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Activity and output - research outcomes

IDRN publications in peer-reviewd journals

One editorial was published in Nature Reviews Microbiology (impact factor of 15.8) in May 2008.

The full reference is Head MG, Hayward AC, Johnson AM. Networking for infectious disease. Nature Reviews Microbiology 6, 328 (May 2008).

To view the editorial online, click here.

Another article was published in the Journal of Antimicrobial Chemotherapy (impact factor 4.3) in July 2009.

The full reference is Head MG. Infectious Disease Research Network. Journal of Antimicrobial Chemotherapy. 2009 64: i25-i27.

To view the article online, click here.

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Antimicrobial resistance and healthcare-associated infections

I-STRAT Trial

Funded by the MRC for 2 years, this study aims to set up a stepped wedge cluster randomised controlled trial of isolation strategies to reduce endemic levels of MRSA and Clostridium difficile. The study is using a network of 30 hospitals willing to participate, which were recruited through the Infectious Diseases Research Network. The IDRN also provided some input into the construction of the grant application.

National Observational Study of the CleanYourHands campaign, and a cluster randomised trial of the effectiveness and cost-effectiveness of feedback in intensive care units and acute general medical wards

This 5-year study has been funded by the National Patient Safety Agency. Ethics Committee approval has been granted. Recruitment of centres has started. The study includes researchers from the Health Protection Agency, Royal Free and University College Medical School, University College London, The London School of Hygiene and Tropical Medicine and Infection Control Staff at the Mid-Essex Hospitals Trust. The IDRN support included development of study design, support in preparing funding submissions, and support in MREC applications. The IDRN has also provided web-design expertise in setting up and hosting online resources for this study.
See the IDRN website for the NOSEC webpage, including initial results from the study, publications and a Hand-hygiene Observation Tool. See also the below publications –

    • Early communication: Does a national campaign to improve hand hygiene in the NHS work? Initial English and Welsh experience from the NOSEC study (National Observational Study to Evaluate the CleanYourHandsCampaign J Hospital Infection 2007 ;66(3); 288-9
    • Development of an observational measure of healthcare worker hand-hygiene behaviour: the hand-hygiene observation tool (HHOT), Journal of Hospital Infection (2008) 68, 222-229

ORION statement

The IDRN provided the web-design expertise to set up a webpage for the ORION statement- guidelines for the transparent reporting of Outbreak Reports and Intervention studies Of Nosocomial infection. This is a CONSORT equivalent for infection control studies.

    • The ORION STATEMENT Guidelines for Transparent Reporting of Outbreak
      Reports and Intervention studies Of Nosocomial infection Lancet Infect Dis 2007; 7: 282–88
    • The ORION STATEMENT Guidelines for Transparent Reporting of Outbreak
      Reports and Intervention studies Of Nosocomial infection. J Antimicrobial Chemother 2007; 59(5):833-40

MRSA bid in relation to hand-hygiene and infection control interventions

This grant application is currently being worked on, and will be submitted to the National Institute for Health Research in 2009. This collaboration is between University of Birmingham, University of Warwick, and City University. The group met and discussed initial ideas at the IDRN behavioural sciences workshop.

Behavioural interventions to improve infection control practice

Two projects have been set up as a result of collaborations at the IDRN behavioural sciences workshop.

    • One is an evaluation of a campaign to improve infection control practices/behaviours. This is led by Barts and the London, and Imperial College are designing the assessment tools and carrying out the analysis.
    • A second study is focused on using simulation to improve infection control practices. This is also a collaboration between Barts and the London and Imperial College. Some tools and practices are being shared between the two studies.

