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. A description of the aetiology and burden of febrile illness, severe sepsis and drug resistant infection in Blantyre and Chikwawa
2. Improving access to antimicrobials for patients with critical illness whilst reducing prescription of unnecessary antimicrobials
3. Exploring the transmission dynamics of E. coli, Klebsiella spp. and Salmonella enterica between humans, animals and the environment