Interview with Annamari Heikinheimo, University Lecturer, Division of Food Hygiene and Environmental Health
Annamari Heikinheimo studies antimicrobial resistance (AMR), the ability of some microbes to fight drugs such as antibiotics. This is a phenomenon parallel to climate change in severity. Resistance develops at an accelerating rate because antibiotics are used so much in today’s world.
I meet Annamari in a coffee room in the EE building in Viikki. A PhD student is tapping away on a PC in the corner. ”We need the space”, Annamari says matter-of-factly, and with the same tone continues: ”In 2050, we’ll all know people who have died of infections immune to any medicine. Then, more people will die of these superinfections than of cancer”. We will have entered a post-antibiotic era, she says.
A little stunned, I listen Annamari explain that bacteria are everywhere on our planet. Some are indispensable for us, some are harmful. Many antimicrobial resistance but the ones that can cause diseases are the problem. Antibiotics spread in the environment as well, and this is why harmless bacteria have had to develop resistance. People transport these bacteria indoors, in hospitals, for instance, and the resistance gene can then end up in hospital bacteria. “People also get these bacteria to their intestines via eating food. When falling sick, entering hospitals and receiving antibiotics, these gut bacteria may become a problem to the patient”, Annamari explains.
“In 2050, more people will die of superinfections than of cancer”
What kind of collaboration do you do with companies?
”I produce information about resistant bacteria and their entry routes to companies on farms, slaughterhouses, in meat industry. I may look at samples of meat, egg, milk, honey, and so on and study prevention measures.”
The topic is extremely sensitive and a huge issue globally. We are used to thinking that we are safe here in Finland, but the phenomenon is highly complex and influenced by the mobility of people, food, and animals. People can also bring the bacteria with them to farms and thence they can end up in food products and finally to humans. On the contrary, resistant bacteria may develop on the farms when using antibiotics on farms.
“Antimicrobial resistance predates humans”
Antimicrobial resistance predates humans
”Resistance to antibiotics has been around for a long time. Bacteria can even give resistance genes or traits or fight one another with it”, Annamari explains. Bacteria reproduce by dividing themselves. DNA is duplicated, a cell divides in two and the daughter cell is a copy. In addition to the one chromosome, there is extra-chromosomal material called plasmids, integrons and other mobile genetic elements.
“Plasmids often control properties that are not entirely indispensable for the survival of the bacterium, such as AMR. These plasmids and the skill set that goes with them can be lost or given away, even to another bacterial species”, Annamari says. Why on earth would a bacterium want to help another species like that? “A good question. Well, bacteria often live in communities with several species, and if they are under a threat, weapons are shared with everyone!”
If we stop using antibiotics, resistance can fade. But not always. It is clear that some bacteria have a permanent capability for it. So if we resume the use of antibiotics, the resistance will spread yet again. ”But an individual person can, in principle, bring a resistant bacterium from abroad and then get rid of it if he/she doesn’t use antibiotics for a long time”, Annamari concludes.
“Together, researchers, farmers, and companies can keep our food safe”
From environment to animals to food
The research on microbes and AMR conducted in the Faculty of Veterinary Medicine is vital also for humans. Animal microbes transfer AMR to bacteria that cause diseases in humans as well. And some of the disease causing bacteria are common to both humans and animals. These bacteria can spread in a direct contact or through the food chain. “I would really stress the importance of the food chain”, Annamari says. ”There can be a hundred-fold difference in the use of antibiotics in meat production in different countries. They can be used as growth-enhancers for perfectly healthy animals.” We are not without problems here in Finland, but globally, the situation is really severe. ”In China, there are bacteria that are immune to any antibiotics – and we all eat foreign food.”
How to fight the resistance?
Antibiotics are not the only antimicrobial substances. Sulphonamide is another, discovered at the same time as penicillin. Other protozoans and viruses exist and phage therapy – viruses attacking bacteria – is a promising field of study. Promising antimicrobial peptides have been isolated from crowberries n the University of Oulu.
Annamari emphasises the work of veterinarians together with farmers and producers: ”Our collaborative work has been crucial for public health. Inspection legislation for milk and meat, pasteurization, ensuring the safety of the whole food chain are examples of it. Now the food chain has diversified. It is not a chain anymore, but rather a net, and the work continues to inhibit the development and transfer of antimicrobial resistance and find ways to prevent infections.”
How does company collaboration help your research?
”We get funding and a means to have an impact. The purity and safety of Finnish food is well known internationally. Together, researchers and companies can make sure that they stay that way. But researchers must be able to raise difficult questions, too, if it seems that things are moving to a bad direction”, Annamari thinks.
Industry collaboration has taught Annamari’s team a lot about Finnish food production. They have received plenty of material support: access to farms, good experimental conditions. Annamari has also seen the difficulties of working with someone’s livelihood. The interests of the companies and researchers are sometimes different. “On average, companies are very responsible in this, it’s about risk management for them. I would like to give positive feedback to Finnish food industry that they have established and maintain Animal Health ETT (Eläintautien torjuntayhdistys ry) which is funded by these companies and working very effectively to maintain Finnish food safety.”
Annamari thinks that negotiating contracts can be challenging. ”You have to know how to define background and result material, responsibilities, risks, trade secrets and all that. The legal team does help us with this but still I am at the centre of it. As a researcher, I would like to have full understanding of what I’m committing myself and my team to, what I can do and what I cannot do, and what the company and we expect from each other. It’s really quite complicated. Training would be necessary!”
”Companies will always have enough questions for win-win projects”
Advice for other researchers interested in business collaboration?
Annamari wants to encourage researchers to do business collaboration but at the same time she reminds them to stay sharp. “It’s important to define your own boundaries and to value your own work and that what you do is useful for the company. You can trust that if you really know and understand the fields of animal disease and food safety, companies will always have enough questions and knowledge-based aims for win-win situations”, she says.
A well planned research project, a clear hypothesis, a good experimental setup, keeping the company involved throughout the project are safe starting points for fruitful collaboration. ”Both parties must understand that they can never be sure about what they will discover. They may find resistance risks that no other company knows about yet and they can be far-sighted and responsible and turn the finding into an asset”, Annamari concludes.