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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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A clinical data review to support investigation of a European outbreak of acute severe hepatitis of unknown etiology (ASHep-UE)

IORD category: COVID-19, Specific Infections
Chief Investigator: Dr Philippa Matthews · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 13 May 2022

Since 31 March 2022, there has been an increase in cases of children presenting with severe liver disease of unknown cause (termed ‘acute severe hepatitis of unknown etiology’ (ASHep-UE)) across multiple countries including the UK. Most of these have been children aged 1–6 years, leading to hospital admissions requiring intensive care, and in some cases … Read more

Analysis of trends in mortality rates following infection with SARS-CoV-2 in patients with underlying haemato-oncology diagnoses at Oxford University Hospitals

IORD category: COVID-19
Chief Investigator: Dr John Willan · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 09 May 2022

Underlying haematological malignancy has previously been shown to be a major risk factor for worse outcomes from infection with SARS-CoV-2. There is concern that this same patient group may mount reduced immune responses to the COVID-19 vaccinations, and thus derive less protection from them. In the general population, with high levels of vaccination, serious adverse … Read more

PREPARE 2 – The impact of the COVID-19 pandemic on infections in myeloma patients

IORD category: COVID-19
Chief Investigator: Dr Sally Moore · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 21 Feb 2022

Myeloma is a blood cancer that results in a weakened immune system and an increased risk of infection. Myeloma is currently incurable and the most common cause of death in patients living with myeloma, aside from the disease itself, is infection. We know that rates of respiratory infections decreased in haematology patients during shielding due … Read more

The prognostic utility of the MeMed COVID-19 Severity™ assay in patients with COVID-19 at Oxford University Hospitals NHS Foundation Trust (OUH)

IORD category: COVID-19
Chief Investigator: Dr Alexander Mentzer, Dr James Fullerton · Sponsor: OUH · Research location: Oxford University · Approval date: 24 Jan 2022

COVID-19 caused by SARS-CoV2, remains a significant cause of hospital attendance, admission and mortality. The clinical presentation of COVID-19 is variable, with most patients experiencing mild self-limiting symptoms, while others progress to respiratory failure. The use of biomarkers early in the disease course, to predict the development of severe disease, has garnered significant interest as … Read more

Identifying “at-risk” populations for E. coli bacteraemias

IORD category: Specific Infections, Specific Pathogens
Chief Investigator: Prof Sarah Walker · Sponsor: OUH · Research location: Oxford University · Approval date: 14 Jan 2022

Since June 2011, every bloodstream infection caused by a bacteria called Escherichia coli (E. coli) has to be reported to the UK Health Security Agency. Monthly counts are published regularly, as well as annual reports describing the overall trend, distribution by age and sex, and geographic distribution by NHS trust. Having a system in place … Read more

Defining normal response to culture-positive and culture-negative sepsis

IORD category: Specific Infections
Chief Investigator: Prof Sarah Walker, Prof David Eyre · Sponsor: OUH · Research location: Oxford University · Approval date: 17 Dec 2021

Longer than necessary antibiotic courses in patients with sepsis (an infection of the blood) may lead to side-effects like C diff diarrhoea, and increase antibiotic resistance. But not switching antibiotics promptly when patients don’t respond or get worse is harmful. In hospital, lots of blood tests are done routinely and patient status is regularly monitored, … Read more

Circadian influences on serologic responses to SARS-CoV-2 vaccination

IORD category: COVID-19
Chief Investigator: Prof Jane McKeating · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 12 Jul 2021

The ‘circadian clock’ is an endogenous 24-hour clock recognised in all biology that, along with a seasonal clock (summer/winter), impacts on how environmental challenges are handled, including the outcome of infectious diseases and vaccinations. The COVID-19 pandemic, caused by SARS-CoV-2 coronavirus, is a global crisis with unprecedented challenges for public health. Vaccinations are being rolled … Read more

Using Machine Learning to Predict Mortality for COVID-19 Patients on Day Zero in the ICU

