Juan Pablo Horcajada at IMIM: Antibiotics are getting less and less effective

Juan Pablo Horcajada coordinates the Infectious Pathology and Antimicrobial Research group at the IMIM, which was set up in 2014 and comprises fifteen people. “We are a clinical research group and we use our healthcare activity at the hospital to take ideas into our studies”, says the doctor.

Investigating HIV

“One of our research areas involves HIV infection. Through time this has become a chronic disease and no longer has the high mortality rates it had before, so sufferers are starting to get older”, explains Horcajada. They look at inflammation, the microbiome, cardiovascular risk, and bone metabolism in people with HIV, including interesting international collaborations. One part of the group focuses on tuberculosis, a disease that was sometimes associated with HIV. On top of this, they take part in international clinical trials of new drugs for controlling the disease.

Complex bacterial infections

Antibiotics are getting less and less effective against infections. This urgent topic is the group’s other main area of research: complex infections caused by multi-antibiotic-resistant microorganisms, in addition to the pharmacokinetics and pharmacodynamics of antibiotics. “We have to study new molecules as well as doing research on older drugs to make them useful in different ways”, says Horcajada. They look into how to use antibiotics so that they work in the best way possible, and in a personalised manner for each patient.

“In the search for antimicrobial treatments, we investigate infections associated with prosthetics, which are extremely complicated, since their control may be very long term”, states the doctor. There are more and more patients who have hip or knee replacements, wear pacemakers or have vascular bypasses that improve their quality of life, but run the risk of infection. Our goal is to optimise the treatment of these infections to avoid having to remove the prosthesis. Sometimes prosthetic infections are multi-resistant, and in these cases the two areas work together. As part of their complex infection research they also carry out clinical trials with new antibiotics. They sign contracts with industry, and are one of the leading centres for European studies of antibiotics to combat infection by multi-resistant microbes.

Raising awareness of the importance of resistance

“In daily practice we need to be careful with antibiotics, they cannot be used too much because they are losing their effectiveness”, explains Horcajada. The group’s members belong to the Catalan and Spanish societies of infectious diseases and clinical microbiology, and do promotional activities on infectious diseases and resistance to antibiotics. They collaborate with programmes for optimising the use of antimicrobials in hospitals and primary care centres (PROA), as part of the National Plan on Antimicrobial Resistance and the Department of Health’s VINCAT programme. “We try to find out how much resistance there is, and where it is, how we should use antibiotics, and how to optimise their use. We also take part in national and local organisations researching tuberculosis, HIV, and healthcare-related infections, where we do a lot of teaching”, continues the researcher.

Horcajada also coordinates the programme to control hospital-acquired infections at Hospital del Mar, which monitors and prevents intrahospital infections. Among other activities, they control the air and water quality at the hospital to ensure environmental biosecurity. “This multidisciplinary programme is made up of doctors from the infectious diseases service, epidemiology nurses, microbiologists, an environmental biosecurity nurse, and the heads of cleaning at the hospital, as properly cleaning the surroundings of patients is key in avoiding resistance”, concludes the doctor.

 

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