AMR and HCAI: Outbreak response
How UKHSA assesses and manages infection outbreaks, provides guidance on usual AMR cases, and delivers specialist pathogen identification and outbreak investigation.
Where outbreaks of HCAI or community Staphylococcal and Streptococcal infections occur, our response includes prompt assessment of the level of risk to determine whether the incident should be managed at a standard or enhanced level.
Confirmation of unusual AMR of public health importance triggers the provision of therapeutic options and guidance to support patient management. We provide ongoing surveillance, analysis and guidance throughout the event.
The Opportunistic Pathogens Section is responsible for identifying and characterising opportunistic pathogens for hospitals in the UK, including outbreak and cross-infection investigation. Their work contributes to the reference laboratory for pathogens from patients with cystic fibrosis covering a wide range of organisms such as Acinetobacter, Burkholderia, Enterococcus, Enterobacter, Klebsiella, Pseudomonas and Serratia.
Work with our AMR and HCAI teams
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Incidents, Outbreaks and Infection Advice and Guidance (IOIG)
The Incidents, Outbreaks and Infection advice and Guidance (IOIG) Team is a small multi-disciplinary team with expertise in clinical microbiology, epidemiology, incident management and guidance development. Formed in November 2021 and restructured since, the team became fully operational in its current form in 2023.
IOIG investigates and responds to national HCAI and AMR incidents and outbreaks, providing expert advice and working closely with multiple teams across the organisation including, but not limited to, Health Protection and others across the HCAI, Fungal, AMR, AMU and Sepsis Division. In addition, the IOIG teamwork with external stakeholders including NHS Trusts and laboratories, and regulatory bodies such as Medicines and Healthcare Products Regulatory Agency (MHRA) and Office for Product Safety and Standards (OPSS).
The team also facilitates the production and publication of evidence-based infection guidance, resources, and toolkits to inform practice and policy, working with colleagues across the division.
National Outbreak Investigations and Incident Response
IOIG has led multiple national investigations into Burkholderia cepacia complex (bcc), a group of Gram-negative bacteria naturally resistant to many antibiotics that can contaminate healthcare and personal products. These included outbreaks associated with the contamination of; non-sterile alcohol-free skin cleansing wipes for first aid use (2020 to 2025), carbomer eye gels (2023 to 2024), and ultrasound gel (2024).
As part of outbreak response, IOIG communicated recommendations and highlighted risks to the public and wider health system via publications such as patient safety alerts and news stories. IOIG provided leadership and clinical expertise to the 2025 Candidozyma (C.) auris national standard incident led by UKHSA.
The incident objectives were to deliver preparedness and response activity; ensure multi-agency working across the UK to mitigate impact on the wider healthcare system and risk to patients; develop microbiological and epidemiological understanding and knowledge; and to facilitate health system preparedness and response to C. auris.