5 Technologies That Could Combat Antimicrobial Resistance.

The flu, measles, pneumonia, and other microbial infections once were easy to treat with antibiotic, antifungal, and antiviral medications. The conditions have become more resistant to drugs, however, increasing the chances of deadly outcomes caused by bacterial, viral, fungal, and parasitic infections. Antimicrobial resistance (AMR) caused more than 1 million deaths in 2021, according to a 2024 report published in The Lancet. The World Health Organization declared in 2023 that AMR had become a major global health threat.

AMR can be blamed on a number of things including the overuse of antibiotics in people, animals, and plants; inadequate sanitation; and a lack of new medications. Other factors include ineffective prevention measures and a dearth of new tools to detect infections.

To discuss how technology can assist with preventing the spread of AMR, the Engineering Research Visioning Alliance held a two-day event last year, attracting more than 50 researchers, industry leaders, and policymakers. The ERVA, funded by the U.S. National Science Foundation, identifies areas that address national and global needs that any parties that fund research—companies, government agencies, and foundations—should consider. The alliance has more than 20 affiliate partners including IEEE.

“ERVA is not necessarily about finding a solution tomorrow,” says Anita Shukla, who chaired the February 2024 event. “It’s about creating long-term research directions that may help minimize, mitigate, or eradicate problems over the long term. We’re enabling research or ideas for research.”

Shukla, a professor of engineering at Brown University, in Providence, R.I., researches biomaterials for applications in drug delivery, including the treatment of bacterial and fungal infections.

The alliance recently released “Engineering Opportunities to Combat Antimicrobial Resistance.” The report identified five grand challenges for researchers: diagnostic biosensors and wearables, engineered antimicrobial surfaces, smart biomaterials, cell engineering, and advanced modeling approaches.

Biosensors to speed up detection

Faster, more accurate, and less expensive diagnostic tools and wearables are needed to better detect infections, the report says. It suggests the development of diagnostic biosensors, which could detect specific components of pathogens within a sample. The biosensors could collect the sample from the patient in a minimal or noninvasive way, according to the report.

The traditional method to find out if someone has an infection is to collect samples of their cells, tissue, blood, mucus, or other bodily fluids and send them to a laboratory for analysis. Depending on the type of infection and test, it can take a few days to get the results.

The alliance suggested the development of diagnostic biosensors that could detect bacteria, viruses, fungi, and parasitic pathogens within the sample on-site. Results need to be provided quickly—ideally in a few hours or less, the report says—in order to reduce the spread of the infection, lessen recovery time for patients, and lower health care costs.

But first, research is needed to develop biosensors that can detect low levels of infection-related biomarkers from patient samples, the report says. A biomarker is a measurable indicator, such as a gene, that can provide information about a person’s health. Currently it can take several days to weeks for a person’s immune system to produce enough antibodies to be detected, delaying a diagnosis.

“I think IEEE members have the right skill set and could make quite a difference if they, along with other engineers, work together to solve this very complex problem.” —Anita Shukla, engineering professor at Brown University, in Providence, R.I.

The authors call for engineers, clinicians, and microbiologists to collaborate on creating devices and designing them for use in clinical settings.

The advancements, the report says, can be incorporated into existing smart devices, or new ones could be designed that are infection-specific.

Another area that should be explored, it says, is developing wearable devices to allow patients to accurately diagnose themselves.

“Engineers, particularly electrical engineers who have a lot of knowledge on various biosensor design and wearable technologies, are the individuals who need to innovate in this space and produce these technologies,” Shukla says.

Cleaner surfaces to stop germ propagation

One way infections spread is from bacteria-contaminated surfaces including hospital beds, medical equipment, doorknobs, and desks. No matter how stringent hospital protocols are for sterilization, sanitation, and disinfection, bacteria attach to most things. The ERVA report notes that more than 90 percent of curtains used by hospitals for privacy between patients in shared rooms are contaminated after one week.

The authors say it’s imperative to develop antimicrobial surfaces that can kill bacterial and fungal pathogens on contact. Also needed are materials that release antimicrobial agents when touched, including metals, polymers, and composites.

New engineered antimicrobial surfaces have to be durable enough to withstand the sanitation and sterilization methods used in hospitals and other clinical settings, Shukla says.

Other locations where antimicrobial surfaces should be installed, she adds, include schools and office buildings.

Smarter materials to deliver medication

Dressings and other biomaterial-based drug delivery methods used today to deliver antibiotics directly to a potential infection site aren’t advanced enough to control the amount of medication they release, according to the report.

That can lead to overuse of the drug and can exacerbate AMR, the report says.

Smarter biomaterials-based delivery systems that release antimicrobials are an urgent area of research, the authors say. Nano- and microscale particles and polymer gels that can release drugs only when a bacterial infection is present are a few examples cited in the report.

“These are materials that can release therapeutics on demand,” Shukla says. “You expose the infection to the therapeutic only when it’s needed so that you’re not introducing more of the drug [than required]—which potentially could accelerate resistance development.”

The materials also should contain components that sense the presence of a bacteria or fungus and signal whether the patient’s immune system is actively fighting the infection, the report says. The germ’s presence would trigger an encapsulated antibiotic or antifungal to be released at the infection site.

There’s an opportunity for electrical engineers to develop components that would be incorporated into the smart material and respond to electric fields to trigger drug release or help detect infection, Shukla says.

Drug-free cellular engineering

Another area where electrical engineers could play a big role, Shukla says, involves immune cells. A potential alternative to antibiotics, engineered white blood cells could enhance the body’s natural response for fighting off infections, according to the report. Such a drug-free approach would require advances in cellular engineering, however, as well as a better understanding of genetically manipulating cells.

For people with persistent infections, it’s important to study long-term interactions between engineered immune cells and bacteria, the report says. Research into creating engineered microbes with antimicrobial activity could help reduce antibiotic use and might prevent infections, it says.

Using advanced modeling to develop new drugs

The alliance says significant research is needed for developing computational modeling. The technology could be used to rapidly develop complex bacterial infection models to evaluate the effectiveness of new antimicrobial drugs and therapeutics.

“Modeling has the opportunity to speed up the development of new drugs and potentially predict the outcomes of new treatments, all in a way that’s less expensive and less subject to the variability that often happens with laboratory-based tests,” Shukla says.

AI-based tools are already being used to predict or develop potential therapeutics, she adds, but new algorithms and approaches are still needed.

“I think IEEE members have the right skill set and could make quite a difference if they, along with other engineers, work together to solve this very complex problem of AMR,” Shukla says. “People working in silos is a problem. If we can get people working together to really tackle this problem, that’s how AMR is going to be solved.”

You can watch Shukla discuss the findings of the visioning event in this webinar, produced on 27 March.