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Methicillin-resistant Staphylococcus aureus (MRSA) are strains of bacteria which are resistant to a range of commonly used antibiotics and as a result are difficult to treat and cause significant morbidity and mortality amongst hospitalised patients and individuals with compromised immunity. Research conducted by Professor Peter Hawkey at the University of Birmingham has demonstrated that by rapidly screening patients for MRSA on hospital admission and then using an effective decolonisation treatment, the rate of MRSA acquisition can be significantly reduced. The Department of Health (DoH), who commissioned the research, used the results of the work to formulate guidance, which was published in 2008, for universal MRSA screening in England. This has contributed to the sustained reduction in MRSA infection in England, which is indicated by the fall in MRSA bacteraemia rates from 7,274 in 2002 to 1,185 in 2011 (-83.7%).
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.
King's College London (KCL) researchers contributed to the discovery that increased C fibre nerve activity in the bladder is a major cause of overactive bladder (OAB) syndrome. Based on this insight, KCL researcher Professor Dasgupta, a surgical urologist at Guy's Hospital, and his team pioneered a new surgical technique for micro-injecting Botulinum Toxin-A (BTX-A) directly into the bladder to suppress C fibres and improve bladder control. The KCL team then conducted the world's first successful clinical trials into the minimally invasive injection of BTX-A n OAB patients. These trials received significant international media coverage. This cost-effective OAB therapy is now licensed by the EU and FDA, is recommended in national and international guidelines, and has significantly improved the treatment of a common health problem.
Healthcare Associated Infections (HAI) can be an unintended consequence of healthcare delivery. They are caused by a range of organisms but are often preventable. GCU-led research has reduced avoidable infections in healthcare in the UK and Europe by stimulating policy debate and investment in new healthcare practice and influencing policy decisions, evidence guidelines, and educational practices. Important changes have been made to national and international approaches to meticillin-resistant Staphylococcus aureus (MRSA) screening with cost savings of £7.5 million to the NHS. 28 European countries now use the HAI point prevalence survey validation method determined by our research.
The use of a formulary to influence prescribing practice is common, with almost all hospitals possessing one that attempts to provide advice on the safe, effective and economic use of medicines. The Maudsley Prescribing Guidelines to Psychiatry steps beyond the function of a mere formulary and provides evidence-based guidance on the use of psychotropic medicines that influences prescribing on both a national and international basis. Now in its 11th Edition and translated into nine languages, much of the evidence in The Guidelines is generated by King's College London research. Additionally, this research is used in other guidelines, in clinical handbooks and in prescribing practices around the world.
Acute promyelocytic leukaemia (APL) is of interest because it is the first cancer that can be cured with drugs that target a unique molecular abnormality. KCL research has developed accurate molecular techniques which are essential to diagnose the disease, guide treatment, and monitor for relapse. Sub-microscopic levels of leukaemic cells remaining in the patient's bone marrow after treatment (referred to as `minimal residual disease') give an early warning of re-occurrence of the disease. Our laboratory has developed sensitive tests for these cells, allowing treatment to be tailored to individual patient needs. This has had a major impact on APL diagnosis and monitoring and has been incorporated in national and international disease-treatment guidelines.
Myeloproliferative neoplasms (MPN) are a group of blood disorders that affect more than 9,000 people in the UK every year. King's College London (KCL) research on the biology, diagnosis and treatment of MPN has had the following significant impacts:
King's College London (KCL) researchers were the first to identify that an early sign of diabetic kidney disease was the presence of albumin in the urine, a condition known as albuminuria. Building on this finding, the KCL Unit of Metabolic Medicine designed and led in-house, national then international randomised controlled clinical trials with the aim of preserving kidney function in diabetic patients. Ultimately, KCL research established that several drug inhibitors of the renin-angiotensin-aldosterone system (RAAS) can control albuminuria, slow the deterioration of kidney function and significantly extend survival rates in diabetic patients. These drugs are now generically available, and their prescription is recommended by current international clinical guidelines across North America, Europe, Australia and Asia. This shows major impact in terms of reach and significance.
Researchers at King's College London (KCL) have established new surgical interventions, including coronectomy, to prevent nerve injuries resulting from wisdom teeth extraction, the most common surgery on the NHS and worldwide. These interventions have been adopted worldwide, for instance coronectomy is now a billable procedure in the US, and are also incorporated into a number of guidelines, for example those by the Royal College of Surgeons and the British Dental association. The KCL team have developed a website aimed at providing information for those with trigeminal nerve injuries, which they can gain both through online content and by directly emailing the specialist team.
King's College London (KCL) researchers discovered that heroin overdose is a common and accidental occurrence which is usually witnessed. Risk of fatal overdose on prison release is exceptionally high with 1 in 200 dying of an overdose within four weeks. KCL researchers proposed and tested the acceptability of prior provision of take-home emergency supplies of the heroin antidote naloxone. KCL research created the stimulus for a national training project for families and carers to administer naloxone and as a result, lives are now being saved. KCL research had a substantial impact on national and international policy and service delivery with take-home naloxone programs introduced around the world. KCL researchers lead the first trial to assess the effectiveness of naloxone for prisoners on release.