Potential reduction of healthcare-associated settings, via novel decontamination methods

This research application arose from an approach from Industry. The IDRN has co-ordinated a grant application to investigate rapid decontamination of hospital areas, particularly communal areas and around bedsides. An outline submission was made to the Health Technology Assessment clinical trials programme.
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Tuberculosis

London TB Nurses Patient Profiling Exercise

Detailed baseline data and 1 year follow up data for over 2000 tuberculosis patients in London have been collected. Key stakeholders include all London TB nurses, the Health Protection Agency and UCL. Key findings have been disseminated to and used by: - local tuberculosis services in order to inform commissioning; the NICE TB guideline development group and the Department of Health in order to inform implementation of the National TB Action Plan.
The IDRN provided advice on study design, assistance with MREC applications, data cleaning, data analysis and dissemination of results to TB services and the Department of Health.

    • Crack cocaine and infectious tuberculosis.  Emerg Infect Dis. 2008 Sep;14(9):1466-9
    • Tuberculosis in London: the importance of homelessness, problem drug use and prison.  Thorax. 2007 Aug;62(8):667-71

Evaluation of mobile x-ray unit for tuberculosis screening

Following a successful pilot involving screening in homeless hostels and Pentonville prison, a bid for funding was submitted to the Department of Health led by the HPA. Funding of £250 000 was agreed, and a full evaluation is now complete. The IDRN provided support with protocol development, funding application and the MREC application.

    • Tuberculosis and social exclusion. BMJ. 2006 Jul 8;333(7558):57-8

BPSU Study of Childhood tuberculosis

This is led by Dr Delane Shingadia (St Bartholomew's and the Royal London Medical School), and the results have now been published. The IDRN provided advice on study design.

    • Tuberculosis in the United Kingdom and Republic of Ireland. Archive of Diseases in Childhood. 2008 Dec 3

IGRA use in tuberculosis disease

This multi-disciplinary, collaborative application was awarded over 1 million pounds by the Health Technology Assessment (summer 2008). The application originated from the IDRN/HPA workshop into interventions trials in the area of health protection, held in London October 07. The IDRN identified this call, and rapidly convened a follow up meeting in response to this call. With the agreement of the project leaders, the IDRN also invited individuals appropriate additional expertise onto the group.

 

The role that infrastructure plays in transmission of tuberculosis

This is a collaboration between the Health Infrastructure Research Centre at University College London (Dr Ka Man Lai) and the Health Protection Agency. As well as consideringh the risk to others, this work will assess the impact of the environment, temperature and humidity, ventilation systems and size and layout of rooms. By gathering this kind of data they hope to be able to spot what kind of environment encourages the transmission of airborne diseases, such as tuberculosis.
The IDRN were approached by Dr Lai to assist in finding collaborative partners for this venture. The IDRN have also promoted and contributed to Dr Lai's UCL-based research networks (U-PATH and AIR-PATH).
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Sexually-transmitted infections

Care Pathways for STIs in Primary Care

This study used an online intervention and resource, see the study webpage. The IDRN provided the web-design expertise and hosting to set up this intervention, and provided statistics of webpage hits and downloads. The study is now completed, and at the paper-preparation stage (two publications).

Accelerated Partner Therapy (APT) Research Study

This study used an online intervention and resource, see the study webpage. The IDRN provided the web-design expertise to set up this intervention.

NATSAL 2010 - National Survey of Sexual Attitudes and Lifestyles 2010

This large collaborative application was submitted to the MRC and Wellcome in late 2007 and has been funded. The IDRN provided assistance regarding the composition of the funding elements of this complex grant, as well as further administrative assistance.

Cost effectiveness of STI services for differing populations in the UK

The IDRN disseminated information on the MRC 2006 call for proposals for projects relating to sexual health. As a result of this dissemination, a collaborative bid was submitted. This bid was successful, and the group awarded approx £375000. The aim of the project, which commenced in April 2008, is to build a Decision Analytic Model as a tool for the evidence based planning of the cost-effectiveness of STI services for differing populations in the UK.