IORD category: COVID-19
Chief Investigator: Dr Nahal Mansouri · Sponsor: Lausanne University Hospital · Research location: Lausanne University Hospital · Approval date: 28 May 2021

Using a dataset of 270 critically ill patients with COVID-19 we have identified a set of variables that predict the mortality for patients on the day of admission to the ICU. The use of this practical prediction model should affect clinical decision-making and medical management of COVID-19 patients. We can predict the chance of survival … Read more

Assessing the utility of calprotectin as an independent predictor of clinical deterioration following COVID diagnoses

IORD category: COVID-19
Chief Investigator: Dr Alexander Mentzer · Sponsor: OUH · Research location: Oxford University · Approval date: 09 Apr 2021

COVID-19, caused by SARS-CoV2, is a novel biphasic disease that may be associated with significant morbidity and mortality in the second phase of illness in select groups of infected individuals. There is significant interest in testing the utility of biomarkers in the first phase of illness for identifying individuals at higher risk of deterioration who … Read more

Analysis of 5 year trends in respiratory virus infections of haematology inpatients at Oxford University Hospitals

IORD category: Specific Infections, Specific Pathogens
Chief Investigator: Dr Toby Eyre · Sponsor: OUH · Research location: Oxford University · Approval date: 09 Apr 2021

Respiratory viral infections can cause serious illnesses in patients with weakened immune systems, such as those who have undergone a bone marrow transplant, or are undergoing chemotherapy for blood cancers. The Haematology department at Oxford University Hospitals (OUH) routinely tests for these viruses if patients are admitted with symptoms suggestive of infection like breathlessness or … Read more

An epidemiological review of paediatric respiratory viruses in acute hospital presentations with respiratory symptoms

IORD category: Specific Infections, Specific Pathogens
Chief Investigator: Dr Nicholas Richens · Sponsor: OUH · Research location: Oxford University · Approval date: 09 Apr 2021

Respiratory viral pathogens have long been known to be responsible for a large burden of seasonal acute paediatric emergency department presentations. We are investigating the local epidemiology of these viral agents which prompt emergency department presentation. The SARS-CoV-2 pandemic has highlighted the need to understand the process of virus propagation within the community. Greater understanding … Read more

THE COVID CLOCK: Circadian influences on SARS-CoV-2 RNA in nose and throat swabs

IORD category: COVID-19
Chief Investigator: Professor Jane McKeating · Sponsor: NIHR OxBRC · Research location: OUH NHS Trust · Approval date: 22 Mar 2021

The ‘circadian clock’ is an inbuilt 24-hour clock recognised in human biology that, along with a seasonal clock (summer/winter), impacts on how environmental challenges are handled, including influencing the outcome of infectious diseases and vaccinations (Borrmann 2020, Sengupta 2021).The COVID-19 pandemic, caused by SARS-CoV-2 coronavirus, is a global crisis with unprecedented challenges for public health. … Read more

Healthcare associated acquisition of Covid-19

IORD category: COVID-19
Chief Investigator: Dr David Eyre · Sponsor: OUH · Research location: Oxford University · Approval date: 18 Oct 2020

Most patients diagnosed with Covid-19 acquire their infection in the community. However, it is not known how much Covid-19 in the first wave of the pandemic was acquired in hospital. National data may be informative, but locally available data in Oxford are more detailed, potentially allowing more precise estimates of the extent of transmission and … Read more

Covid-19 seroprevalence in inflammatory bowel disease patients on maintenance biological therapy: a comparison with healthcare workers

IORD category: COVID-19
Chief Investigator: Professor Jack Satsangi · Sponsor: OUH · Research location: Oxford University · Approval date: 18 Oct 2020

The inflammatory bowel diseases (IBD), Crohn’s disease (CD) and ulcerative colitis (UC) affect approximately 1% of the UK population; and 25-30% of these patients are now treated with biological therapies which target the immune system to maintain remission. It has been hypothesized that these patients may be at increased risk of either clinically apparent SARS-CoV-2 … Read more

Descriptive Study of confirmed and probable COVID patients

IORD category: COVID-19
Chief Investigator: Dr Andrew Brent, Dr Monique Andersson · Sponsor: OUH · Research location: Oxford University · Approval date: 07 Aug 2020

