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:

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.

Antimicrobial Stewardship Programme

Our AMS Programme is a strategic initiative designed to curb the growing threat of antimicrobial resistance (AMR).

Publications

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Zoe A Dyson, Philip M Ashton, Farhana Khanam, Angeziwa Chunga Chirambo, Mila Shakya, James E Meiring, Susan Tonks, Abhilasha Karkey, Chisomo Msefula, John D Clemens, Sarah J Dunstan, Stephen Baker, Gordon Dougan, Virginia E Pitzer, Buddha Basnyat, Firdausi Qadri, Robert S Heyderman, Melita A Gordon, Andrew J Pollard, Kathryn E Holt; STRATAA Study Group
Lancet Microbe
July 6, 2024
DOI: 10.1016/S2666-5247(24)00047-8
Huong Thi Lan Vu, Thuy Thi Thanh Pham, Yen Hai Duong, Quan Anh Truong, Hong Khanh Nguyen, Tu Thi Cam Nguyen, Long Xuan Trinh, Ha Thi Hong Nguyen, Minh Quang Le, Vinh Hai Vu, Duc Minh Chau, Nguyet Thi Huynh, Em Thi Hoang Dung Vo, Hoa Nguyen Minh Le, Thach Ngoc Pham, Todd M Pollack, H Rogier Van Doorn.
JAC Antimicrob Resist
April 16, 2024
DOI: 10.1093/jacamr/dlae064
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