IORD – Ongoing approved projects and project outputs

Neonatal sepsis is a major cause of death in infants and young children in low-income and middle-income countries. There is increasing concern that rising antimicrobial resistance is reducing the effectiveness of recommended antibiotic treatments. New studies are being set-up to test new approaches to manage this condition, but are hampered by lack of information about … Read more

Antibiotics are mainly old drugs that have been in use for many years. The doses of antibiotics we use to treat infections were mainly worked out using older methods in the 1960s-1980s. Often one fixed dose is used in adults with normal kidney function, and this dose is reduced in adults with poorer kidney function … Read more

Increasingly detailed electronic health records are available and being used to try to work out how to improve management and outcomes in hospitals. However, these data are not always recorded accurately, and the impact of this on how they should best be used is unknown. We plan to look at commonly recorded measurements of patient … Read more

Acute kidney injury (AKI) is a sudden reduction in kidney function (commonly caused by infections and other illnesses) and occurs in about one-fifth of patients admitted to hospital. Compared to admissions not complicated by AKI, hospitalisation with AKI has been associated with longer stay and higher in-hospital mortality. Furthermore, AKI is not only associated with … Read more

Electronic health records (EHR) are increasingly being used to conduct epidemiological research but there is little awareness or guidance regarding appropriate methods to check the validity of using such data when it spans long time periods.  Many things which contribute to how and what data is recorded, such as the reorganisation of services, or updates in … Read more

Fever is an important sign of infection and can be used to work out how to manage patients after they arrive at a hospital Emergency Department (ED) (called a “care pathway”). Often, patients with fever need specific tests or may even be admitted to hospital straightaway (for example if sepsis is suspected; severe infections responsible … Read more

A large number of companies making tests to diagnose infections are aiming to design tests which will be used by GPs in community settings. These rapid tests can give a single result to help doctors decide if an infection is present, or can perform a combination of different tests on a single patient sample at … Read more

The C-reactive protein (CRP) test is used by clinicians in various health care settings. CRP is an acute phase protein released into the blood during an infection or inflammation. There is an increase in the use of CRP test in primary care, accident and emergency departments and outpatient clinics. Measuring CRP in children can be … Read more

Re-admissions are instances where patients are admitted to hospital within a short period of time after having been sent home from a previous hospital admission. Re-admissions have been thought to reflect poor hospital care, with a potential negative impact on patient health. They are expensive for hospitals, which also face financial penalties if re-admissions occur. … Read more

A delayed discharge occurs when a patient remains in hospital after having been declared medically fit to return home from a hospital admission. Patients may remain in hospital for reasons other than medical need due to for example delays in finding appropriate placements for community care, need to make equipment alterations in the home, or … Read more

The numbers of children coming to A&E have steadily increased over the last 5 years, and are continuing to increase. This puts a large burden on NHS staff. However, the reasons behind this increase are not entirely clear. Parents may be bringing children who are less sick because they struggle to get emergency appointments with … Read more

Although relatively rare (under 5%), surgical site infections are the most common complication of planned operations (hospital admissions for what is termed “elective surgery”). Other complications (such as needing to be re-operated on, or even dying) are also rare, but may also be related to underlying infections, even when these cannot be directly identified by … Read more

Urine cultures are the most commonly performed microbiology test at the Oxford University Hospitals but clinical impression is that many of these tests may be unnecessary. IORD provides an opportunity to see if we can answer clinical questions about the value of tests such as urine cultures for clinical management using routinely collected data. We … Read more

Within a hospital, infectious disease can potentially pass from person-to-person through close contact. Without comprehensive data on actual contacts between different patients (contact ‘networks’), it is reasonable to assume that there is an increased chance of transmission of an infection between patients on the same ward, and that this chance would be even higher if … Read more

See manuscript on The Lancet

Summary of findings: We found that increases in severity of C. difficile diarrhoea, likely to due to the arrival of the hypervirulent 027 strain in the UK, could have been detected three years early using routine monitoring of neutrophil counts at diagnosis, compared with looking at patient survival. This study shows how automated electronic systems … Read more