BSMS > Research > Global health and Infection > Research areas > Infectious diseases

Infectious diseases

A diverse group of researchers at BSMS are working on infection, trying to understand the roles that immunological, genetic, pathogenic or environmental factors play in disease both locally and globally. Linking in with our global health strengths, we are able to undertake this research from a world-wide perspective with many projects married between UK groups and groups in Egypt, Sudan, Cameroon, Ethiopia and Zambia.

We focus on three key areas with specific applications in both our local hospitals and in low income settings. We have a particular interest in host pathogen-interactions in various contexts including sepsis b, healthcare-associated infections (HCAI), sexually transmitted diseases, viral hepatitis and tuberculosis.

The second theme is antimicrobial resistance (AMR) as a major global health issue. The rise in resistance rates is alarming and an increasing number of countries are reporting resistance to all of the commonly used antimicrobials, leading to untreatable fatal infections. This theme includes work on antimicrobial stewardship, including a partnership with University Teaching Hospital in Lusaka, Zambia funded through the Commonwealth Partnerships for Antimicrobial Stewardship Scheme.

The third theme is tuberculosis (TB), using genome-wide technologies to understand drug action in TB patients, to define TB bacteria that survive early drug therapy, and to identify the mode of action of novel anti-bacterial compounds. Overlapping with theme one above, we also explore the interactions between the host and Mycobacterium tuberculosis, that bacteria that causes tuberculosis, during human disease to understand genetic factors that influence susceptibility to TB and to define biomarkers that will help to shorten TB drug therapy.

Healthcare-associated infections

Antimicrobial resistance

Combating tuberculosis

A researchers hands in purple latex gloves pouring a clear liquid into a square petri dish

Healthcare-associated Infections

Healthcare-associated infections (HCAI) are a major concern globally. In Europe alone it is estimated that more than four million patients are affected by HCAI every year. HCAI comprise a broad range of diseases including blood-stream infections (bacteraemia, septicaemia), surgical site infections, and device-related infections. They cause high rates of morbidity and mortality to patients and result in a significant financial burden to healthcare institutes.

Staphylococci are leading pathogens causing HCAI. Whilst these organisms are harmlessly carried by a large proportion of the general population they can cause life-threatening disease in vulnerable patients. Our group works to enhance understanding of the epidemiology of infection and spread of these organisms in order to develop ways to prevent acquisition of infection and optimally manage infections if they do occur.

Healthcare-associated Infections areas of research at BSMS

Staphylococcal research

Prof Llewelyn is a member of the UK Clinical Infection Research Group (UKCIRG) and International Staphylococcus Aureus Collaboration (ISAC). These initiatives deliver large-scale observational and interventional studies in management of Staphylococcal infection. Prof Llewelyn is currently seconded to the Oxford Biomedical Research Centre where he leads studies applying microbial whole genome sequencing to understand Staphylococcal disease pathogenesis and develop novel diagnostics. Read more >

Researchers working on healthcare-associated infections projects

Please click on each name to read more about their specific projects.

Prof Martin Llewelyn >

Tackling Antimicrobial Resistance (AMR)

The rise in the rates of bacterial resistance to antimicrobials is alarming as increasing number of countries report resistance to all of the commonly used antimicrobials. AMR impedes effective treatment and prevention of infection which, compromises patient outcomes and can lead to untreatable fatal infections and global spread of resistant organisms. The WHO fear that without intervention more people will die of AMR-related infections than from cancer by 2050. Misuse of antimicrobial agents in people and animals is a dominant driving force.

Our group represent a network of cross-disciplinary researchers who are passionate about tackling AMR by understanding factors contributing towards its development and implementing strategies to optimise antimicrobial use particularly in low- and middle-income countries where significant data gaps exist.

AMR areas of research at BSMS

Epidemiology of Gram-negative and Gram-positive infections

An interdisciplinary project, run by Dr Leena Al-Hassan, aims to investigate the epidemiology of Gram-negative infections and characterise the main mechanisms of antibiotic resistance in different African countries, as well as looking at the role of mobile genetic elements in the transmission of resistance globally.

Research includes the epidemiology of both Gram-negative and Gram-positive infections, genetic mechanisms of resistance, evolution and transmission in the hospital setting, as well as the community, and antimicrobial stewardship.

Application of microbial genome sequencing

A team working with Prof Martin Llewelyn is currently looking at application of microbial genome sequencing to the study of transmission and pathogenesis of S. aureus infection and reducing antibiotic usage in hospitals through optimising treatment strategies. This is in collaboration with groups such as Modernising Medical Microbiology, the International Staphylococcus Aureus Collaboration and the NIHR-funded Antibiotic Reduction and Conservation in Hospitals (ARK-Hospital) programme.

Antibiotic Review Kit (ARK) Hospital

ARK-Hospital is an NIHR Programme Grants for Applied Research funded project developing a complex behaviour-change intervention to substantially and safely reduce antibiotic overuse in hospitals. Further information can be found on the project website www.arkstudy.ox.ac.uk. Prof Llewelyn is leading the clinical trial and the faecal ‘resistome’ sub-study.

