Characterising AMR in care homes using WGS

  • Research type

    Research Study

  • Full title

    Characterising Antimicrobial Resistance in Care Homes using Whole Geneome Sequening

  • IRAS ID

    266199

  • Contact name

    Benjamin Parcell

  • Contact email

    b.parcell@nhs.net

  • Sponsor organisation

    University of Dundee

  • Duration of Study in the UK

    3 years, 5 months, 31 days

  • Research summary

    Antimicrobial resistance (AMR) is a global public health threat and is problematic among resident of care homes. The problem of AMR (which in this context means the same as antibiotic resistance) happens when antibiotics become ineffective against previously susceptible bacteria, resulting in persistent, complicated infections.
    Prescribing antibiotics for care home residents is a complicated and multifactorial problem. Care homes are enclosed environments with high numbers of frail elderly people living together, requiring daily living assistance, antibiotics to treat infections because they are more prone to infections due to compromised immune system and use of invasive devices such as catheters (one of the main reason for urinary tract infection). There are some adverse effects of antibiotics such as the risk of colonisation and future infection with resistant bacteria.

    Frequent opportunities for bacterial transmission occurs in care homes through group activities, sharing of living space, objects, bathroom facilities and frequent hospital visits. The transmission of infection challenges healthcare facilities in the implementation of effective infection control policies to prevent further spread.

    There is not much work on how bacteria are transmitted within the care homes or any method of identification of highly (colonised patients) to help prescribe more appropriate antibiotics. So what is the role of bacteria in transmission? What is the role of resident factors? What should be the focus of antibiotic prescribing and infection control interventions? To answer these questions it is important to understand the underlying causes of AMR.

    This study will use bacterial genomic data from clinical samples from the residents of care homes and link with source patients’ electronic health record (EHR) to inform on bacterial epidemiology and resident risk factors for AMR. This will help inform future research and better infection control and antibiotic prescribing guidelines in care homes.

  • REC name

    East of Scotland Research Ethics Service REC 1

  • REC reference

    19/ES/0096

  • Date of REC Opinion

    27 Aug 2019

  • REC opinion

    Favourable Opinion