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Antimicrobial Resistance and Modernising Microbiology

Home > Research Themes > Antimicrobial Resistance and Modernising Microbiology > IORD Projects

IORD – Ongoing approved projects and project outputs

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Ranges of laboratory test results observed in hospitalised neonates

IORD categorisation: Electronic Health Records

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

Impact of weight and renal function on antibiotic doses received, and potential impact on CRP response

IORD categorisation: Electronic Health Records

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

Recording of routine physiological measurements and potential for impact on analyses of electronic health records

IORD categorisation: 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 commonly recorded measurements of patient … 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

IORD categorisation: Electronic Health Records

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

Using unsupervised computational methods on electronic health records, to identify changes in underlying infrastructure or data quality over time

IORD categorisation: Electronic Health Records

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

The impact of patients presenting with fever on Emergency Department and Hospital performance in Oxfordshire

IORD categorisation: Electronic Health Records

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

Frequency of test requests from Primary Care to Clinical Microbiology

IORD categorisation: Electronic Health Records

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

C-reactive protein test in children

IORD categorisation: Electronic Health Records

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

Emergency hospital readmissions: determinants, weekend effect and time-trend

IORD categorisation: Electronic Health Records

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

Delayed discharges in hospitalized elderly patients: complications, mortality and time-trend

IORD categorisation: Electronic Health Records

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

What is driving increases in paediatric A&E attendances?

IORD categorisation: Electronic Health Records

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

Can we identify surgical site infections using routine electronic health record data?

IORD categorisation: Electronic Health Records, Specific Infections

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 as it is done in person by an infection … 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

IORD categorisation: Antimicrobial Resistance and Antibiotics, Electronic Health Records, Specific Pathogens

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 infections. To develop the best treatment strategies, it is important to understand which bacteria (bugs) … Read more

Outcomes after elective surgery: prognostic information in baseline blood tests

IORD categorisation: Electronic Health Records

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

To what extent do urine cultures provide prognostic information for poor outcomes?

IORD categorisation: Electronic Health Records

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

Understanding the causes of changes in severity biomarkers

IORD categorisation: Electronic Health Records

Statistical Network Modelling of Ward Transfer Patterns and theirRelationship to Hospital Acquired Infections

IORD categorisation: Electronic Health Records, Specific Infections

Asymptomatic carriage candidate selection

IORD categorisation: Electronic Health Records

Panoramic view of the John Radcliffe Hospital infection networks

IORD categorisation: Electronic Health Records

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

Detecting and adjusting for severe illness in inpatients using passively collected data

IORD categorisation: Electronic Health Records

See manuscript on The Lancet

Improving threat detection and quality surveillance: tools for infection management

IORD categorisation: Electronic Health Records

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

Antimicrobial Resistance and Modernising Microbiology Theme

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