Natural History of Mycoplasma genitalium

This research question was formulated at an IDRN strategy workshop, with the IDRN subsequently co-ordinating meetings involving a multi-disciplinary international collaborative group. A grant application was submitted to the Health Technology Assessment in late 2006.
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hepatitis

Chronic hepatitis B in the UK - characteristics and prevalence of disease

Joint funding from industry and Nuffield Foundation has recently been negotiated for this study. The study began in Autumn 2006. The IDRN provided advice on study design, assistance with preparation of the protocol, advice on pseudonymisation of data, advice on the MREC application and the PIAG submission.
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pneumococci

Oral Streptococcus pneumoniae

This collaboration between Universities Liverpool and Glasgow arose from discussions at the Strep pneumoniae workshop in April 2009. Samples and data have been shared between the two groups.

Strep pneumoniae phase 1 studies

This collaboration between Universities Liverpool and Glasgow arose from discussions at the Strep pneumoniae workshop in April 2009.

Immunological mucosal model

This collaboration has involved an exchange of knowledge and methodology between University of Bern, Switzerland, and University of Liverpool. Colleagues from Liverpool have gone to Switzerland to learn the techniques employed there and apply them to their own research in the UK.

Role of P4 (a PsaA peptide fragment) as adjuvant and antigen in prevention and treatment of pneumococcal infection

This phd will commence at University of Liverpool as a result of the student attending the Strep workshop and collaborating with senior lecturers attending the event.

Human experimental pneumococcal carriage

A research assistant secured a post at the University of Liverpool, after attending the Strep workshop. The project is funded by the Gates Foundation.

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respiratory (general)

Flu Watch :  Community study of behavioral & biological determinants of transmission to inform seasonal & pandemic planning

The IDRN co-ordinated this successful bid for a large national cohort study of influenza transmission in households. The study is ongoing and has to date successfully recruited around 2000 patients. The MRC awarded this project almost £2million.

Influenza pathogenesis

A grant proposal for approx £270k was submitted to the Department of Health in spring 09, as a result of a collaboration between Imperial College London and University of Liverpool, initiated at the IDRN Strep pneumoniae workshop in April 2009.

Psychological impact of Legionnaire's Disease

This PhD studentship is currently at the application stage. It is a project that was initiated at the behavioural sciences workshop, and is a collaboration between the Institute of Psychiatry at Kings College London, HPA West Midlands and HPA Porton Down.
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Gastrointestinal infections / food safety

National Intestinal Infectious Disease Study

This Food Standards Agency funded study is a collaborative, multi-disciplinary study, and is being led by the University of Manchester. The IDRN provided fora for collaborators to meet, and also organised protocol development groups that laid early foundations for this study.

Carriage and invasion on multiply-resistant ESBL-producing strains of Escherichia coli

The IDRN held a research strategy workshop concerning Acinetobacter and infection due to ESBLs on 02 December 2005. Three protocol development groups on the carriage of multiply-resistant ESBL-producing organisms have subsequently been held, with a full application submitted to the MRC Infections and Immunity Board in January 2008.
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antibiotics

Developing and testing a system for analysing antimicrobial prescribing in primary care

This project has been funded by the HPA Strategic R & D fund, and is led by the HPA. The IDRN provided advice on the study design.

Web based gentamicin monitoring tool

The IDRN received a request from Dr Armando Gonzalez, a microbiologist seeking statistical support for his study, the development of a web based gentamicin monitoring tool to facilitate safe and effective use of gentamicin. A request was sent out through our mailing list, with several responses received. As a result, Dr Gonzalez collaborated with colleagues at Imperial College London.

Fighting Resistance To Antibiotics With New Technologies

This was a workshop organised and hosted in 2006 by the University of Leeds, in collaboration with various European partners and the pharmaceutical industry. The IDRN contributed a small amount of sponsorship to ensure the event took place. The workshop has had the following outputs -

  • Improved understanding of the molecular biology and physiology of Acinetobacter baumanni, particularly in the biofilm mode of growth. University of Leeds laboratories have since secured additional funding to expand the biofilm work. The funding has come from the MRC, BBSRC and Industry.
  • Inhibition of LPS biosynthesis at the level of LpxC and the C55 isoprenoid lipid cycle. A full collaborative application, involving partners from Leeds, Paris and Ljubljana, will be submitted to the Wellcome Trust in January 2009.
  • Beta-lactamase inhibitors. A pan-European proposal was submitted to the EU.
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immunology

Trends in Immunology publication

The academic leaders on the IDRN lymphocyte kinetics workshop, and the speakers at the event, have collaborated on a publication of the meeting's proceedings. This article will be published in Trends in Immunology in spring 2009.

