagnostics, diagnostics research, clinical trials, patient treatment, disease research, drug research or other.
2. Top three (associated) therapeutic areas: relating to participants work with antibiotics or antibiotic resistance (e.g. general bacterial infections, infections associated with autoimmune disease etc). Options: arthritis, autoimmune diseases, general bacterial infections, bone metabolism, cancer, cardiovascular, central nervous system, dermatology, endocrine, gastrointestinal, genitourinary system, haematology, inflammation, metabolic disorders, musculoskeletal disorders, nutrition, obstetrics and gynaecology, ophthalmology, pain, respiratory, viral infections or other.
3. Main activity: Participants disclosures relating to antibiotics and/or antibiotic resistance. Options: research to identify naturally occurring antibiotics; research to identify semisynthetic, antibiotics, research to identify synthetic antibiotics, new mechanistic strategies to combat antibiotic resistance, new bacterial drug targets
new diagnostics for identifying bacterial types, genetic studies of resistance genes, or the resistome, other.
4 . Antibiotic source: Participants disclosures on the main source of the antibiotics on which they are working. Options: natural, semisynthetic, synthetic, other
5. Gram negative bacteria: Participants’ disclosures on the top three gram negative bacteria, with which they are working. Options: Acinetobacter species, Actinobacillus species, Bacteroides fragilis, Bacteroides sp., Bordetella pertussis, Borrelia burgdorferi, Brucella abortus, Brucella canis, Brucella melitensis, Brucella suis, Campylobacter jejuni, Chlamydia pneumoniae, Chlamydia trachomatis, Chlamydophila pneumoniae, Chlamydophila psittaci, Chlymidia peumoniae, Cyanobacteria, Enterobacter, Erwinia species, Escherichia coli, Francisella tularensis, Fusobacterium nucleatum, Haemophilus influenzae, Helicobacter pylori, Klebsiella pneumoniae, Legionella pneumophila, Leptospira interrogans, Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Proteus bacilli, Pseudomonas aeruginosa, Rickettsia rickettsii, Salmonella typhimurium, Serratia marcescens, Shigella sonnei, Treponema pallidum, Vibrio cholerae, Yersinia pestis or other.
6. Gram positive bacteria: Participants’ disclosures on the top three gram positive bacteria, with which they are working. Options: Bacillus anthracis, Bacillus cereus, Bacillus subtilis, Clostridium botulinum, Clostridium difficile, Clostridium perfringens, Clostridium tetani, Corynebacterium Diphtheriae, Corynebacterium jeikeium, Enterococcos faecalis, Enterococcos faecium, Enterococcus faecalis, Lactobacillus species, Listeria monocytogenes, Listeria monocytogenes, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans, other.
7. Other bacteria: Participants’ disclosures on the top three other bacteria, with which they are working: Options: Gardnerella vaginalis, Mycobacterium leprae, Mycobacterium tuberculosis, Mycobacterium ulcerans, Mycoplasma peumoniae, Mycoplasma pneumoniae, other
8. Companion diagnostics: Participants’ disclosures on their work with antibiotics and/or antibiotic resistance, relating to the use (or not) of companion diagnostic tests. Options: Yes or no.
9. Companion diagnostics: For those participants who answered ‘yes’ to question 8 – participant’s description of the companion diagnostic
10. Identification methods: Participants’ disclosures on the use of bacterial identification methods in their work relating to antibiotics and/or antibiotic resistance. [this refers to tests that are able to identify the specific or major causal bacterium or subtype, prior to the development of antibiotics to target the associated pathogen(s).
11. Methods: For those participants who answered ‘yes’ to question 10 – participants’ top three laboratory tests used to identify the specific causal bacteria associated with their work related to antibiotic resistance Options: microscopic morphological characteristics (e.g. cocci, rods), differential staining (e.g. gram positive, acid fast stain), biochemical tests (e.g. lactose fermentation), serology (e.g. slid agglutination, serological testing), phage typing, fatty acid profiles, flow cytometry (e.g. for pseudomonas, listeria), plasmid fingerprinting, nucleic acid hybridisation, polymerase chain reaction (pcr) microarray or other.
12. Preferred Products: For those participants who answered ‘yes’ to question 10 – participants disclosures on their preferred products for the identification of bacterial pathogens.
13. Preferred supplier: For those participants who answered ‘yes’ to question10 – participants disclosures on their preferred supplier companies for products used for the identification of bacterial pathogens.
14. Future identification methods: For those participants who answered ‘no’ to question 10 – participants disclosures on their anticipated use of bacterial identification methods three years from now, in their work relating to antibiotics and/or antibiotic resistance.
15. Future methods: For those participants who answered ‘yes’ to question 14 – participants anticipated use of bacterial identification methods three years from now, relating to their work on antibiotics and/or antibiotic resistance. Options: microscopic morphological characteristics (e.g. cocci, rods), differential staining (e.g. gram positive, acid fast stain), biochemical tests (e.g. lactose fermentation), serology (e.g. slid agglutination, serological testing), phage typing, fatty acid profiles, flow cytometry (e.g. for pseudomonas, listeria), plasmid fingerprinting, nucleic acid hybridisation, polymerase chain reaction (pcr) microarray or other.
