Questions to be answered
- 1. What is the aetiology of febrile illness in urban and rural Malawi?
2. How do we optimise the management of infectious disease in sSA to minimise both mortality in the individual and antimicrobial resistance in the community?
3. How can we interrupt the transmission of enteric pathogens including AMR-bacteria?
- MLW has conducted sentinel surveillance of bloodstream infection (BSI) and antimicrobial resistance (AMR) since 1998. This has enabled the description of three epidemics of invasive Salmonella disease and a host of other bacterial pathogens, plus longitudinal trends in drug resistant bloodstream infection (DR-BSI). This surveillance only describes approximately 12% of febrile illness presenting to QECH, does not extend to nosocomial infection nor to community or rural sites. We do not know the optimal management of febrile illness in our context, nor how to interrupt transmission of enteric pathogens through targeted WASH strategies, nor how best to steward our antimicrobials to mitigate AMR spread. The BDRI group will address these knowledge gaps.
- 1. To describe the aetiology and burden of febrile illness, severe sepsis and drug resistant infection in Blantyre and Chikwawa
2. To optimise antimicrobial therapy in the management of febrile illness and sepsis, to improve access to antimicrobials for patients with critical illness whilst reducing prescription of unnecessary antimicrobials
3. To explore the transmission dynamics of E. coli, Klebsiella spp. and Salmonella enterica between humans, animals and the environment
Drivers of Resistance in Uganda and Malawi MRC, £3 million
SWARM, Wellcome Trust, £450,000
TENTACLE, Wellcome Trust, £450,000
ANTIDOTE, Wellcome Trust, £450,000
DASSIM, Wellcome Trust, £450,000
Environmental reservoirs of Salmonella Typhi, Bill and Melinda Gates Foundation, $1.5 million
Febrile Illness Aetiologies in a Broad range of Endemicities (FIEBRE), DFID, £950,000
- Hammarlöf DL, Kröger C, Owen SV, Canals R, Lacharme-Lora L, Wenner N, Schager AE, Wells TJ, Henderson IR, Wigley P, Hokamp K, Feasey NA, Gordon MA, Hinton JCD. Role of a single noncoding nucleotide in the evolution of an epidemic African clade of Salmonella. Proc Natl Acad Sci U S A. 2018 Mar 13;115(11) PMID: 29487214
- Maze MJ, Bassat Q, Feasey NA, Mandomando I, Musicha P, Crump JA. The epidemiology of febrile illness in sub-Saharan Africa: implications for diagnosis and management. Clin Microbiol Infect. 2018 Feb 15. Review.PMID: 29454844
- Edwards T, Sasaki S, Williams C, Hobbs G, Feasey NA, Evans K, Adams ER. Speciation of common Gram-negative pathogens using a highly multiplexed high resolution melt curve assay. Sci Rep. 2018 Jan 18;8(1):1114. PMID: 29348433
- Lewis JM, Savage RS, Beeching NJ, Beadsworth MBJ, Feasey N, Covington JA. Identifying volatile metabolite signatures for the diagnosis of bacterial respiratory tract infection using electronic nose technology: A pilot study. PLoS One. 2017 Dec 18;12(12). PMID: 29252995
- Ashton PM, Owen SV, Kaindama L, Rowe WPM, Lane CR, Larkin L, Nair S, Jenkins C, de Pinna EM, Feasey NA, Hinton JCD, Dallman TJ. Public health surveillance in the UK revolutionises our understanding of the invasive Salmonella Typhimurium epidemic in Africa. Genome Med. 2017 Oct 31;9(1):92. PMID: 29084588
- Musicha P, Cornick JE, Bar-Zeev N, French N, Masesa C, Denis B, Kennedy N, Mallewa J, Gordon MA, Msefula CL, Heyderman RS, Everett DB, Feasey NA. Trends in antimicrobial resistance in bloodstream infection isolates at a large urban hospital in Malawi (1998–2016): a surveillance study. Lancet ID 2017 In press
- Musicha P, Feasey N, Cain A, Kallonen T, Chaguza C, Peno C, Khonga M, Thompson S, Gray K, Mather A, Heyderman R, Everett D, Thomson NR, Msefula C. Genomic landscape of extended spectrum β-lactamase resistance among Escherichia coli isolates from an urban African setting. JAC. Jan 2017
- Owen S, Wenner N, Canals R, Makumi A, Hammarlöf DL, Gordon MA, Aertsen A, Feasey NA, Hinton JCD. Feb 2017 Frontiers in Microbiology