The COVID-19 pandemic started in December 2019 and quickly spread around the world. A key challenge in all healthcare settings is to identify patients with possible COVID-19 at presentation, to inform both clinical management and infection prevention and control interventions. Diagnosis relies in most cases on PCR of nose and throat swabs for the SARS-CoV-2 … Read more

Aggregate analysis of Oxford University Hospitals staff Covid-19 testing data

IORD category: COVID-19
Chief Investigator: Dr David Eyre · Sponsor: OUH · Research location: Oxford University · Approval date: 24 Jun 2020

Oxford University Hospitals (OUH) has conducted a large staff testing programme for Covid-19. Staff were tested using a combination of antibody and PCR tests looking for previous and current infection with the virus that causes Covid-19 (SARS-CoV-2). These results were stored in the electronic healthcare records of each staff member. Staff provided details of potential … Read more

Global Research on AntiMicrobial resistance (GRAM) Project

IORD category: Antimicrobial Resistance and Antibiotics, Specific Infections
Chief Investigator: Professor Susanna Dunachie · Sponsor: Oxford University · Research location: Oxford University · Approval date: 05 May 2020

The Global Research on AntiMicrobial resistance (GRAM) Project is the flagship study of the Oxford GBD (Global Burden of Disease) Group, and aims to provide robust, comprehensive and timely evidence of the burden of antimicrobial resistance (AMR) in 195 countries and territories. The Oxford GBD Group is a partnership between the Big Data Institute (BDI) … Read more

PreVent: predicting need to ventilation and ICU admission in patients admitted with COVID-19

IORD category: COVID-19
Chief Investigator: Dr David Eyre · Sponsor: OUH · Research location: Oxford University · Approval date: 05 May 2020

Up to 30% of patients admitted to hospital with COVID (novel coronavirus infection) will require admission to an intensive care unit (ICU) and potentially help with breathing via a ventilator. We will develop statistical and artificial intelligence approaches to predict which patients are most likely to require admission to ICU and ventilation. These tools will … Read more

The impact of SARS-CoV-2 on hospital admissions, antimicrobial prescribing and serious bacterial infections

IORD category: Antimicrobial Resistance and Antibiotics, COVID-19
Chief Investigator: Prof Sarah Walker · Sponsor: OUH · Research location: Oxford University · Approval date: 05 May 2020

The Covid-19 pandemic is having a profound impact on healthcare globally. Whilst the virus is directly devastating for many suffering from severe infection, there are also wider implications. These include potentially lower use of healthcare for other serious conditions with potential adverse outcomes. Additionally, managing Covid-19 cases may change antibiotic prescribing in hospitals, and have … Read more

The microbiological features associated with greater risk of recurrent UTI

IORD category: Specific Infections
Chief Investigator: Dr Gail Hayward · Sponsor: OUH · Research location: Oxford University · Approval date: 10 Apr 2020

Around half of all women will suffer from at least one urinary tract infection (UTI) in their lifetime, and it is the most common bacterial infection treated by General Practitioners (GPs). Up to 800,000 women in the UK suffer from frequent UTIs each year. Such ‘recurrent UTI’ causes painful and distressing symptoms, difficulty in managing … Read more

Impact of antibiotics on detection and transmission of MRSA

IORD category: Antimicrobial Resistance and Antibiotics, Specific Pathogens
Chief Investigator: Dr David Eyre · Sponsor: OUH · Research location: Oxford University · Approval date: 02 Jul 2019

Antibiotics are commonly used to treat infections, but they may also affect how other infections are detected and transmitted. MRSA is a potentially serious healthcare-associated infection. Over the past decade there has been major progress in reducing the number of patients who carry MRSA on their skin and other body sites, and in reducing infections … Read more

Ranges of laboratory test results observed in hospitalised neonates

IORD category: Electronic Health Records
Chief Investigator: Professor Sarah Walker · Sponsor: OUH · Research location: Oxford University · Approval date: 02 Jul 2019

