A Swiss centre of expertise to combat new types of resistance to antibiotics has recently been established at the University of Fribourg under the aegis of the Swiss Federal Bureau of Public Health.

Since the beginning of 2017, the University of Fribourg has been home to the National Reference Centre for the Early Detection and Monitoring of Antibiotic Resistance (NARA). It is the first Swiss Reference Centre for medicine to be set up in the Canton of Fribourg. This is a response to a challenging public health situation and arises out of a national strategy developed to meet this challenge.

NARA has been placed under the direction of Patrice Nordmann, Professor of Medical and Molecular Microbiology in the Department of Medicine at the University of Fribourg, who has long studied resistant bacteria and in his areas of expertise has been awarded, amongst others, the prizes of the European Society of Clinical Microbiology and Infectious Diseases, 2013, the American Society of Microbiology, 2105, as well as the Louis Pasteur Prize of the Paris Academy of Sciences, 2012.

A public health challenge
Antibiotic-resistant bacteria are increasing rapidly over the whole world, in particular in developing countries, but also in countries like Greece, Italy and the United States, where multi-resistant bacteria have been discovered. In Switzerland, the overall epidemiological situation is better, but it too cannot escape the global trend toward multi-resistance, in particular because of the importation of strains from elsewhere in the world.

In the light of this situation, on 18 November 2015 the Federal Council adopted the National Antibiotic Resistance Strategy (StAR) which came into effect at the beginning of 2016. Within this framework, NARA was assigned to the Medical and Molecular Microbiology Unit of the Department of Medicine at the University of Fribourg in December 2016. This unit is also the site of the only foreign research unit located on Swiss soil of the National Institute of Health and Medical Research, Paris (INSERM), enabling an optimal synergy with several research groups in microbiology and infectious diseases working in university hospitals in Paris. This research activity also results in numerous international publications by the Fribourg Microbiology Unit .

Rapid detection tests
NARA’s main mission is the early detection of the emergence of any new form of antibiotic  resistance in Switzerland which might impact on public health. If the need arises, NARA will be in a position to suggest an optimal antibiotic treatment, issue therapeutic advice to the doctors treating infected Swiss patients and contribute to the management of multi-resistant bacterial epidemics in Switzerland.

NARA has also taken on the task of developing new rapid diagnostic tests which now require complementary approaches involving rapid culture, biochemistry, immunology and molecular biology. The aim is to get results within 2 hours of receiving an infected sample. These rapid tests are produced at the University of Fribourg and then validated in numerous European and North American hospitals.

Monitoring technology
Another of NARA’s tasks is the evaluation of new diagnostic techniques developed by Swiss or foreign universities and industries in order to recommend the most up-to-date diagnostic tests to all Swiss laboratories and to evaluate new antibiotic treatments.

NARA also works in partnership with Swiss veterinary hospitals (VetSuisse) and Swiss hospitals (notably CHUV (Centre Hospitalier Universitaire Vaudois), the Fribourg Hospital Network, the Neuchâtel Hospital Network and private laboratories), as well as the Swiss Centre for the Epidemiological Monitoring of Antibiotic Resistance (ANRESIS).

Apart from Professor Patrice Nordmann who specialises in microbiology and infectious diseases, the scientific staff of NARA includes Dr Dominique Blanc in the areas of microbial epidemiology and the prevention of hospital-acquired infections (CHUV) and Dr Laurent Poirel (Microbiology Unit, Fribourg) whose competence lies at the interface between observed emerging resistances in humans and those observed in animals. The laboratory hosts Swiss and foreign students and interns of all kinds (doctors, pharmacists, biologists and other scientists), and so underpins their training and the influence of Swiss medicine.

An international symposium on emerging resistances under the auspices of the European Society of Clinical Microbiology and Infectious Diseases will be organised at the University of Fribourg on 14-15 September 2017.