Vanesa García: «Antimicrobial resistance could become the first cause of death in the world»
There are many prisms through which the world of public health can be observed. And as time goes by, the importance of making them share spaces and weaving collaborative networks becomes more evident.
The confluence of perspectives and the emergence of synergies that eventually become inescapable make each link in the global chain essential to overcoming challenges such as food, food safety or antimicrobial resistance.
Work such as diagnosing and characterizing foodborne pathogenic bacteria, monitoring high-risk microorganisms, and studying their role in the spread of antimicrobial resistance is crucial for perspectives such as ‘One Health’ to be developed in their fullest dimension.
A very broad dimension that Vanesa García Menéndez, PhD from the University of Oviedo, knows perfectly well.
Her extensive professional background, backed by 15 years of professional career in which she has carried out, among many other things, 11 projects, four contracts in the private sector and more than 40 scientific publications, allows her to enjoy a consolidated vision of the cross-cutting world of food safety and the multitude of actors that come into play in its achievement.
Member of the USC's Escherichia coli Reference Laboratory (LREC), researcher in the National Antibiotic Resistance Plan (PRAN) and, in a few days, assistant professor at Campus Terra, Vanesa García divides her time between research and teaching in the fields of Microbiology, Virology and Food Technology and Safety.
Today, we are drawing on her experience and voice to reveal some of the secrets of this scientific field that is so critical for the immediate future of our society.
-Your experience and research career revolve around the idea of ‘One Health,’ a concept introduced at the beginning of this century that gives much to discuss in the health field. What is this approach based on?
-According to the World Organization for Animal Health (OIE), 60% of the pathogens that cause human disease originate in domestic and wild animals, and 75% of emerging infectious diseases are of animal origin.
The One Health concept is essential for controlling zoonotic diseases and numerous cross-cutting issues such as antimicrobial resistance, food safety and climate change.
The redefinition of the ‘One Health’ concept, updated in December 2021 by the quadripartite OMSA, Food and Agriculture Organization of the United Nations (FAO), World Health Organization (WHO) and United Nations Environment Programme (UNEP), establishes that ‘One Health’ is much more than interdisciplinary collaboration between human and veterinary medicine, requiring multidisciplinary exchanges between different scientific and technological fields without forgetting the fundamental contribution of the humanities and social sciences.
This multidisciplinary collaboration is the philosophy we have been using in our research proposals for years, and it works very well for us, as reflected in the results obtained.
-What are the advantages of applying a cross-disciplinary and interdependent perspective?
-It is the only possible approach to address global priorities such as climate change, food security and antibiotic resistance. I don’t say so myself, but the institutions mentioned above (WHO, FAO, OMSA, UNEP).
-One of your most recent projects was a study on the presence of multidrug-resistant bacteria in supermarket meat, concluding that 40% of the samples were contaminated. How can action be taken to tackle this problem?
-My group has worked on food safety and the ‘From Farm to Fork’ concept for many years. Specifically, the study mentioned is part of a national project PID2019-104439RB-C21 completed at the end of 2023, in which we analyzed a hundred meats (chicken, turkey, pork and beef) purchased directly at the point of sale to the consumer.
Although, in most cases, the microbiological quality was within safe limits based on counts, the protocol we designed and applied in the study allowed us to recover multidrug-resistant Escherichia coli and Klebsiella pneumoniae strains in 40% of all samples.
The study, presented at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) in Copenhagen last year, even attracted the attention of EFSA representatives. Unfortunately, it also generated a lot of alarm. However, we explained to different media that our findings show a downward trend compared to our previous publications and in line with EFSA reports.
We also explained that “Education, cooking and proper handling” are key to reducing infections caused by “superbugs” in food. On the other hand, the different administrations involved in food safety, such as AESAN or EFSA, watch over the consumer’s health. Of course, we must remember the work of public health inspectors, many of whom are veterinarians from this Campus.
-Bacterial resistance to antibiotics is a problem whose consequences, as we have seen, are already suffering. What does this dynamic mean for the global food supply?