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 category: Electronic Health Records
Chief Investigator: Prof Sarah Walker · Sponsor: OUH · Research location: Oxford University · Approval date: 02 Jul 2019

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 category: Electronic Health Records
Chief Investigator: Prof Sarah Walker · Sponsor: OUH · Research location: Oxford University · Approval date: 02 Jul 2019

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

PREDICTS’: Prognosis and Risk Evaluation, Determined from Influenza CT Scores

IORD category: Specific Pathogens
Chief Investigator: Dr Philippa Matthews · Sponsor: OUH · Research location: Oxford University · Approval date: 12 Jun 2019

Every year, influenza virus causes significant illness globally. Many people are admitted to the John Radcliffe hospital with the virus and tested using molecular test. Currently, we do not use all the information that the test provides. This study aims to use the extra information from the current test (called the CT value) to work … Read more

Investigating overlap between Enterobacteriaceae isolated from wastewater environments and patients

IORD category: Specific Pathogens
Chief Investigator: Dr Bede Constantinides · Sponsor: OUH · Research location: Oxford University · Approval date: 29 Mar 2019

There are increasing numbers of reports of micro-organisms that can cause human infections being found in wastewater environments, like sinks, drains and toilets. These could potentially be transmitted to unwell people in hospitals. However, whether this really occurs is unclear. We have sequenced all the genetic variation of micro-organisms found in sinks in some hospital … Read more

Investigating transmission of influenza in the Oxford University Hospitals

IORD category: Specific Pathogens
Chief Investigator: Dr Philippa Matthews · Sponsor: OUH · Research location: Oxford University · Approval date: 29 Mar 2019

Every year influenza (‘flu’) puts a major strain on UK hospitals. Whilst many patients are admitted with influenza, other patients can get it during their hospital stay. This is because it is very easy to transmit, and it is not always obvious who has flu. We are using genetic sequencing to work out the ‘letters’ … Read more

Clinical implications of sputum bacterial pathogens in asthma

IORD category: Specific Infections
Chief Investigator: Dr Timothy Hinks · Sponsor: OUH · Research location: Oxford University · Approval date: 29 Mar 2019

Acute exacerbations of asthma are often triggered by airways infection and a proportion of these infections are due to bacteria. We know that a group of patients with asthma have chronic airways infection with Haemophilus influenzae and this may be related to poor symptom control and more frequent exacerbations. Our aim is to look at the frequency … 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 category: Electronic Health Records
Chief Investigator: Dr Doreen Zhu · Sponsor: OUH · Research location: Oxford University · Approval date: 29 Mar 2019

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 category: Electronic Health Records
Chief Investigator: Phuong Quan · Sponsor: OUH · Research location: Oxford University · Approval date: 29 Mar 2019

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 category: Electronic Health Records
Chief Investigator: Prof Tim Peto · Sponsor: OUH · Research location: Oxford University · Approval date: 07 Nov 2018

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

What is driving changes in the incidence of E. coli bloodstream infections in Oxfordshire?

IORD category: Specific Pathogens
Chief Investigator: Prof Sarah Walker · Sponsor: OUH · Research location: Oxford University · Approval date: 07 Nov 2018

Across England, the number of bloodstream infections caused by a group of bacteria which include ‘Esherichia coli’ (E. coli) and ‘Klebsiella pneuomoniae’ (K. pneumoniae) has been rising significantly for the last few years. A recent investigation by our group using the IORD database has in addition revealed that antibiotic resistance in these infections is also … Read more

Can we estimate resistance in bloodstream infections from resistance in other types of specimen?

IORD category: Antimicrobial Resistance and Antibiotics, Specific Infections
Chief Investigator: Prof Tim Peto · Sponsor: OUH · Research location: Oxford University · Approval date: 17 Sep 2018

In order to reduce the threat of antimicrobial resistance, a first key step is to understand how much resistance there is. This is typically done by looking at bacteria causing serious infections, particularly bloodstream infections. However, growing bacteria from blood usually requires sophisticated machines which heat samples of blood in special nutrients. These machines are … Read more

What diagnostic codes are used in inpatient admission records for patients who have bacteraemia?

