Humanimal Trust is supporting a study coordinated by Action Medical Research, being undertaken by Dr Nazima Pathan and his team at the University of Cambridge studying Infection prevention and its impact on antimicrobial resistance in critically ill children - this study has potential to benefit animals too. Dr Pathan’s interim report is outlined below:
Young children, particularly those with severe and complex disease, are at significant risk of secondary infection by antimicrobial resistant bacteria. The gut microbiome, comprising of trillions of normally beneficial bacteria, is a reservoir of antimicrobial resistance genes and often the source of healthcare[1]associated infection (HAI). In critically ill adults, evidence suggests selective decontamination of the digestive tract (SDD) reduces HAIs and improves survival. The effects of both standard and SDD[1]enhanced infection on antimicrobial resistance gene carriage following critical illness are unclear. We have undertaken analysis of samples from children enrolled to an NIHR funded pilot clinical trial evaluating the feasibility of SDD in critically ill children. The trial infrastructure allowed us to efficiently collect samples from across six UK PICU sites and using the clinical database of the trial, we will combine culture-based methods (per trial protocol) with shotgun metagenomic profiling to examine antimicrobial resistance gene carriage in the faecal and oropharyngeal microbiomes during and 3 months after critical illness. At this time the trial sample collection is nearing completion (samples are collected up to 12 weeks post PICU discharge) and we are about to send these for sequencing in the next month. We will correlate with data on clinical disease severity and antimicrobial use in the PICU setting and examine how the microbiome recovers over time following hospital discharge. An understanding of whether SDD results in significant or sustained increases in antimicrobial resistance will inform the rationale for a future definitive clinical trial. We will use the data from this study to guide the development of a more personalised approach to SDD-enhanced infection control and the development of age-appropriate microbiota-based interventions to clear resistant bacteria in the intestinal microbiome.
Further updates from our supported research studies will be available soon…