-Indeed, we are suffering the consequences of antimicrobial resistance, what we know as the silent pandemic, a pandemic that is estimated could cause ten million deaths a year by 2050 and become the leading cause of death in the world if we do not take action. The WHO has identified antimicrobial resistance as one of the top 10 global public health threats.
It should be remembered that antimicrobial resistance jeopardizes food safety, sustainable production and, globally, the Farm to Fork strategy at the heart of the European Green Pact. And among the challenges for 2030, we have a 50% reduction in antibiotic sales.
Resistant bacteria are found in all ecosystems and can be transmitted from agricultural production systems through the food chain to the consumer, who is exposed through ingesting contaminated food. In addition, antimicrobial resistance can make zoonotic foodborne diseases more difficult to treat.
-What tools and strategies are available to reverse this trend?
-There are several strategies and control plans at both international and national levels to effectively address the challenge of antibiotic resistance and protect food safety and public health in the short and long term.
For example, at the national level, we have the National Plan against Antibiotic Resistance (PRAN), a strategic and action plan approved in 2014, whose objective is to reduce the risk of selection and dissemination of antibiotic resistance under the ‘One Health’ perspective.
The PRAN has six common lines of action for human, animal and environmental health, including surveillance of antibiotic consumption and control of antibiotic resistance, as well as training for professionals, communication and public awareness of this problem. Antimicrobial resistance surveillance programs are also at different points in the food chain.
For example, the National Plan for Official Control of the Food Chain (PNCOCA), which describes the official control systems along the entire food chain in Spain, includes surveillance for antimicrobial resistance of zoonotic food agents, from primary production to points of sale to the final consumer.
Also important is the promotion of sustainable practices that reduce the need for antibiotics in the primary sector, the promotion of research and development of new antibiotics and therapeutic alternatives, and education and awareness of the responsible use of antibiotics in human and veterinary medicine.
-You belong to the LREC group or Reference Laboratory of Escherichia coli of the USC. What are your current lines of research?
-Currently, there are two research lines in the LREC group. Specifically, the line in which I work, led by Professor Azucena Mora, is food safety, antimicrobial resistance and ‘One Health.’ Our projects focus on multidrug-resistant enterobacteria (superbugs), including those resistant to third and fourth-generation cephalosporins and carbapenems, especially E. coli and K. pneumonia, as pathogens of critical priority for the WHO because they can cause serious infections, including urinary tract infections (UTI).
The main reservoir of these UTI-causing bacteria is the patient’s microbiota, a potential source of acquisition, food. Thus, we look for these bacteria in food, production animals, companion animals, wildlife, and the environment; we characterize them and compare their characteristics with those recovered from UTI.
We establish the flow of these bacteria between the different niches covered by the ‘One Health’ concept to identify and develop intervention points to cut their transmission from the farm to the table and the environment. It is important to remember that the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), of which I am a member, warns that in 2023, there were more than 20,000 deaths due to multidrug-resistant infections, which means that in Spain, “20 times more deaths are occurring from this cause than from traffic accidents”. UTIs are the most frequent cause of death from multidrug-resistant infections, and E. coli resistant to extended-spectrum cephalosporins is the most frequent etiology.
In this context, we have completed the national project “Food safety: a study of high-risk clones as vaccine candidates and application of anti-biofilm strategies based on Quorum Sensing”, where we have collaborated with different institutions (Central University Hospital of Asturias, Biomedical Research Center of La Rioja, University of Copenhagen, Federal Institute for Risk Assessment of Germany (BfR)).
Among other findings, we have found that specific E. coli clones recovered from meat and UTI samples show high genomic similarity and a similar ability, in in vitro cell assays, to adhere to and invade bladder epithelial cells.
We have again obtained funding from the state research agency to continue this line of research, “Food safety: integrated monitoring of antibioresistance and intervention targets from the environment, to the farm and to the table,” which makes us very happy. In addition, we also collaborate directly with PRAN and AESAN, whose scientific committee Dr. Azucena Mora is a member of, and we also have contracts with several companies in the veterinary sector to support the use of alternatives to antibiotics.
I am very happy and grateful to Campus Terra because I have recently obtained funding as principal investigator to develop the project “Study of wild boar as a reservoir of E. coli strains with extraintestinal pathogenic capacity for humans/ JABACOLIX” within the call for “Campus Terra Collaborative Projects, University of Santiago de Compostela (USC).”