16. Preferred tests and instrumentation: For those participants who answered ‘yes’ to question 14 – participants’ anticipated preferred laboratory tests and instrumentation three years from now, for identifying bacterial pathogens.
17. Future suppliers: For those participants who answered ‘yes’ to question 14 – participants anticipated preferred company suppliers three years from now, of laboratory tests for identifying bacterial pathogens.
18. Antibiotics against Gram negative bacteria: Participants’ disclosures on the top three antibiotic classes that are used against gram negative bacteria, in their work on antibiotics or antibiotic resistance. Options: aminocyclitols, aminoglycosides, carbapenems, cephalosporins, monobactams, penicillins, cyclic lipopeptides, folate antagonists, fluoroquinolones, glycopeptides, immunomodulators, ketolides, lincosamides, macrocyclics, macrolides, mycobacterials, nitrofurans, oxazolidinones, peptides, pleuromutilins, polypeptides, pyridopyrimidines, quinolones, streptogramins, sulphonamides, tetracycline, other.
19. Antibiotics against Gram positive bacteria: Participants’ disclosures on the top three antibiotic classes that are used against gram positive bacteria, in their work on antibiotics or antibiotic resistance. Options: aminocyclitols, aminoglycosides, carbapenems, cephalosporins, monobactams, penicillins, cyclic lipopeptides, folate antagonists, fluoroquinolones, glycopeptides, immunomodulators, ketolides, lincosamides, macrocyclics, macrolides, mycobacterials, nitrofurans, oxazolidinones, peptides, pleuromutilins, polypeptides, pyridopyrimidines, quinolones, streptogramins, sulphonamides, tetracycline, other.
20. Antibiotics against other bacteria: Participants’ disclosures on the top three antibiotic classes that are used other bacteria, in their work on antibiotics or antibiotic resistance. Options: aminocyclitols, aminoglycosides, carbapenems, cephalosporins, monobactams, penicillins, cyclic lipopeptides, folate antagonists, fluoroquinolones, glycopeptides, immunomodulators, ketolides, lincosamides, macrocyclics, macrolides, mycobacterials, nitrofurans, oxazolidinones, peptides, pleuromutilins, polypeptides, pyridopyrimidines, quinolones, streptogramins, sulphonamides, tetracycline, other
21. Novel combinations: Participants disclosures on the use of novel combinations of antibiotics or antibiotic enhancers (e.g. lactamases). .
22. Combinations: For those participants who answered ‘yes’ to question x – participants’, disclosures on the research into novel combinations.
23. Single antibiotics or combinations: Participants disclosures on the percentage (%) of their developments that relate to one, two, three or more than three antibiotics at the same time (enhancers such as lactamase inhibitors are not included). Options1: one antibiotic, two antibiotics together , three antibiotics together, more then three antibiotics, other.
24. Integrated programmes: Participants disclosures on their work with integrated programmes that give access to information on resistant or susceptible bacterial pathogens in their community, prevalent or emerging antibiotic resistance genes or any other 'surveillance-related' information, to support decisions on the use of specific antibiotics.
25. Current programme: For those participants who answered ‘yes’ to question 24 – participants disclosures on name of the programme and the geographic area in which it operates.
26. Future integrated programme: For those participants who answered ‘no’ to question 24 – participants disclosures on whether they anticipate working with, in three years from now, any integrated programmes that gives access to information on resistant or susceptible bacterial pathogens in your community, prevalent or emerging antibiotic resistance genes or any other 'surveillance-related' information, to support decisions on the use of specific antibiotics.
27. Name and location: For those participants who answered ‘yes’ to question 26 – participants disclosures in the name and geographic location of the integrated programme.
28. Antimicrobial stewardship programmes: Participant disclosures on whether their work is associated with an antimicrobial stewardship programme [antimicrobial stewardship refers to coordinated interventions designed to improve and measure the appropriate use of antimicrobials - The Infectious Diseases Society of America (IDSA)].
29. Name and location: For those participants who answered ‘yes’ to question 28 – participants disclosures on the name and geographic location of the antimicrobial stewardship programme.
30 Future antimicrobial stewardship programmes: For those participants who answered ‘no’ to question 28 – participants anticipated activities in three years from now, on whether their work will be linked to or associated with, an antimicrobial stewardship programme.
31. Name and location: For those participants who answered ‘yes’ to question 30 – participants disclosures on the name and geographic location of the antimicrobial stewardship programme.
32. Innovation: In their own field, participants’ disclosures on what they believe to be the areas of greatest need in terms of innovation or change, to more effectively deal with and manage antibiotic resistance.
33. Barriers: In their own field, participants’ disclosures on what they believe are the greatest barriers to more effectively dealing with or managing antibiotic resistance.
34. Initiatives: In their own field, participants opinions on what new initiatives government departments can promote, to more effectively deal with or manage antibiotic resistance.

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