Drug-Resistant Infections

Our objective is to understand and improve antimicrobial use (AMU) and antimicrobial resistance (AMR) in agriculture, the community, and hospitals. Our approach is interdisciplinary – led by a number of OUCRU’s research groups and public engagement teams.

Our research encompasses the spectrum of important drug-resistant infections in the region, including multi-drug resistant (MDR) gram-negative bacteria, Mycobacterium tuberculosis, and artemisinin-resistant Plasmodium falciparum.

Ha Noi

In the Ha Noi Unit, the research has included driving the situation analysis and development of a National Action Plan for AMR (2013-2020), establishing a surveillance network of hospitals (VINARES) and a reference laboratory, both of which have been recognised by the Ministry of Health Vietnam and received national status under Fleming Fund grants. OUCRU currently has a seat on the advisory panel to the Vietnamese Ministry of Health for the development and implementation of the National Action Plan 2021-2030.

In the last seven years, the Ha Noi Unit has focused on applied descriptive and interventional studies on drug-resistant infections in ICU and community-based interventions to reduce use and resistance, including using rapid diagnostics (C-Reactive Protein) and implementing and researching antimicrobial stewardship at provincial-level hospitals.

Ho Chi Minh City

In Ho Chi Minh city, the Unit has focused on bacterial drug resistance, developing clinical microbiology capacity in a wide spectrum of hospitals, drug-resistant infections in the ICU, resistance among enteric pathogens (Shigella and Salmonella Typhi), and at the human-animal interface (E. coli, non-Typhi Salmonella, S. suis). This has also included large-scale whole-genome and microbiome sequencing. In addition, part of the portfolio of malaria and tuberculosis research groups is dedicated to drug-resistant infections, including treatment trials, whole genome sequencing and more discovery-oriented research on resistance mechanisms and emergence.

Indonesia

Over the past four years, OUCRU Indonesia has leveraged the existing expertise and networks in Vietnam and nurtured a closely aligned yet context-specific research programme. This includes mixed-method research to understand patterns and drivers of antibiotic prescribing in hospitals and identify opportunities for stewardship interventions. OUCRU Indonesia takes part in several large international projects that are delivered in both countries on AMR surveillance, antibiotic stewardship, and blood culture barriers.

Conducting these studies across the two countries in our programme and the wider Oxford Tropical Network allows for local tailoring and contextualisation, while the collaboration between the two countries and the wider Oxford Tropical Network network enhances the generalisability and impact of results.

The current DRI research programme falls under the following overarching aims:

Improve the impact of surveillance of drug-resistant infections using clinically oriented case-based hospital surveillance and whole genome sequencing.

Continue our antimicrobial stewardship programmes at provincial-level hospitals and expand to district-level hospitals:

  • Antibiotic Stewardship Programme
  • Microbiology solutions

To evaluate interventions to reduce antibiotic use and resistance at the community level, taking a OneHealth approach.

To conduct innovative clinical trials to evaluate treatment outcomes of drug-resistant infections.

Explore quantitatively how climate and AMR are related and combine this with community engagement to explore public understanding of the health risks associated with climate change and AMR.

Public and Community Engagement: Engaging the public in our AMR research through activities in hospitals and communities, including photo-voice co-production events, advisory boards and community-led interventions in farming groups.

Publications

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Hoang Huy Tran, Hien Anh Thi Nguyen, Huyen Bang Tran, Bich Ngoc Thi Vu, Tu Cam Thi Nguyen, Costanza Tacoli, Thao Phuong Tran, Tung Son Trinh, Thien Huong Ngoc Cai, Behzad Nadjm, Kieu Huong Thi Tran, Quynh Dieu Pham, Thuong Hong Thi Nguyen, Trang Thu Nguyen, Thai Duy Pham, Thomas Kesteman, Duc Anh Dang, Tien Dac Tran, H Rogier van Doorn, Sonia Lewycka
Sci Rep
December 29, 2022
DOI: 10.1038/s41598-022-27084-z
H. Rogier van Doorn, Thyl Miliya, Anousone Douangnouvong, Ngan Ta Thi Dieu, Chansovannara Soputhy, Meymey Lem, Danoy Chommanam, Valy Keoluangkhot, Bandith Soumphonphakdy, Khaysy Rassavong, Khamphong Thanadabouth, Manoloth Sayarath, Vilada Chansamouth, Minh Dien Vu, Phu Khiem Dong, Van Duong Dang, Van Bac Tran, Thi Kim Yen Do, Thi Ngoc Ninh, Hong Long Nguyen, Ngoc Hao Kim, Sothea Prak, Manivanh Vongsouvath, Dinh Trang Van, Thi Kim Tuyen Nguyen, Hong Khanh Nguyen, Raph L. Hamers, Clare Ling, Tamalee Roberts, Naomi Waithira, Prapass Wannapinij, Tien Viet Dung Vu, Olivier Celhay, Chanpheaktra Ngoun, Susath Vongphachanh, Ngoc Thach Pham, Elizabeth A. Ashley, Paul Turner
Wellcome Open Res
December 29, 2022
DOI: 10.12688/wellcomeopenres.18317.1
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