IORD category: Specific Infections
Chief Investigator: Prof Sarah Walker · Sponsor: OUH · Research location: Oxford University · Approval date: 17 Sep 2018

Routinely collected electronic health record data is increasingly being used as a fast and inexpensive way to investigate different diseases. Often these diseases are identified by “diagnostic codes” which are assigned to every admission to hospital, either as the primary code (“the main condition treated or investigated during the relevant episode of healthcare”) or as … Read more

Determinants of antibiotic treatment duration and outcomes in cellulitis

IORD category: Specific Infections
Chief Investigator: Professor Martin Llewelyn · Sponsor: OUH · Research location: Brighton and Sussex University Medical School · Approval date: 18 May 2018

Cellulitis is a bacterial infection of the skin and most commonly affects the legs where the affected area becomes red, hot, swollen and painful. Approximately 1000 patients are admitted to Oxford hospitals with cellulitis each year. Cellulitis is treated with antibiotics, given through the vein (intravenously) at first and then switched to tablets (orally). Doctors … Read more

Frequency of test requests from Primary Care to Clinical Microbiology

IORD category: Electronic Health Records
Chief Investigator: Dr Gail Hayward, Dr Thomas Fanshawe · Sponsor: OUH · Research location: Oxford University · Approval date: 18 May 2018

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

Antimicrobial prescribing and risk of future resistant infection

IORD category: Antimicrobial Resistance and Antibiotics
Chief Investigator: Dr Nicola Fawcett · Sponsor: OUH · Research location: Oxford University · Approval date: 23 Mar 2018

Infections due to one particular family of bacteria called Enterobacteriaceae are increasing in Oxfordshire and worldwide, as are infections resistant to the commonly-used beta-lactam antibiotics (such as co-amoxiclav, sometimes also called augmentin). Treating people with particular types of antibiotics may make people more likely to get resistant infections in the future. We want to see … Read more

Contribution of “sepsis” to mortality in Oxfordshire

IORD category: Specific Infections
Chief Investigator: Dr Andrew Brent, Prof Tim Peto · Sponsor: OUH · Research location: Oxford University · Approval date: 23 Mar 2018

The Sepsis Trust estimates that 44,000 people in the UK die every year from sepsis. However, exactly where these estimates come from, and how reliable they are is unclear. “Sepsis” is generally used to mean an infection of the blood – where bugs get into the blood and cause high temperature, low pulse, low blood … Read more

Outcomes following “sepsis” in Oxfordshire

IORD category: Specific Infections
Chief Investigator: Dr Andrew Brent, Prof Tim Peto · Sponsor: OUH · Research location: Oxford University · Approval date: 23 Mar 2018

The Sepsis Trust estimates that 44,000 people in the UK die every year from sepsis, and this is currently the focus of much attention in hospitals and the media. “Sepsis” is generally used to mean an infection of the blood – where bugs get into the blood and cause high temperature, low pulse, low blood … Read more

Contribution of inflammation to infectious and supposedly non-infectious respiratory conditions leading to inpatient admission

IORD category: Specific Infections
Chief Investigator: Prof Sarah Walker · Sponsor: OUH · Research location: Oxford University · Approval date: 23 Mar 2018

Patients are usually defined by their clinical symptoms, for example pneumonia as opposed to bronchitis or chronic obstructive pulmonary disease (COPD). However, scientists are starting to work out that sometimes the same underlying problem can lead to different clinical presentations. One example is when the body reacts to something, called inflammation. A particular kind of … Read more

C-reactive protein test in children

IORD category: Electronic Health Records
Chief Investigator: Dr Gea Holtman; Prof Ann van den Bruel · Sponsor: OUH · Research location: Oxford University · Approval date: 05 Jan 2018

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

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

IORD category: Electronic Health Records
Chief Investigator: Dr Julia Pakpoor · Sponsor: OUH · Research location: Oxford University · Approval date: 12 Oct 2017

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 changes in the incidence of Streptococcal infections in Oxfordshire?