A project in collaboration with the Veterinary Internal Medicine group and Dr. Ana López Beceiro, also from Campus Terra, will allow us to strengthen and complement the research lines of both groups and initiate students from this Campus in research. In this sense, the LREC projects led by both Dr. A. Mora and myself have been, together with the support of the Campus Terra grants, a source of funding for young people such as Sofía Travers, Carla Polo, Leticia Carballeira and Pablo Gallego, students of the Degree in Veterinary Medicine and Biochemistry who, thanks to these grants, have been initiated into the fascinating world of research.
In addition to the research activity, we also disseminate and communicate our projects. We are participating, together with other groups of Campus Terra, in the FECYT project “Ciencia á Feira,” through which we will make known the problem of antibiotic resistance in schools and fairs in different municipalities of Lugo. I should also mention that I am participating in the scientific organization of the “Congreso Ibérico da Mocidade Investigadora do Campus Terra’ Raíces do coñecemento’ (to be held in October), an initiative of Campus Terra that offers a unique opportunity for both undergraduate and Master students and young researchers to learn about the excellent lines of research being developed in this Campus.
-What is the importance of this type of scientific grouping in the current scenario?
-Obtaining funding is becoming increasingly difficult, so being part of scientific groups, where the potential of a group of scientists is added, increases the chances of continuing to grow in research. In this sense, being part of a group or cluster is important.
In this case, the LREC is a competitive reference group of the Xunta de Galicia, so we obtained funding from the Xunta de Galicia thanks to the fulfillment of certain requirements and the sum of the research activities of all the group members. Having two lines of research strengthens us. The idea is that they will increase as the “juniors” become “seniors” and we train new young people.
-During your career, you have made several international stays that, among other things, have broadened your horizons as a researcher. What do you take away from these experiences?
-My doctoral thesis was developed under a co-supervision agreement between the University of Oviedo and the University of Osnabrück (Germany), through which I made two stays of 6 and 3 months in Osnabrück, which allowed me to obtain my doctoral degree from both universities. Subsequently, I received a postdoctoral grant from the Xunta de Galicia, allowing me to attend the University of Copenhagen for 30 months.
During these stays, I was fortunate to collaborate and meet researchers from different parts of the world, acquire a global perspective on my field of study, and learn new methodologies, approaches and scientific cultures, which have been fundamental to broaden my horizons and continue to grow.
Based on my experience, stays are essential for any researcher. It is not only about acquiring new knowledge and skills; it is also about integrating teamwork, coordination, collaboration and open-mindedness into a new group. It is an excellent opportunity for learning and professional and personal growth. I have made friends and collaborators from these stays and incorporated these into my projects. They are also an opportunity for our students to have the same chance I had in my day.
-During your stay at the University of Copenhagen, your work focused on identifying essential genes in the uropathogenic Escherichia coli bacteria, the main cause of human urinary tract infections. What were the conclusions of this work?
-In the project that I developed during my stay at the University of Copenhagen, applying the TraDIS methodology, we identified and validated genes essential for the growth of uropathogenic E. coli in culture media and, to cause a UTI, we saw that these genes differ according to the culture medium. In addition, we improved the murine model of urinary tract infection, identifying and confirming several relevant factors during the development of a UTI, which could be targets for developing new therapies or treatments against UTI.
During this stay, I could also participate in other projects and collaborate with my colleagues; it was a fruitful period, with more than ten publications. In addition, once here at Campus Terra, I have implemented some of the techniques I developed in Copenhagen in our group, such as cell infections or mutagenesis.
-Finally, what role does genetic research play in the One Health concept?
-Genetic and genomic tools are essential to understand better how microorganisms flow between the three unique health interfaces (human, animal and environmental).
We combine conventional microbiology with genomics. This allows us to be sure of what is in the samples, identify and characterize clones, develop vaccines, and search for alternatives to antibiotics (vaccines, phage studies). We are starting with metagenomics. This year has been intense, but we already have several advanced studies combining different in vitro, in vivo and omics methodologies.