Community-Based Antimicrobial Resistance Spread - Feasibility Studies
Research type
Research Study
Full title
Feasibility Studies to Inform Novel Proposals to Avert Community-Based Antimicrobial Resistance Spread.
IRAS ID
172026
Contact name
Olga Tosas Auguet
Contact email
Sponsor organisation
NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust - King's College London
Duration of Study in the UK
1 years, 1 months, 1 days
Research summary
Bacteria that are resistant to antibiotics are an increasing threat to patients. An immediate challenge comes from resistant Gram-negative bacteria (RGNB), which can be carried in the gut for prolonged periods of time. These organisms may be carried by people without causing illness, but may become relevant if the person becomes unwell or has an intervention such as surgery. It is not known how much transmission of these organisms occurs in the community, and interventions to prevent their spread have so far been focused on hospital settings. It is also not known what effect the gut microbiota (the bacteria that normally live in the healthy gut) affects the carriage of RGNB.
We aim to investigate if the gut microbiota can have a protective effect against RGNB, and therefore, if natural mechanisms that promote healthy gut microbiota could be used to combat RGNB. In order to do this, we are carrying out two proof-of-principle studies. The first (Study A; “Mapping”), will collect data on RGNB from routine samples analysed by the diagnostic laboratories of a hospital cohort and will produce maps of RGNB. This will address whether transmission clusters of RGNB occur in our community and what population traits may be associated with these. The second (Study B; “Tracking”), will follow-up patients who carry RGNB in their gut on discharge from hospital to collect longitudinal stool samples for six months. We will also collect stool samples from other household residents and environmental samples to identify whether household-level transmission of RGNB occurs. We will obtain preliminary data on how household-level transmission relates to colonisation burden and the gut microbiota profile. These studies will inform the feasibility and value of planning subsequent large association studies to explore what factors facilitate community spread of RGNB and what interventions could be exploited to limit this.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
15/LO/0654
Date of REC Opinion
22 Apr 2015
REC opinion
Unfavourable Opinion