IORD category: Specific Pathogens
Chief Investigator: Phuong Quan · Sponsor: OUH · Research location: Oxford University · Approval date: 12 Oct 2017

Across England, the number of infections caused by a family of bacteria called Streptococcus have been rising strongly for the last few years. However, the reasons behind these increases are not well understood at the moment. We plan to use the extra information in the IORD database to look at some different reasons why these … Read more

Impact on gram-negative bacteraemia of empirically prescribed antibiotics

IORD category: Specific Pathogens
Chief Investigator: Prof Sarah Walker · Sponsor: OUH · Research location: Oxford University · Approval date: 12 Oct 2017

Antibiotics are prescribed when sick patients arrive at hospital, before doctors know what kind of bacteria is causing an infection and what antibiotics it might be resistant to. Even when a bacteria is identified as causing an infection, it is labelled as “resistant” (R) or “susceptible” (S) based on fairly arbitrary definitions. However, resistance is … Read more

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

IORD category: Electronic Health Records
Chief Investigator: Dr Julia Pakpoor · Sponsor: OUH · Research location: Oxford University · Approval date: 12 Oct 2017

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

Investigation into novel outbreak with Candida auris

IORD category: Specific Pathogens
Chief Investigator: Dr Katie Jeffrey · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 16 Jun 2017

Recently a fungus called Candida auris, resistant to multiple antifungal treatments, emerged globally. It is related to the family that causes thrush, Candida albicans, but behaves differently, usually infecting or colonizing patients in intensive care facilities. This organism is now colonizing patients on a ward in Oxford, the Neurosciences Intensive Care Unit (ICU). Little information … Read more

Changes in the incidence and importance of endocarditis as a diagnosis code in Oxfordshire hospitals

IORD category: Specific Infections
Chief Investigator: Prof Sarah Walker · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 21 Jul 2016

In 2008 guidance recommended no longer using antibiotics to prevent people getting infections of the heart after having surgery at their dentists. This was because there was no strong evidence showing this was necessary, and to reduce overall use of antibiotics to avoid increasing antibiotic resistance in future. However, in 2015, a group looked at … Read more

What is driving changes in the incidence of E. coli bloodstream infections in Oxfordshire?

IORD category: Specific Pathogens
Chief Investigator: Prof Sarah Walker · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 21 Jul 2016

Across England, the number of bloodstream infections caused by a bacteria called ‘Esherichia coli’ (E. coli) have been rising strongly for the last few years. However, the reasons behind these increases are not well understood at the moment. We plan to use the extra information in the IORD database to look at some different reasons … Read more

Antibiotic use – if you use less antibiotic in general medicine are there adverse consequences?

IORD category: Antimicrobial Resistance and Antibiotics
Chief Investigator: Profs Sarah Walker & Tim Peto · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 19 Mar 2015

Reducing antibiotic use to combat antimicrobial resistance is a priority. We want to know if we can do this safely and without putting patients at undue risk. Antibiotic use was measured over 1 week in an intensive audit of practice in the Acute/General Medicine service at the John Radcliffe. This showed that one Consultant team … Read more

Do birth characteristics influence susceptibility to childhood infections?

IORD category: Specific Infections
Chief Investigator: Prof Stephen Kennedy · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 25 Feb 2015

Newborns differ a great deal in terms of their size at birth. In particular, their weight, length and head circumference are determined by how well they have grown in the womb and their age at birth, i.e. premature babies are smaller than babies born at term. We seek to understand whether these differences at birth … Read more

What is driving increases in paediatric A&E attendances?

