The SAFE Journey : Conquering Superbugs in the City of Gaudí

Two students and a laboratory technician from Rabat (Morocco) write about their participation in a training programme on antimicrobial resistance in Barcelona.

[This article was written by Sobha el Ftouh, PhD student, Research Laboratory of the Universitary Hospital Ibn Sina, Rabat; Asmae Mejahed, Pharmacy student, Abulcasis International University of Health Sciences, Rabat; Rachid Hamidi, Pharmacy student, Abulcasis International University of Health Sciences, Rabat.]

"When different molecules come together, amazing reactions occur”. Thus, when the DNA of a bacterium encounters an antibiotic, ingenious resistances emerge: this encounter gives rise to new mechanisms.. And so it was with our journey as part of the SAFE (Superbug Awareness For Education) programme: a trip from Rabat (Morocco) to Barcelona (Spain), full of experiences that sparked new ideas and paved the way for real solutions to the problem of antimicrobial resistance.

Asmae and Rachid had the opportunity to attend this training programme, organised by the Faculty of Pharmacy of the Universitat de Barcelona (UB) in collaboration with ISGlobal, after winning a competition to design a tool to raise awareness of the insidious pandemic of antimicrobial resistance as part of the SAFE programme. Sobha came as a laboratory technician because she will be replicating the programme in Rabat.

Superbug Awareness For Education (SAFE) is an educational programme launched in January 2020 and implemented in Spain, Portugal and Italy. It targets high school teachers (with an online course) and university and pre-university students in the field of antimicrobial resistance. All SAFE activities within the Mediterranean Health Observatory are funded by the Spanish Agency for International Development Cooperation (AECID) and started last December 2022 in collaboration with the Abulcasis International University of Health Sciences in Rabat.

Why Are We Interested in Antimicrobial Resistance?

Each of the three of us has a personal reason to care about antimicrobial resistance:

• Rachid believes that although antimicrobial resistance is a threat to humanity, there is much we can learn from these tiny creatures, such as their resilience, agility and ability to adapt. "These values and ingenuity fascinated me and I wanted to learn more about them. That's why I took part in the competition organized by the SAFE team," he explains.
• Asmae entered the competition to understand the origin of antimicrobial resistance and how we can tackle it in hospitals.
• Sobha, who is writing her doctoral thesis on antimicrobial resistance in intensive care units, believes it is important to raise awareness. "I also believe that our gut microbiota is the key to health and we need to preserve it," she says.

What Did We Learn about Antimicrobial Resistance?

The training took place at the Faculty of Pharmacy of UB and included seven sessions. The theoretical part covered key issues related to antimicrobial resistance, with a focus on exploring the origins of antimicrobial resistance and the mechanisms for detecting it.

The practical part included a detailed introduction to the SAFE project and an in-depth study of the necessary steps for collecting and culturing soil samples. After preparing the culture medium and culturing the samples, bacterial colonies were obtained, which were then used to inoculate a new culture medium so that pure cultures could be grown. Finally, we performed an antibiotic test on these cultures to see if the cultured bacteria could produce substances that inhibit the growth of superbugs.

“I was surprised to find antibiotics in the soil,” says Asmae. This test was carried out on non-virulent bacteria, similar to the WHO's priority bacteria. In the final practical session, cultures were examined to identify potential candidates for the search for new antibiotic molecules to combat bacterial resistance. “I realized that science and humanity, like resistance, are limitless,” says Rachid.

Increased Awareness of Antibiotic Stewardship in Hospitals

The courses and placements, carried out in optimal conditions, were an opportunity to share rich and varied experiences with students from the same Faculty of Pharmacy and with Professor David Miñana. These privileged moments promoted exchange, reflection and discovery in a studious and convivial atmosphere. In other words, the learning process was very attractive.

"I was impressed by the ease with which this complex issue was illustrated. The simplicity of the material used in the exercise was also inspiring," Sobha. "This trip has inspired me to think about other sources of antibiotics, such as my grandmother's recipes, and to explore the soil and plants around the mountains where I like to practice my hobby of trekking, without forgetting my activity in primary schools to bring children closer to the world of bacteria".

This empirical approach to screening soil microbial biodiversity is of interest for the research and development of new antibiotics to combat the growing threat of antibiotic resistance. In the end, this stay in Barcelona as part of the SAFE initiative was an exceptional academic and human adventure, marked by scientific rigour and benevolent humanism, and full of inspiring reflections.

"Although we are convinced that scientific research requires a lot of resources, I believe that perseverance and simple experiments, such as those carried out in the laboratories in Barcelona, can lead to promising results," says Rachid.

Asmae adds: "Now I am much more concerned about antibiotic stewardship in hospitals. We have to look for new antibiotics, make our environment aware of antimicrobial resistance and always ask for antibiotic susceptibility testing”.