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Brighton & Sussex Medical School

TACTIC

TACTIC

TACTIC logo

Antimicrobial Resistance is a growing research area in the Department of Global Health and Infection (GHI) at BSMS. Over past five years we have developed an extensive AMR research portfolio focusing on collecting pilot data on the epidemiology of resistant organisms in Africa, establishing an international research network, and building capacity for researchers in LMICs. We are leading TACTIC (Tackling AMR Challenges through Translational Interdisciplinary Collaborations).

The aim is to assemble an international partnership that brings together world leaders in the field of antibiotic resistance (ABR), across interdisciplinary aspects: social and biomedical scientists working together to develop a comprehensive research plan. The network’s expertise ranges from basic molecular microbiology and medicine, through to social sciences with a common research goal: understanding the diverse drivers of antibiotic resistance, a pre-requisite for interventions towards solving the problem.

 

TACTIC group photo in conference

Network objectives 

The objectives of the network are to:

  • Advance the understanding of the global spread of AMR:
    • Bring together researchers with expertise and skillsets in the genomics and epidemiology of ABR
  • Strengthen cross-disciplinary research on AMR
    • Bring together researchers from the biomedical and social sciences to develop common research questions and research designs
  • Enhance AMR research in Low- and Middle-Income Countries 
    • Integrate the partners’ existing extended research networks and collaborations in low and middle income countries (LMICs) and build capacity for local scientists

Investing in local AMR projects in LMICs will bring many benefits both on the long- and short-term. In the short-term, we will 

  1. Build capacity for local scientists who need training and support to be able to produce data of excellent quality that would strengthen their position globally.
  2. Produce data useful for the global research community, to bridge any knowledge gaps in epidemiology and spread of resistance globally. 
  3. Facilitate knowledge exchange and promote local engagement of scientists by running local workshops on Genomics in AMR 

In the long term, the data produced will:

  • Create locally-relevant infection, prevention and control (IPC) measures, underpin antibiotic prescribing based on local data and epidemiology.
  • Benefit the community, patients and their families, in reducing the burden of infections.
  • Reduce the burden of infections will have direct economic benefits, as WHO estimates the LMIC burden is 3x higher, with an estimated cost of ~€7 billion per annum. 
  • Establish a cohort of independent scientists with strong skills and knowledge. 
  • Enhance community engagement and knowledge in AMR. 
A group of researchers outside at the university of sussex

Who we are

The expertise within the network includes molecular microbiology, clinical microbiology and infectious diseases, as well as international relations, policy, anthropology and development studies. 

BSMS

Brighton and Sussex Medical School (BSMS) is an equal partnership between the Universities of Sussex and Brighton together with NHS organisations throughout the South East region. The research undertaken at BSMS aims to make a genuine contribution to the evidence and science underpinning clinical practice, and to benefit people and patients in their health and wellbeing At BSMS our medical research has developed a strong reputation for making a real impact locally, nationally and internationally. BSMS has a vibrant global health research programme with academic links around the world. Taking an inter- and multi-disciplinary approach, we work on existing and newly arising health issues, including neglected tropical and non-communicable diseases, infectious diseases (tuberculosis, malaria, HIV), antibiotic resistance, health risk behaviours and their determinants, occupational health policy and practice, and hospital-acquired infections in low-income settings. Read more at www.bsms.ac.uk/global-health-and-infection

CGHP

Established in 2011, the Centre for Global Health Policy seeks to creatively promote the quality and equality of people’s health around the world by advancing rigorous research for improving global health policy. The Centre undertakes and promotes research on The Global Politics of Health, Making Global Health Policy, and Power in Global Health. Researchers from CGHP, the Institute of Development Studies, the Science Policy Research Unit (SPRU), the AMR research team at Brighton and Sussex Medical School and the Social, Technological and Environmental Pathways to Sustainability (STEPS) Centre form the Sussex AMR study group which reflects the complexity of the AMR global challenge and the required capabilities to address this, by bringing together researchers from across the social and natural sciences. 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. Read more at www.sussex.ac.uk/globalhealthpolicy

ISGlobal

The Barcelona Institute for Global Health (ISGlobal) is the fruit of an innovative alliance between "la Caixa", academic institutions and government bodies to contribute to the efforts undertaken by the international community to address the challenges in global health. ISGlobal is a consolidated hub of excellence in research that has grown out of work first started in the world of health care by the Hospital Clínic and the Parc de Salut MAR and in the academic sphere by the University of Barcelona and Pompeu Fabra University. Its ultimate goal is to help close the gaps in health disparities between and within different regions of the world. Among other initiatives, ISGlobal's Antimicrobial Resistance Initiative is designed to help to fight the growing emergence and spread of pathogens resistant to antimicrobial drugs from a multidisciplinary approach through the institute's core activities: research, training, technical assistance and analysis. www.isglobal.org/antimicrobial-resistance 

