Dynamics and Drivers of Antimicrobial Resistance

  • Research type

    Research Study

  • Full title

    Understanding the variation in microbial diversity and the abundance of antimicrobial genes in patients living in rural NHS Lothian as part of larger project -Investigating the Multi-scale Dynamics and Drivers of Antimicrobial Resistance in One Health Systems of China and the UK

  • IRAS ID

    358710

  • Contact name

    Ross Fitzgerald

  • Contact email

    ross.fitzgerald@roslin.ed.ac.uk

  • Sponsor organisation

    The University of Edinburgh

  • Clinicaltrials.gov Identifier

    MR/Y015169/1, MRC reference number of grant secured for larger project titled 'Investigating the Multi-scale Dynamics and Drivers of Antimicrobial Resistance in One Health Syste' in which this study is embedded in.

  • Duration of Study in the UK

    3 years, 0 months, 1 days

  • Research summary

    This study will analyze human-associated bacterial communities and their antibiotic resistance profiles over two years among people living near farms in the Lothian region. We will examine urine, stool, and skin swabs from human samples submitted from specific postcodes to NHS microbiology laboratories. Samples will be collected every six months at four timepoints. Bacterial isolates and original microbial samples will be gathered at the 'point of discard', meaning they come from routine clinical care and require no active participant involvement. We will record the age, gender, and antimicrobial history of the patients.

    We will isolate and perform whole genome sequencing (WGS) on clinically relevant bacteria (e.g. E. coli, S. aureus) to obtain complete DNA information on the bacterial strains found amongst patients. Additionally, metagenomic sequencing will analyze all genomic material in the original samples. This will enable us to track species divergence and antimicrobial resistance among patients, as well as map out microbial species variance between patients. The results will contribute to a broader study investigating bacterial transmission dynamics and antibiotic resistance patterns across various 'One Health' niches—including soil, wastewater, livestock, and humans—by incorporating data from farming and sewage samples alongside the human microbiological samples. The ultimate aim of this larger study is to explore how bacterial strains and antimicrobial resistances emerge and are transmitted across these diverse One Health contexts. In the end, our study provides a 2-year genomic surveillance of the Lothians, which is of great public interest as it can inform potential infection sources, levels of drug resistance in the community, and insights into how bacteria spread and evolve.

  • REC name

    East Midlands - Nottingham 2 Research Ethics Committee

  • REC reference

    25/EM/0215

  • Date of REC Opinion

    16 Sep 2025

  • REC opinion

    Favourable Opinion