International Research Consortium Established to Study Antimicrobial Resistance in Iceland

December 5, 2019

WASHINGTON, DC (Dec. 5, 2019) — An interdisciplinary, international consortium has been formed to study antimicrobial resistance in Iceland, a unique and ideal location to study this growing public health threat. The consortium will undertake a national scale One Health study to advance our understanding of how antimicrobial-resistant bacteria from environmental sources, such as food and food animals, could impact human health.

The consortium will conduct a national study to map out antimicrobial-resistant bacteria in diverse settings, including the major species of domestic food animals, as well as both domestic and imported meats in Iceland, and compare them to the bacteria causing infections in Icelandic residents over the next five years.

“The ecology of antimicrobial resistance is complex outside of the laboratory, so we’re starting in Iceland – a relatively small, geographically-isolated country with an excellent public health infrastructure – to start chipping away at this issue,” said Lance B. Price, PhD, founding director of the Antibiotic Resistance Action Center (ARAC) at the George Washington University Milken Institute School of Public Health (Milken Institute SPH), one of the leads in the consortium.  “It’s refreshing to work in a country, where everyone shares such a strong commitment to public health and to the global fight against antimicrobial-resistant infections. I couldn’t be more excited about this project.”

The consortium encompasses important industries and sectors that are vital to studying the ecology of bacteria and antimicrobial resistance and its impact on animals, food and people. It is led jointly by ARAC and Landspitali, the National University Hospital of Iceland. Other partners include the Center for Ecosystem Science and Society (ECOSS) at Northern Arizona University, the Institute for Experimental Pathology at the University of Iceland at Keldur, the Icelandic Food and Veterinary Authority (MAST) and MATÍS at the University of Iceland.

Unique features of Iceland include its geographical isolation, the relatively homogenous population, and its excellent tracking of antimicrobial use in both humans and animals.  However, there are also some emerging threats to its enviably low antimicrobial resistance, including an expected change to their policy of not importing fresh meat. In addition, Iceland has a population of approximately 350,000 residents, but its booming tourism industry brings more than 2 million visitors to Iceland each year from all corners of the world.

“Iceland currently has one of the lowest antimicrobial-resistant infection rates in the world, even lower than some other countries that use less antimicrobials than we use in our hospitals. If we can understand how we have achieved this, then we stand a better chance of maintaining our fortunate status and, hopefully, help other countries reduce their resistance rates,” said Karl G. Kristinsson, MD, PhD, Head of the Department of Clinical Microbiology at Landspitali University Hospital. “There is significant discussion taking place in Iceland about recent policy changes related to importing and consuming of raw imported meat, so it’s very important we understand the implication of trade and policy changes on antimicrobial resistance. Not only is it important for Iceland, but it can also be useful for the rest of the world.”

The consortium’s ultimate goal will be to better understand the dynamics of antimicrobial-resistant bacteria among humans, animals, and the environment and use this knowledge to build evidence-based policies.

'We're really eager to work with our collaborators on two questions where ecosystem science and society meet: how can ecological tools help us learn about how antimicrobial resistance spreads, and what can we do to protect the microbial communities that keep us healthy?” said Bruce Hungate, PhD, director of the Center for Ecosystem Science and Society at Northern Arizona University.

The near-term goal of the consortium will be to study how an expected policy change in Iceland – one that will allow the import of fresh meats – will affect the types of antimicrobial-resistant infections seen in Iceland.

“We are thrilled about this opportunity to work with our colleagues in the consortium to answer some pressing questions about how complex real-world factors such as trade, food production, travel, and transmissions in the community and hospitals affect antimicrobial resistance,” said Cindy Liu, MD, MPH, PhD, chief medical officer at ARAC. “What we learn about our first target pathogen (Escherichia coli) could help us understand other pathogens and develop solutions to combat the growing threat of antimicrobial resistance.”