IMMIH

The Institute of Medical Microbiology, Immunology and Hygiene supplies the whole of the University of Cologne with bacteriological, parasitological-tropic-medical, infection-serological-immunological and molecular-biological diagnostics. Ten research groups at the IMMIH focus on mainly three research areas: 1) infection and cancer immunology, 2) antimicrobial resistance and diagnostics, and 3) translational research on infectious diseases. One of the research groups led by Dr Paul Higgins is focusing on Multi-drug resistance mechanisms of Gram negative bacteria, Molecular epidemiology of ESKAPE organisms and N. gonorrhoeae. Read more at immih.uk-koeln.de 

Partners (current)

The National Cancer Institute in Cairo, Egypt

Cairo University

Theodore Bilharz Research Institute

University of Khartoum

Afhad University for Women

Sudan University for Science and Technology

Ibn Sina University

Brighton Lusaka Health Link

researcher being presented a certificate

Projects

SSRP

In collaboration with the School of Global Studies at Sussex, we are conducting a project in the National Cancer Institute (NCI) in Cairo, Egypt looking at how the AMR data is produced and used in the healthcare setting, tracking the ‘life-cycle’ of data in the microbiological, local healthcare and political context. This project is interdisciplinary in nature, combining a bio-social approach to AMR. 

IDCF

Over the last 3 years, we have been able to establish a small team of researchers in Sudan in order to build capacity in AMR research. AMR data generation is very poor and scarce due to limited infrastructure, capacity and funding. The aim of this project is to build capacity in AMR research for local Sudanese scientists and provide them with expertise to novel laboratory/molecular techniques that have transformed the way we investigate AMR, such as whole-genome sequencing (WGS), through opportunities for individual training, as well as a series of locally-held workshops. 

Brighton-Lusaka Pharmacy Link

Established in 2014, the Brighton–Lusaka Pharmacy Link (BLPL) connects Zambian pharmacists from the University Teaching Hospitals (UTH) and the University of Zambia with British pharmacists from University Hospitals Sussex NHS Foundation Trust, the University of Brighton and the University of Sussex. Together, the group reviews common interests, identifies system gaps in both England or Zambia, and develops joint educational goals — most recently focusing on antimicrobial stewardship (AMS) and infection prevention and control (IPC) in Zambia. Misuse of antimicrobials, combined with poor IPC, can result in antimicrobial resistance (AMR). This may increase length of hospital stay, cost of treatment and the risk of adverse effects, as well as prolonged morbidity and mortality. Therefore, in 2018, the BLPL partnership was awarded one of 12 Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) grants to implement AMS at UTH. To ensure engagement and sustainability, a pharmacist-led multidisciplinary team (MDT) was established, which included physicians from Brighton and Sussex Medical School, University Hospitals Sussex NHS Foundation Trust and UTH, as well as IPC team physicians, nurses and pharmacists from Ndola Teaching Hospital, Zambia.

Past activities

Meetings: Brighton, Barcelona, Brighton, Amsterdam

Since 2016, TACTIC successfully held 5 meetings across all the partner countries. The first meeting for the network took place at BSMS in October 2016, where all the network partners met to discuss the activities planned through this network, and develop a research strategy. Over the years, we met in Barcelona, Amsterdam, Cairo and recently in Vienna. 

TACTIC also aimed to provide LMIC partner with opportunities for training, and consequently provided researchers with opportunities for research tuition in areas such as microbial genetics and epidemiology, and training on whole-genome sequencing (WGS) methodology.

WGS training for Cairo Uni staff at BSMS

A new sequencer (MiSeq) was installed in Cairo University, and the microbiology team there required training on using the machine, reagents, and interpretation of the results, which was be provided by the clinical microbiology team at University Hospitals Sussex NHS Foundation Trust (Kevin Cole and Dr James Price). The training visits took place in October 2017. 

Local workshops 

Dr Leena Al-Hassan held a workshop at the NCI in Cairo on mobile genetic elements and their role in horizontal gene transfer of resistance in Gram-negative bacteria. This workshop was attended by 25 participants from different universities around Egypt. This workshop was part of the capacity building initiative of the network.Dr Paul Higgins participated in a workshop on Whole-Genome Sequencing in Cairo in November 2018 to carry out training for the Microbiology team at the National Cancer Institute on sequencing data interpretation and software.

Individual research tuition opportunities

Through the previous pilot studies we have provided two PhD students with opportunities for short research tuition at BSMS, and participation in international conferences to present their work, and to be part of the TACTIC network. Hana El Badawy (from Sudan) visited the Higgins lab in Cologne, to work on the epidemiology of Acinetobacter baumannii from Soba University Hospital. Her data was presented in the 12th International Symposium on the Biology of Acinetobacter in Frankfurt 2019. Einas Awad (from Sudan) visited to BSMS to work with Dr Leena Al-Hassan on genomic analysis of Acinetobacter baumannii and Klebsiella pneumoniae from Sudan. Einas’ work on using multi-locus sequence typing of K. pneumoniae from four Khartoum State Hospitals was presented the 29th European Congress of Clinical Microbiology and Infectious Diseases in Amsterdam 2019. Kassu Desta from Addis Ababa University conducted a 4-month research tuition at BSMS to work with Dr James Price, Dr Leena Al-Hassan, and Dr Daire Cantillon, to characterise the epidemiology of Staphylococcus aureus isolates from clinical and environmental sources within Black Lion Hospital in Addis Ababa, Ethiopia.