A Doctor’s Mission to Stop Superbugs

Interview with Nasreen Hassoun-Kheir: PrIMAVeRa

The PrIMAVeRa project has made a significant contribution to the fight against antimicrobial resistance (AMR). One example is a recent perspective article that sets out a forward-looking research agenda. The lead author, Nasreen Hassoun-Kheir explained how systematic reviews and a Delphi exercise were used to pinpoint urgent research priorities, emphasising the critical need for innovative preventive and treatment solutions, such as vaccines and monoclonal antibodies (mAbs). Addressing these priorities will not only strengthen the evidence base for future burden estimates but also tackle the growing AMR burden in Europe. By providing clear guidance, this research agenda is intended to inspire funders and researchers to address the most pressing knowledge gaps in AMR.

Can you tell us about your background and what inspired you to pursue research in AMR?

I am a medical doctor specialising in infectious diseases and infection control, with extensive experience in a high AMR setting. During my clinical practice, I handle difficult-to-treat infections daily. The challenges of managing resistant infections have inspired me to pursue research in AMR, aiming to understand its impact and develop interventions to stop its spread. To further enhance my skill set, I am also working towards a Master’s degree in epidemiology, focusing on infectious diseases. This additional training allows me to better study AMR and explore methods to limit its dissemination using established study methodologies. Witnessing the severe impact of AMR on my own patients’ outcomes firsthand and on a public health scale has enhanced my commitment to better understand AMR and explore effective solutions to combat this global threat.

Nasreen Hassoun-Kheir is an infectious diseases doctor working as a research fellow at the Geneva University Hospitals and WHO collaborating centre on AMR.

What specific aspects of AMR are you investigating?

My research focuses on several critical aspects of AMR, including hospital-acquired infections, impact of infection control and prevention interventions, and transmission dynamics of multidrug-resistant (MDR) pathogens among hospitalised patients. I have conducted studies on carbapenem-resistant Enterobacterales (CRE), examining risk factors, clinical significance, and the impact of CRE colonisation in hospitalised patients. I am also interested in assessing the overall burden of AMR, which is the stem of my work in the PrIMAVeRa project. I recently received the European Society of Clinical Microbiology and Infectious Disease (ESCMID) Young Investigator research grant to study the association between the appropriateness of empirical antimicrobial treatment and outcomes in patients with bloodstream infections. I’m also deeply interested in One-Health research and in the role of aquatic ecosystems as reservoirs for resistant pathogens, and I’m involved in JPIAMR projects focusing on the role of the hospital environment in the dissemination of multidrug-resistant Gram-negative organisms (RESERVOIR project).

AMR research is one of the most complex global challenges. What motivates you?

I stay motivated and passionate about my work by continuously focusing on its potential impact on public health. The potential to contribute to significant improvements in infection control and AMR management drives me forward. Engaging with passionate colleagues, staying updated on advancements in the field, and witnessing the outcomes of our research keep me inspired and encourage me to fulfill my goals.

What advice would you give other researchers or students interested in AMR research?

For those interested in AMR research, my advice is to stay curious and open-minded. Building a strong basis in clinical and research skills is essential to achieve the best results. My main advice is to stay persistent and keep trying, even if things don’t work out at first. The field can be tough, and you might face problems, but each challenge is a chance to learn and improve. Keep pushing forward, and your efforts will eventually lead to great results.

In your opinion, what role can the public play in the fight against AMR?

The public can contribute to the fight against AMR by using antibiotics responsibly, such as only taking them when prescribed by a healthcare professional. Additionally, practising good hygiene, such as regular handwashing and staying up-to-date with vaccinations, can help prevent infections and reduce the actual need for antibiotics. Educating themselves and others about AMR and supporting initiatives that promote responsible use of antimicrobials also play an important role in combating resistance.

You are a medical doctor, research fellow, and a Master’s student. How do you balance different roles in your life?

Balancing my professional and personal life involves careful time management and prioritising both work and family. I make sure to set aside quality time to spend with my husband and three daughters, integrating fixed timed for family activities within my daily schedule. Staying organised and maintaining clear boundaries between work and personal time is not an easy task, but it helps me stay focused and present in both areas.

Want to know more? Take a look at other publications from PrIMAVeRa:

  • Hassoun-Kheir N, Guedes M, Arieti F, et al. Expert consensus on antimicrobial resistance research priorities to focus development and implementation of antibacterial vaccines and monoclonal antibodies. Eurosurveillance. 2024;29(47):2400212. doi:10.2807/1560-7917.ES.2024.29.47.2400212
  • Leclerc QJ, Duval A, Guillemot D, Opatowski L, Temime L. Using contact network dynamics to implement efficient interventions against pathogen spread in hospital settings: A modelling study. PLOS Medicine. 2024;21(7):e1004433. doi:10.1371/journal.pmed.1004433
  • Pezzani MD, Arieti F, Rajendran NB, et al. Frequency of bloodstream infections caused by six key antibiotic-resistant pathogens for prioritization of research and discovery of new therapies in Europe: a systematic review. Clinical Microbiology and Infection. 2024;30:S4-S13. doi:10.1016/j.cmi.2023.10.019
  • Robotham J v., Tacconelli E, Vella V, de Kraker MEA. Synthesizing pathogen- and infection-specific estimates of the burden of antimicrobial resistance in Europe for health-technology assessment: gaps, heterogeneity, and bias. Clinical Microbiology and Infection. 2024;30:S1-S3. doi:10.1016/j.cmi.2023.10.004
  • Kingston R, Vella V, Pouwels KB, et al. Excess resource use and cost of drug-resistant infections for six key pathogens in Europe: a systematic review and Bayesian meta-analysis. Clinical Microbiology and Infection. 2024;30:S26-S36. doi:10.1016/j.cmi.2023.12.013
  • Hassoun-Kheir N, Buetti N, Olivier V, et al. Targeted mupirocin-based decolonization for Staphylococcus aureus carriers and the subsequent risk of mupirocin resistance in haemodialysis patients – a longitudinal study over 20 years. Journal of Hospital Infection. 2023;135:55-58. doi:10.1016/j.jhin.2023.01.019
  • Hassoun-Kheir N, Harbarth S. Estimating antimicrobial resistance burden in Europe—what are the next steps? The Lancet Public Health. 2022;7(11):e886-e887. doi:10.1016/S2468-2667(22)00250-X
  • de Kraker MEA, Harbarth S. Global burden of antimicrobial resistance: essential pieces of a global puzzle. The Lancet. 2022;399(10344):2347. doi:10.1016/S0140-6736(22)00940-0