Labelling techniques in lymphocyte kinetics

A collaboration, set up from the IDRN workshop on lymphocyte kinetics, has discussed reconciling the different results obtained from labelling techniques. A publication is in preparation. This international collaboration involved St Georges, University of London, Imperial College London, and University of Utrecht.

Modelling T lymphocyte recirculation

This international collaboration, set up at the IDRN lymphocyte kinetics workshop, involves the University of Rome and the National Institute of Health, USA. Further meetings on the subject of modelling T lymphocytes have taken place in late 2008.

Modelling and statistical components of lymphocyte kinetics

This collaboration, from the IDRN lymphocyte kinetics workshop, resulted in an exchange of data and techniques between colleagues from Maidstone & Tunbridge Wells NHS Trust and the University of Leeds.

T cell dynamics in humans

Colleagues from University of Utrecht and the National Institute of Health, USA met at the IDRN lymphocyte kinetics workshop. Utrecht colleagues have subsequently gained placements at the NIH to work on T cell dynamics, and this project will be commencing in April 2009.
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mycoses

Determining the molecular basis of the Cryptococci Vancouver Island Outbreak

An international collaboration between the University of Birmingham and the CBS Fungal Diversity Centre, Netherlands was set up from the IDRN mycoses workshop. A joint grant application was submitted to the Wellcome Trust, and funding of around £320k was awarded in June 2009.

Gene knockout techniques

The University of Birmingham have sent staff to the University of Newcastle for training on the use of gene knockout techniques, as a result of collaborations formed at the mycoses workshop.

Stress responses in C.albicans following phagocytosis

This is a collaboration between the University of Aberdeen and University of Newcastle has been set up, and a joint grant proposal is currently being written. The collaboration was set up at the IDRN mycoses workshop.

Virulence defects in strains mutated for specific stress regulators

This collaboration, set up at the IDRN mycoses workshop, is currently working on a joint publication, and involves the University of Aberdeen and University of Newcastle.
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other areas

Pilot study of scabies outbreaks in residential homes for the elderly

This pilot study has obtained funding of £10 000 from the British Skin Foundation (July 2009) to to systematically investigate suspected scabies outbreaks at residential care facilities. This study was originally discussed at the IDRN scabies workshop (Brighton, November 2008), before the IDRN organised further small meetings to discuss the development of this study. After completion of the pilot study, the intention is to seek further funding for other research ideas.

Health Survey for England

Infectious disease epidemiological research using the resource of the Health Survey for England. A collaborative application for funding is in preparation.

Is the cultural context of MMR rejection a key to an effective public health discourse?

The below paper has now been published in the Journal of the Royal Institute of Public Health. The IDRN supported the quantitative work through providing contacts at the Health Protection Agency and provided forums for early presentation of the work, which informed analysis.

Is the cultural context of MMR rejection a key to an effective public health discourse? Public Health. 2006 Sep;120(9):783-94

Behavioural sciences projects

Further outputs from the behavioural sciences workshop include

  • A collaboration between HPA Porton Down and HPA North-East to look at risk communication in chemical incidents. An application has been submitted to the HPA Strategic Fund.
  • A collaboration between HPA Porton Down and Kings College London was renewed at the workshop, and they are now looking at an EU project focusing on chemical terrorism.
  • A behavioural sciences research network is planned, subject to funding. The IDRN has provided significant advice and assistance with the development work for this.
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Fellowships

British Infection Society Fellowship - Dr Sarah Anderson, project on tuberculosis in primary care

MRC Research Fellowships -
Dr Laura Shallcross, Staphylococcal infections in the community
Dr Ben Killingley, Interventions to prevent household transmission of influenza
Dr Charlotte Warren-Gash, Role of influenza as a trigger for acute myocardial infarction
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