IORD category: Electronic Health Records
Chief Investigator: Prof Sarah Walker · Sponsor: OUH · Research location: Oxford University · Approval date: 25 Feb 2015

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 category: Electronic Health Records, Specific Infections
Chief Investigator: Prof Sarah Walker · Sponsor: OUH · Research location: Oxford University · Approval date: 25 Feb 2015

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 category: Antimicrobial Resistance and Antibiotics, Electronic Health Records, Specific Pathogens
Chief Investigator: Dr Nicole Stoesser · Sponsor: OUH · Research location: Oxford University · Approval date: 12 Jan 2015

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

Determining patterns of Gram Negative resistance and their genetic basis

IORD category: Specific Pathogens
Chief Investigator: Dr David Clifton · Sponsor: OUH · Research location: Oxford University · Approval date: 17 Sep 2014

Our knowledge of resistance of bacteria, such as E. coli, to antibiotic drugs is incomplete. An understanding of how such resistance is passed on from generation to generation of bacteria is important in helping us to determine which drugs should be given to patients, and in helping us formulate new drugs. This project aims to … Read more

Antimicrobial susceptibility profiles of urinary isolates from samples collected in the community

IORD category: Antimicrobial Resistance and Antibiotics
Chief Investigator: Dr Kyle Knox · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 04 Jul 2014

Urinary tract infections comprise around 1% of the 300 million general practice consultations annually in the UK; most of these are acute uncomplicated UTIs (AUUTIs) in women of childbearing age. AUUTIs affect around 50% of women during their lifetime and, by 24 years of age, one-third of women have had a UTI. Although AUUTIs generally … Read more

Outcomes after elective surgery: prognostic information in baseline blood tests

IORD category: Electronic Health Records
Chief Investigator: Dr David Wyllie · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 04 Jul 2014

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 category: Electronic Health Records
Chief Investigator: Phuong Quan · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 03 May 2013

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

Incidence and outcomes following C. difficile infections in Oxfordshire, and predictors of poor outcomes

IORD category: Specific Pathogens
Chief Investigator: Dr Sarah Walker · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 14 Sep 2012

This project aims to estimate the incidence of C. difficile infection in Oxfordshire, inside and outside hospitals (inpatient, outpatient/day case/A&E, community), over calendar time, analysing the trends to identify potential new strains (as measured by multi-locus sequence type, MLST) threatening the health of Oxfordshire residents. We will also explore whether and how outcomes following C. … Read more

C. difficile recurrence: incidence, predictors and risk scores

IORD category: Specific Pathogens
Chief Investigator: Dr Sarah Walker · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 14 Sep 2012

This project focusses on patients who do not recover straightaway from C. difficile, but in whom either initial treatment for the infection does not work, or in whom the infection comes back (termed “recurrence” of infection). We want to work how often C. difficile recurrence happens, and how long does this typically take. We will … Read more

Using secondary data sources to investigate incidence and severity of respiratory infections

IORD category: Specific Infections
Chief Investigator: Phuong Quan · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 07 Jun 2012

Summary of findings: In this project, we looked at the hospital database of all people admitted to hospital, and found that admissions for pneumonia had almost tripled over the space of 15 years, an alarming increase. By looking at different types of data available in IORD, it became clear that there wasn’t a simple explanation … Read more

A search for temporospatial clusters of blood stream infection in intensive care and high dependency units

IORD category: Specific Infections
Chief Investigator: Dr Angela Minassian · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 14 Nov 2011

Understanding the causes of changes in severity biomarkers

IORD category: Electronic Health Records
Chief Investigator: Dr David Wyllie · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 21 Oct 2011

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

IORD category: Electronic Health Records, Specific Infections
Chief Investigator: John Finney · Sponsor: OUH · Research location: OU Dept of Statistics · Approval date: 22 Jul 2011

Asymptomatic carriage candidate selection

IORD category: Electronic Health Records
Chief Investigator: John Finney · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 22 Jul 2011

Mortality following invasive pneumococcal disease in Oxfordshire 1995-2010

IORD category: Specific Pathogens
Chief Investigator: Dr Kyle Knox · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 05 Nov 2010

C. difficile transmission in Oxfordshire hospitals 2006-2009 using Markov Chain Monte Carlo estimation and information from patients not tested for C. difficile

IORD category: Specific Pathogens
Chief Investigator: Dr Madeleine Cule · Sponsor: OUH · Research location: OU Dept of Statistics · Approval date: 05 Nov 2010

See publication: Probabilistic transmission models incorporating sequencing data for healthcare-associated Clostridioides difficile outperform heuristic rules and identify strain-specific differences in transmission