FORESIGHT is a European Stakeholder Appraisal of Diagnostics to Manage Antimicrobial Resistance This is a collaboration between the University of Sussex Science Policy Research Unit (SPRU) and the Office for Health Economics. It is funded by the MRC.

The Consensus on Antimicrobial Stewardship Evaluations (CASE) Working Group led by Prof Llewelyn is an international initiative funded by the Joint Programme Initiative on AMR (JPIAMR) through the MRC. It is developing guidance for funders and researches on how antimicrobial stewardship interventions should be evaluated.

Prioritising Antimicrobial Resistance: Establishing an Interdisciplinary International Research Network (IRPN) to Tackle an Evolving Global Health Threat

A research partnership between the Wellcome Trust Brighton and Sussex Centre for Global Health Research (WTBSCGHR), The Centre for Global Health Policy (CGHP) at the University of Sussex, The Institute of Global Health (ISGlobal) at the University of Barcelona, and the Institute of Medical Microbiology, Immunology and Hygiene (IMMIH) at the University of Cologne.

These institutes have different, but overlapping, research experience and the IRPN partners form a global, collaborative, research network, including Egypt, Sudan, Ethiopia, Morocco, Mozambique, Cameroon, Bolivia and Peru. The partnership aims to obtain insight into the epidemiology of resistance at a global level, expand research and learning in novel technologies in whole-genome sequencing (WGS) to better understand the genetics of pathogens, and to gather data on the social and policy drivers that shape the evolution of resistance.

Building global surveillance data: towards a sustainable global response to AMR

In collaboration with the School of Global Studies and the Institute of Development Studies (IDS), a Sussex Sustainability and Research Programme (SSRP) fund was awarded to this project which aims to improve the knowledge base of the global AMR response by investigating how global surveillance systems can be linked better into local health system in LMICs.

The project will track the life-cycle of data that is produced in routine clinical practice and follow its trajectory in local healthcare facilities, the health system and the policy level as well as using molecular diagnostics (including whole-genome sequencing) on bacterial samples from hospitalised patients.

The Sussex Antimicrobial Resistance Study Group

The AMR study group serves as a platform to generate transformative knowledge through interdisciplinary collaborations. We hold regular meetings to share research expertise, engage in new ways of thinking about critical issues, and to develop partnerships, projects, and publications aimed a range of audiences, in order to contribute to addressing the challenge of AMR.

MORE about Sussex AMR Study Group >

Researchers working on AMR projects

Please click on each name to read more about their specific projects.

Prof Martin Llewelyn >
Dr Leena Al-Hassan >

PhD and Postdoc students working on AMR

Kevin Cole
Leon Peto
Angela McBride

Academic Clinical Fellows

Lizzie Cross
Simon Stoneham

Combating Tuberculosis and NTM Infections

Our work on tuberculosis (TB) uses genome-wide technologies to understand drug action in TB patients, to define TB bacteria that survive early drug therapy, and to identify the mode of action of novel anti-bacterial compounds. Overlapping with the AMR work, we also explore the interactions between the host and Mycobacterium tuberculosis, the bacteria that causes tuberculosis, during human disease to understand genetic factors that influence susceptibility to TB and to define biomarkers that will help to shorten TB drug therapy.

Despite being declared a global emergency over 20 years ago, one and a half million people still die from TB each year. Tuberculosis (TB) is the leading cause of death worldwide by a contagious disease and more than 2 billion people are infected with Mycobacterium tuberculosis. The standard drug therapy for TB uses combinations of four drugs over 6 months. Antimicrobial drug resistance (AMR) is a growing problem, with TB accounting for one third of drug-resistant bacterial infections. The recommended treatment for multidrug-resistant TB lasts 18–24 months or more, and is wholly dependent on increasingly toxic combinations of drugs. New drugs are needed to maintain and improve TB treatment success, shortening the duration of therapy and targeting drug-resistant bacteria.

The TB group in the Department of Global Health and Infection works together with UK, European and international partners in collaborative research projects and multidisciplinary industry-university consortia to discover new strategies to reduce the burden of TB disease. We place knowledge exchange and multilateral research training between high/middle and low-income countries at the centre of our research agenda.

Our approach combines molecular microbiology and human genetics to identify novel ways of preventing TB transmission and disease. We use genome-wide technologies to understand drug action in TB patients, to define TB bacteria that survive early drug therapy, and to identify the mode of action of novel anti-bacterial compounds.

We also explore the interactions between host and pathogen during human disease to understand genetic factors that influence susceptibility to TB and to define biomarkers that will help to shorten TB drug therapy. Dr Simon Waddell's main research areas include tuberculosis drug discovery, mycobacterial pathogenesis and TB biomarkers.

BSMS researchers working on TB projects

Please click on each name to read more about their specific projects.

Prof Melanie Newport >
Prof Simon Waddell >

PhD and Postdoc students working on tuberculosis

Heena Jagatia
Adam Roberts
Abdul Jabbar
Dr Filomena Perrone

Alumni from TB research group

Rehab Ahmed
Dr Alfredo Castañeda-García
Elena Hailu
Dr Leticia Muraro Wildner
Dr Kaj Kreutzfeldt

Read about the TB/NTM research team at BSMS >