Antimicrobial resistance is a growing threat to public health worldwide. In hospitals, if antibiotics do not treat severe infections effectively this can lead to more deaths and longer hospital stays. However, prompt adjustments to antibiotic treatments to switch to an antibiotic that works may ... READ MORE
IORD – Ongoing approved projects and project outputs
Ranges of laboratory test results observed in hospitalised neonates
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 ... READ MORE
Impact of weight and renal function on antibiotic doses received, and potential impact on CRP response
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 ... READ MORE
Recording of routine physiological measurements and potential for impact on analyses of electronic health records
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 ... READ MORE
Examining the independent predictive value of acute kidney injury among patients with and without infection on outcome in the Oxford University Hospitals NHS Foundation Trust
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 ... READ MORE
Using unsupervised computational methods on electronic health records, to identify changes in underlying infrastructure or data quality over time
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 ... READ MORE
The impact of patients presenting with fever on Emergency Department and Hospital performance in Oxfordshire
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 ... READ MORE
Frequency of test requests from Primary Care to Clinical Microbiology
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 ... READ MORE
C-reactive protein test in children
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. ... READ MORE
Emergency hospital readmissions: determinants, weekend effect and time-trend
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 ... READ MORE
Delayed discharges in hospitalized elderly patients: complications, mortality and time-trend
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 ... READ MORE
What is driving increases in paediatric A&E attendances?
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 ... READ MORE
Can we identify surgical site infections using routine electronic health record data?
Millions of operations are carried out in the NHS every year. Infection is a rare but important complication that can happen after surgery. Specific operations are routinely monitored every year in every NHS hospital to see how often these post-surgery infections occur. This is very time-consuming ... READ MORE
Trends in bacterial pathogens, antibiotic resistance, antibiotic usage and patient outcomes in critical care in the Oxford University NHS Trust hospitals, 1999-2014
Antibiotics are medicines that are hugely important in treating many infections, and antibiotic resistance is a major clinical problem. Research has shown that increased use of antibiotics, whether appropriate or inappropriate, seems to be associated with higher numbers of antibiotic-resistant ... READ MORE
Outcomes after elective surgery: prognostic information in baseline blood tests
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 ... READ MORE
To what extent do urine cultures provide prognostic information for poor outcomes?
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 ... READ MORE
Understanding the causes of changes in severity biomarkers
... READ MORE
Statistical Network Modelling of Ward Transfer Patterns and their Relationship to Hospital Acquired Infections
... READ MORE
Asymptomatic carriage candidate selection
... READ MORE
Panoramic view of the John Radcliffe Hospital infection networks
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 ... READ MORE
Detecting and adjusting for severe illness in inpatients using passively collected data
See manuscript on The Lancet ... READ MORE
Improving threat detection and quality surveillance: tools for infection management
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 ... READ MORE