Infection & Antimicrobial Resistance

North-west London has substantial social inequality and an ethnically diverse population. The area has long been associated with a high burden of infectious diseases, but this came into sharp focus with the high mortality from COVID-19. Engagement with the local community and patient groups prior to COVID-19 identified antimicrobial resistance (AMR), HIV and pandemic preparedness as research priorities to safeguard and protect the health of the Northwest London population and beyond.

• To develop improved approaches to preventing infection (potentially supported by human challenge studies)
• To identify new diagnostic markers to determine viral/bacterial infection and novel means for rapid diagnosis
• To evaluate the impact of rapid diagnostics on clinical pathways
• To identify novel therapeutic agents and better ways to use existing therapeutics

Novel prevention and vaccination strategies

Investigators are working on the next generation of vaccines, particularly RNA-based technologies including self-amplifying RNA. Theme members work closely with colleagues in bioengineering to develop new methodologies for delivery and with industrial partners on Phase I/II studies. Aligned with this, the discovery of monoclonal antibodies for both diagnostics and therapeutics is embedded in the theme, focussed particularly on bacterial infection.

Work on vaccine development is supported by controlled human infection models (CHIM).  Local investigators have a long track record in respiratory virus challenge work (influenza, rhinovirus, RSV) and led the first human challenge studies with SARS-CoV2. In partnership with Imperial College NHS Trust and Chelsea and Westminster NHS Foundation Trust, this programme continues with a wider capacity for human challenges including malaria and salmonella infections.

Diagnostics and digital health

Theme investigators have led the discovery of new diagnostic markers to support the management of patients with a fever (both adults and children). Novel gene expression and metabolic markers are being developed as diagnostics in collaboration with industrial partners. During the COVID-19 pandemic, investigators led the clinical development of COVIDnudge,  a novel point-of-care diagnostic rolled out across the NHS. Translation of new tests to the NHS is supported by the Colebrook Laboratory and the Molecular Diagnostics Unit.

Digital support tools and altering are an area of major focus, investigators continue to evaluate tools for prompt detection and management of sepsis, and selection of antimicrobials, working closely with the BRC Digital Health Theme.

In partnership with the NHS, the BRC Igenios Clinic provides a service for children and young adults with severe infection to identify rare genetic variants that might offer insight into disease susceptibility and guide future management.

Novel therapeutic approaches and precision medicine

Investigators are developing and evaluating novel therapies that offer potential curative therapy for chronic viral infection (particularly HIV, HTLV and hepatitis C). Trials of neutralising antibody therapy are underway and novel cellular therapeutics are in development (for example iNKT cellular therapy). Trials are also underway for novel monoclonal therapy that might prevent the emergence of malignancy in patients living with HTLV.

The theme supports studies that evaluate the optimum way to use existing antimicrobials. The Centre for antimicrobial optimisation explores the optimum dosing, particularly of antibacterials while the theme supports the development of platform therapeutic trials,  including REMAPCAP-flu,  to evaluate different treatments for patients admitted to hospitals with influenza.

Our theme research priorities were established through engagement with local community and patient groups. Research projects within our theme are committed to raising public awareness,  delivering educational content and actively surveying the public and research participants for feedback. Our community partners will also provide critical feedback on research projects and lay summaries, and ensure that the research is beneficial to the public.

At the management level, our community partners with lived experience will help guide our theme’s strategy by contributing to the theme steering committee meetings. We also work closely with the BRC Patient Experience Research Centre to coordinate PPIEP activities.

Our research focuses on addressing infections that affect ethnically diverse populations, including underserved and marginalized groups. We are dedicated to promoting diversity in research participation by fostering trust and understanding within the community. Our commitment to inclusivity and diversity also extends to our community partners, who will be chosen from a wide range of backgrounds. Additionally, we apply EDI principles in our recruitment processes to create an inclusive academic community that accommodates individuals with diverse physical needs.