In spite of a century of often fruitful control and prevention efforts, infectious diseases remain a major problem in public health, causing over 14 million deaths every year in the world. Four infectious diseases (lower respiratory infections, diarrhoeal diseases, HIV/AIDS and tuberculosis) are among the 10 leading causes of death in the world. Furthermore, new epidemic or pandemic threats are constantly emerging, others practically extinct re-emerge. Severe bacterial infections, including nosocomial infections, are a well-recognized but still increasing concern. Acquired bacterial resistance to antibiotics has now become extensive and has reached dangerous levels even beyond the limits of hospital environment. HIV infection is not only spreading at an alarming rate in developing countries, but continues to pose serious patient management questions in France. Two main causes explain these facts. On the one hand, demography, behaviour and technology changes in the human societies associated with the 20th century ecological alterations of the planet have created the ideal conditions for the emerging and spread of infectious agents. The multiplication of the migration of humans all over the world now implicates that no infectious agent, including multiresistant bacteria, is confined to one region of the globe. On the other hand, the constant ability of microorganisms to evolve and adapt allows them to find new environmental niches, to diversify their pathogenicity and to increase their drug resistance.
The goal of the laboratory is to study, through a multidisciplinary approach, at both microbial population and human population levels, the ecological and evolutionary forces as well as the mechanisms allowing microorganisms to adapt, to become virulent and resistant to antimicrobial agents. Three major microorganisms are mainly studied, Escherichia coli and others multiresistant enterobacteriaceae, HIV and HCV. We search to optimise the current preventive and therapeutic strategies to fight these pathogens and we develop new approaches on both aspects. The effectiveness but also cost and cost-effectiveness of these interventions are evaluated to propose decision-making strategies.
Our research is characterised by both fundamental and applied approaches. We develop projects with immediate implications on the management of patients and decision-making processes in health institutions but also more fundamental projects devoted to better characterise the genetics, physiology and ecology of infectious agents, and theoretical approaches in statistics and population genetics to develop new framework to analyse these agents. The interplay between these different approaches is a key point of our laboratory. To achieve such research, IAME mixes basic scientists with medical doctors from various specialities and puts a special emphasis on mathematical and statistical approaches.