AMR and HCAI: Research and interventions
UKHSA advances infection prevention and antimicrobial stewardship through integrated research, specialist microbiology, community interventions and large‑scale studies.
Scientific Research
Research scientists and analysts combine qualitative and quantitative methods to develop and monitor antimicrobial stewardship (AMS) and HCAI interventions using mathematical modelling and behavioural science approaches.
Work with our AMR and HCAI teams
We work with industry, academia and government. Contact AMR and HCAI to find out how we can help you.
AMR bioinformatics
The division’s bioinformatics team have been building their capability to acquire, analyse and act on pathogen genome sequence data. Aligned to UKHSA’s Pathogen Genomics Strategy, we work with reference microbiology laboratories to build bioinformatic analytical pipelines. We collaborate with various teams in the division to combat AMR with pathogen genomics-derived insights.
Pathogen genomics applied to AMR will provide detailed understanding of resistance mechanisms and transmission patterns, enabling healthcare practitioners and policymakers to implement targeted infection control interventions and antimicrobial stewardship programs, ultimately preserving the efficacy of antibiotics and protecting public health.
Our research covers:
- genetic basis of vancomycin and daptomycin resistance in S.aureus
- nanopore technology
- Staphylococcus aureus (MSSA)
- identification and control of invasive Group A streptococcus infection outbreaks
- identification and investigation of inequalities in Group B streptococcus infection
- development of novel assays for identification of bacterial toxins including real-time PCR, MALDI-ToF
- validation of Novaseq technology and comparison with other 3rd generation sequencing technologies
- One Health research projects between APHA and UKHSA
- evaluation of interventions to reduce surgical site infection risk
- investigation of patient and surgical risk factors for surgical site infections
- antimicrobial stewardship interventions
Reference microbiology
The division inputs into specialist reference microbiology services that deliver laboratory testing across a wide range of topics, including:
- investigation of bacterial strains demonstrating unusual AMR
- diagnosis of clinical toxinoses and environmental health sampling postmortem investigation
- surveillance of invasive disease (including all MRSA bacteraemia isolates)
- identification of transmission events and spikes in outbreaks
Primary Care and Interventions Unit (PCIU)
The UKHSA Primary Care and Interventions Unit (PCIU) works to prevent and improve the management of common infections in primary care through research, guidance, resource development and education of professionals, the general public and young people.
The unit leads AMR public health surveys and 2 important intervention programmes providing the public with wraparound support and messaging to improve the management of common infections and antibiotic resistance. e-Bug is an international educational programme targeting school children, educators and community groups. TARGET (Treat antibiotics responsibly: guidance, education, and tools) is an antimicrobial stewardship toolkit for healthcare professionals.
PCIU: important outputs
PCIU has:
- successfully rolled out TARGET AMS training to over 2,000 healthcare professionals in England
- e-Bug collaborated on the EU-funded SafeConsumE project (2018 to 2022) to reduce the health-burden from foodbourne illnesses
- TARGET developed a suite of AMS resources for community pharmacy settings and collaborated with NHSE to embed these in the 2020 to 2024 Pharmacy Quality Schemes
- e-Bug supported schools during the COVID-19 pandemic by providing important IPC training and teaching materials
Further resources on e-Bug and TARGET
e-Bug leads the internationally available ‘e-Bug’ online education resource for schools and communities to educate young people on the following topics:
- introduction to microbes
- hand hygiene
- respiratory hygiene
- antimicrobial resistance
The resource includes age appropriate lesson plans and interactive activities.
The TARGET programme includes information on interventions to prevent and treat infections optimally in the community.
The programme provides guidance and diagnostic tools for professionals to use and supports primary healthcare providers through antimicrobial stewardship and appropriate prescribing.
SIREN study
UKHSA’s SIREN Study was established early in the COVID-19 pandemic to understand infection rates and vaccine effectiveness in healthcare workers (HCWs) across the UK. The SIREN team, created to deliver the study, now has capability to deliver ongoing research on HCAI and AMR.
SIREN remains the largest global study in HCWs (n=44,500) and has been monitoring SARS-CoV-2 infections in UK HCWs continuously since June 2020, providing timely and authoritative updates on vaccine effectiveness, post-infection immunity and infection trends to national scientific experts and policymakers, including the Joint Committee on Vaccination and Immunisations.
SIREN is an agile study that has continually adapted to the evolving pandemic. Since 2022, we have expanded testing of HCWs to include influenza and respiratory syncytial virus (RSV), conducted mixed methods research to understand barriers and enablers to vaccination, and studied the impact of illness and staff absence on the workforce.
SIREN: important outputs
SIREN:
- establised a network of 135 NHS sites, public health agencies and academic collaborators across the UK
- produced robust and timely evidence on the effectiveness of the vaccine programme and duration of immunity following infection
- included additional data on health equity, specifically ethicity and IMD, into our annual epidemiology commentary
- established a UK-wide HCW Public Participant Involvement and Engagement panel for co-development of the evolving study
- created a large sera biobank with over 400,000 samples for future research