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Research by Professor Laura Piddock at the University of Birmingham has shown that the use of fluoroquinolone antibiotics in veterinary medicine can select for antibiotic resistance in certain strains of bacteria which then present a potential risk to human health. Fluoroquinolone antibiotics are widely used in human medicine to treat bacterial infections. For those patients with chronic bacterial gastroenteritis and/or an invasive infection, fluoroquinolone antibiotics are the empiric treatment of choice by GPs; resistance to these agents represents a large public health risk. The outcomes of the research have been used by policy makers to define the human risks of food borne infection from antibiotic resistant strains and have led to the review and amendment of international policy on the use of antibiotics in food producing animals, in particular the World Health Organisation (published outside of the review period) and US Food and Drug Administration (FDA). The research described has had a direct impact on international policy and the ban on the use of certain antibiotics has had an impact on the levels of fluoroquinolone resistance in bacteria isolated from food producing animals, reducing the transmission of resistant strains to humans.
Professor James and colleagues developed a comprehensive, multi-strand strategy for control of healthcare-associated infections caused by life-threatening bacterial superbugs Clostridium difficile (C.diff) and methicillin-resistant Staphylococcus aureus (MRSA). Founded on research to understand the transmission, virulence and antibiotic resistance of these species, their approach resulted in: (i) increased public awareness of healthcare associated infections; (ii) changed behaviours of the public and healthcare professionals to reduce transmission; (iii) improved national healthcare policies to control infections; and (iv) development of new antibiotic methods to tackle the rapidly-evolving resistance. The outcome is a nationwide decline in reported cases of C.diff and MRSA infections in patients since 2008, with consequent economic benefits to the NHS, Government and employers.
Cardiff Researchers in 2009 discovered the new antibiotic resistance determinant NDM-1 and in 2010/11 characterised its rapid worldwide spread through Gram-negative bacteria (e.g. Escherichia coli and Vibrio cholerae). NDM-1 redefined how antibiotic resistance can spread locally and internationally and create new extensively-drug resistance (XDR) that severely limits therapeutic options. This discovery has resulted in: 1) new policies for the admission of overseas patients to hospitals in the UK, France, USA, Australia and China, 2) linkage between MDR transmission and poor sewerage treatment, 3) potable water treatment in Southern Asia 4) positioning papers for the World Health Assembly and 5) policy-changes by the World Health Organisation.
Local authorities, the UK government and the European Commission have benefitted from the widespread application of new molecular methodologies, developed in 2005 and applied by the University of Reading's Vertebrate Pests Unit (VPU) to identify and quantify anticoagulant rodenticide resistance in rodent populations. Rodents are a major global pest that consumes our food, causes contamination with urine and faeces, damages structures through gnawing, transmits diseases, and impacts on species of conservation concern. Due to historical success and recent regulatory restrictions, anticoagulant rodenticides are the most common control method for these pests. However, physiological resistance to anticoagulants is now widespread and the VPU has been involved in mapping this resistance and identifying the genetic basis for the resistance. Their research has led to new methodologies to identify anticoagulant resistance that have been adopted by the global plant science industry and to new guidance in treating resistant populations that has been adopted by the European biocides industry.
Weak acids (e.g. sorbic acid) are used by food manufacturers to prevent fungal contamination of food and beverages. Professor Archer in the Molecular Microbiology group determined the fungal species that cause such contamination, and identified fungal genes and enzymes that confer resistance to sorbic acid during initial outgrowth of fungal spores. They characterised the biochemistry of the resistance mechanism, enabling design of improved mould inhibitors. These inhibitors, used at the correct time, have improved manufacturing processes to prevent mould contamination and product wastage. Knowledge of mould genetics has also been applied to other industries to improve food additive and biofuel manufacturing processes.
Research by the University of Southampton has contributed significantly to reducing the global threat of antibiotic resistance. A series of both conventional placebo-controlled and novel open design trials has influenced a number of important national clinical guidelines for Respiratory Tract Infections (RTIs) and the implementation of novel prescribing strategies that discourage unnecessary antibiotic prescription. As a direct result of the research, delayed prescribing for all acute respiratory infections is a tool in the everyday practice of the UK's GPs. Southampton's work in this field has informed international guidelines currently in place in the United States, Israel and the European Union.
Novel bioluminescent bacterial biosensors developed at UWE, Bristol, and commercialised by Randox, have been used by a range of companies to demonstrate effectiveness of drugs and decontamination procedures. This has improved development processes at companies including Clavis Pharma, Purest Solutions and Dycem, leading to new manufacturing processes and quality control test methods. The biosensors are used in novel applications to give pharmacodynamic data on effectiveness of drugs and real time in-situ demonstration of effectiveness of decontamination processes. These biosensors, pioneered and developed by Vyv Salisbury's group, have been commercially adopted and used for evaluation by at least six collaborating companies.
Decreased crop yields caused by the evolution of herbicide-resistant weeds are a global threat to agriculture and food security. Evolution of weed resistance to the herbicide glyphosate is particularly prevalent in North and South America, where genetically modified glyphosate-resistant crops are widely grown. Research carried out at the University of Warwick between 2008 and 2013 and led by Dr Paul Neve, in collaboration with industry and academia, has resulted in the development of computer models to simulate the evolution of glyphosate resistance in weeds. This modelling research identified new, more sustainable farming strategies for the use of this technology, such as avoidance of sole reliance on glyphosate and more effective ways to manage the timing of herbicide application. These recommendations have been disseminated widely throughout North America by the attendance of Neve and project collaborators at grower conferences, workshops and road shows, and have also attracted associated press coverage. The research has fundamentally changed farmer and industry management of genetically modified herbicide-resistant crops by providing new plant growth guidelines that are being used to combat herbicide-resistant weeds; for example, providing the cotton growth guidelines used for 75% of this crop in the mid-southern USA.
Research by Cardiff University is contributing to initiatives within the NHS and across Europe to safely reduce unnecessary antibiotic prescribing and thus help contain antimicrobial resistant bacteria. Our researchers conducted observational studies of prescribing patterns linked to local resistance data and qualitative research with GPs and patients on their perceptions of acute respiratory tract infections and antibiotic use and resistance. This enabled the Cardiff team to develop clinician training and patient education resources (covering issues such as communication skills, point of care testing, and typical duration of infections) to reduce unnecessary prescribing. Our trials proved these interventions were effective, at times cutting prescribing by as much as two-thirds. Our research has provided the basis for new clinical guidelines, antibiotic stewardship initiatives and policies, and educational tools for clinicians and patients that are being used in the UK and internationally.
Research led by Dr Holmes has identified a novel variant of methicillin-resistant Staphylococcus aureus (MRSA) in livestock. This represents a previously unidentified reservoir of infection which has had impact on the epidemiology of MRSA and its management. This research also impacts on antibiotic use in agriculture and its role in the emergence of antibiotic resistance. As a consequence of these research findings commercial tests and testing protocols have been developed to detect the new MRSA variant, which are now used widely in clinical settings throughout Europe. The discovery has also been used to inform policy decisions at a governmental level in the USA and Europe.