Panoramic view of the John Radcliffe Hospital infection networks

IORD category: Electronic Health Records
Chief Investigator: Mr John Finney · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 05 Nov 2010

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

S. aureus transmission in ITU, Trauma, Geratology and Vascular specialities in the John Radcliffe Hospital, Oxford 2009-

IORD category: Specific Pathogens
Chief Investigator: Prof Derrick Crook · Sponsor: OUH · Research location: OUH NHS Trust, OU Dept of Statistics, WTCHG · Approval date: 05 Nov 2010

Microbiology of Bronchiectasis and Cystic fibrosis

IORD category: Specific Infections
Chief Investigator: Dr David Wyllie · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 05 Nov 2010

Analysis of 2009/10 Hospital Norovirus outbreak

IORD category: Specific Pathogens
Chief Investigator: Dr Nick Wong · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 05 Nov 2010

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

IORD category: Electronic Health Records
Chief Investigator: Dr David Wyllie · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 04 Mar 2010

See manuscript on The Lancet

Improving threat detection and quality surveillance: tools for infection management

IORD category: Electronic Health Records
Chief Investigator: Dr David Wyllie · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 04 Mar 2010

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

Infection and mortality in patients with bronchoalveolar lavage/pleural fluid samples

IORD category: Specific Infections
Chief Investigator: Dr Susan Williamson · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 04 Mar 2010

Nosocomial MRSA endemicity: addition or replacement (multi-centre, multi-cohort study)

IORD category: Specific Pathogens
Chief Investigator: Prof Marc Bonten · Sponsor: Utrecht University · Research location: University Med Centre Utrecht · Approval date: 04 Mar 2010

Summary of findings: Trends in the rates of serious bloodstream infections caused by antibiotic-sensitive microbes were similar between 1998-2007 across 14 hospitals in Europe, but rates of serious bloodstream infections caused by antibiotic-resistant microbes increased much more in hospitals in countries were antibiotic resistance is in endemic. So antibiotic-resistant infections increase the total disease burden, … Read more

C. difficile testing specificity in Oxfordshire 1997-2009

IORD category: Specific Pathogens
Chief Investigator: · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 04 Mar 2010

C. difficile transmission in Oxfordshire hospitals 2006-2009

IORD category: Specific Pathogens
Chief Investigator: Prof Tim Peto · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 04 Mar 2010

Summary of findings: In an endemic setting, with well-implemented infection control measures, ward-based contact with other patients with C. difficile diarrhoea cannot account for the majority of new cases – no more than 25% of new cases in Oxfordshire over 2 years could be linked to a previous source based on strain-typing and ward movements. … Read more

Incidence of and competition between different pathogens isolated from blood and other sterile sites in Oxfordshire 1997-2009

IORD category: Specific Pathogens
Chief Investigator: Dr David Wyllie · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 04 Mar 2010

Competition between MRSA and MSSA at an individual level in Oxfordshire 1997-2009

IORD category: Specific Pathogens
Chief Investigator: Dr A. Sarah Walker · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 04 Mar 2010

MRSA incidence 1998-2009

IORD category: Specific Pathogens
Chief Investigator: Dr David Wyllie · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 04 Mar 2010

Summary of findings: Rates of MRSA infection in blood and other sites were falling before intensification of infection-control measures in 2006. This, together with strain-specific changes in MRSA isolation, strongly suggests that incompletely understood biological factors are responsible for the much recent variation in MRSA isolation. A major, mainly meticillin-sensitive, S aureus burden remains. See … Read more

Klebsiella in Oxfordshire 1998-2009

IORD category: Specific Pathogens
Chief Investigator: Dr A. Sarah Walker · Sponsor: OUH · Research location: OUH NHS Trust · Approval date: 04 Mar 2010

Antimicrobial Resistance and Modernising Microbiology Theme

  • Introduction
  • Infections in Oxfordshire Research Database (IORD)
  • IORD – Ongoing approved projects and project outputs
  • Contacts
  • Videos for this theme
  • News for this theme

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