A one health approach to unravelling hospital and community generated AMR at teh University of Edinburgh

Supervisors: Dr Adrian Muwonge, Dr. Stella Mazeri, Prof. Mark Bronsvoort and Prof. Ross Fitzgerald

Closing Date:  5th January 2022

Antimicrobial resistance (AMR) threatens the sustainability of health systems, which disproportionately impacts developing countries. The current bottleneck for designing realistic global control strategies, is our inability to quantify AMR burden in the community. This is critical for evaluating livestock targeted interventions, particularly since 73% of all antibiotics sold globally are used in animals raised for food. The PhD studentship will examine the behavioral, phenotypic and genotypic dynamics that drive Hospital and Community generated resistance (HGR and CGR) using bacteremia causing pathogens(BCP) E.coli and S. aureus. To do so, they will use five datasets from the Fleming fund Fellowship study in two districts of Uganda, with the following objectives;

1. Develop a spatial analytical framework using the distribution of human & animal antibiotic access points as proxy for antibiotic usage (Dataset-C)

1. Examine the relationship between prevalence of resistant BCP in hospitals and antibiotic prescription practice (Datasets-A&D)

1. Examine the BCP resistance profiles in communities, follow-up cases and their livestock (Datasets-B&C)

1. Elucidate transmission from phylodynamic characteristics of BCP recovered in hospital and community settings (Dataset-E)

Datasets

The study was strategically designed to cover three Fleming fund thematic areas for tackling AMR i.e. how we use antibiotics (Stewardship), how we detect antibiotic resistance (diagnostics) and how we monitor trends of antibiotic resistance (surveillance). Cross-sectional and retrospective data were collected, collated respectively. At regional referral hospitals, 300 Bacteremia patients were identified in Jinja and Mbarara, those who kept animals, households were visited and 920 samples collected for BCP culture and resistance profiling (Dataset-A). In the same communities, 480 household visited to collect 1420 samples (Dataset B). In addition to 1200 geo-mapped drug outlets and hospitals (Dataset-C), a review of 2400 hospital-prescription patterns was also done (Dataset-D). In total 650 BCP isolates have been sequenced and awaiting analysis (Dataset-E).

References

Fleming fund scholarship activities at the University of Edinburgh 2020 https://www.ed.ac.uk/edinburgh-infectious-diseases/news/news/ugandafleming-fellowships-in-amr-surveillance

Mugerwa, I.; Nabadda, S.N.; Midega, J.; Guma, C.; Kalyesubula, S.; Muwonge, A. Antimicrobial Resistance Situational Analysis 2019–2020: Design and Performance for Human Health Surveillance in Uganda. Trop. Med. Infect. Dis. 2021, 6, 178. https://doi.org/10.3390/tropicalmed6040178

We would encourage applicants to list up to three projects of interest (ranked 1st, 2nd and 3rd choice) from those listed with a closing date of 5th January 2022 at https://www.ed.ac.uk/roslin/work-study/opportunities/studentships 

This opportunity is open to UK and international students and provides funding to cover stipend, tuition fees and consumable/travel costs.  Applications including a statement of interest and full CV with names and addresses (including email addresses) of two academic referees, should be emailed to [email protected].

When applying for the studentship please state clearly the project title/s and the supervisor/s in your covering letter.

A webinar will be held on Tuesday 14th December at 13.00hrs (UK time) to assist you in the application process and tell you a little more about studying for a PhD with us.  It will also give you an opportunity to ask any questions you may have.  If interested in joining us please send your name and email address to [email protected]by Friday 10th December and we will send you a link to the on line meeting

ALL APPLICATION PROCEDURES MUST BE COMPLETED BY THE CLOSING DATE 5th JANUARY 2022