(duplicate) Community-Based Antimicrobial Resistance Spread - Feasibil
Research type
Research Study
Full title
Feasibility Studies to Inform Novel Proposals to Avert Community-Based Antimicrobial Resistance Spread.
IRAS ID
183624
Contact name
Olga Tosas Auguet
Contact email
Sponsor organisation
Guy's & St. Thomas' NHS Foundation Trust
Duration of Study in the UK
1 years, 1 months, 0 days
Research summary
Antimicrobial resistance has become a global threat. Until now, the focus to contain and avert transmission of resistant gram negative bacteria (RGNB) has been limited to the health care setting. Consequently, interventions have had little practical applicability to the wider community. A significant additional and largely unquantified threat is the spread of gut-colonising RGNB in the community that can then gain admission to hospitals. Recognition of this threat has led to an expanding admission screening programme for RGNB in hospitals.
Despite the community reservoir, there is little understanding of the epidemiology and dynamics of RGNB outside the hospital, the potential for household transmission, the role that gut microbiota (bacteria that normally live in the healthy gut) may play in limiting transmission, and of associations between behavioural patterns, gut microbiota and spread of gut-colonising RGNB. These gaps limit the potential for exploiting natural mechanisms or behavioural patterns that can reduce resistance spread in the community in addition to in the hospital.
We plan to address these gaps in large association studies. A population-based study will use spatial models to describe the geographical pattern of gut-colonising RGNB in relation to population traits. Individual-level studies will investigate associations between gut microbiota profile, duration and load of gut colonisation, and transmission potential of gut-colonising RGNB. These studies should characterise population niches that may promote resistance spread and behavioural, environmental and host factors that may suppress resistance carriage through influence on the gut microbiota. Ultimately, these should inform interventions to contain community resistance transmission.
To support these large studies, we are seeking approval to conduct two feasibility studies to test the adequacy of our research methods and data collection processes and offer support for proof of concept. The studies will generate preliminary data on (1) the spatial epidemiology of RGNB in relation to population traits, using clinical isolates from hospitals as proxy for gut-colonising RGNB, (2) the temporal dynamics of gut colonisation by RGNB in relation to gut microbiota profile and household-level transmission potential.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
15/LO/1360
Date of REC Opinion
21 Sep 2015
REC opinion
Favourable Opinion