Staphylococcus aureus is a type of bacteria that can cause range of infections from skin infections such as boils and impectigo to food poisoning and abscesses. However it becomes particularly serious and potentially life threatening, when the bacteria infects the blood stream (bacteraemia). This includes diseases such as MRSA, pneumonia, meningitis or sepsis, which can result in death in 25 per cent of cases.
Approximately 12,500 cases of staphylococcus aureus occur in the UK each year, killing an estimated 3,000 patients and costing the NHS around £225 million.
With less than 1,600 people participating in trials to determine the best treatment option for staphylococcus aureus bacteraemia there was a limited evidence base until the ARREST trial.
Read the full case study.
Following the declaration of the swine flu as a pandemic, in preparations for the winter flu season in the autumn of 2009, the UK acquired two new influenza A H1N1 vaccines: Pandemrix and Celvapan. Due to the urgent need to provide effective vaccines in a short amount of time, both vaccines had been licensed for use without having undergone testing on children.
The University of Oxford’s Oxford Vaccine Group, which is linked to the NIHR Oxford Biomedical Research Centre, was appointed to conduct research to provide paediatric data on these vaccines, with fast-tracked ethical and regulatory approvals, due to the time critical nature of the research. After being awarded the research grant on 1 September 2009, the research team was able to redeploy resources - including the hiring of 80 staff - using NIHR infrastructure.
Combined, these rapid actions allowed the first vaccine administrations to take place within a month of commencing the study. The team reported an interim analysis of the data by mid-November, informing the Joint Committee for Immunisation and Vaccination and the Department of Health that both vaccines were well tolerated by participating children.
Sexually transmitted infections (STIs) are common and treatable but men are more reluctant than women to have a test.
Research funded by NIHR Programme Grants for Applied Research found that most men aged 18-35 would be willing to collect and send off a urine sample using a kit to test for STIs, according to a national survey. GP surgeries were the most popular place to collect kits, followed by pharmacies and sexual health clinics.
Clostridium difficile, also known as C. difficile, or ‘C diff’, is a bacterium which can live harmlessly in the gut of many people. However these bacteria can make toxins (poisons) which cause very severe diarrhoea with complications that can lead to death. The aim of the Modify study was to test whether new monoclonal antibody drugs (drugs which were designed to neutralise the C. difficile toxins), would reduce the recurrence of the infection when used alongside standard antibiotic treatment.
You can find out more about Infection studies in your area through Be Part of Research website.
The NIHR Clinical Research Network (CRN) provides researchers with the practical support they need to make clinical studies happen in the NHS. We provide world-class health service infrastructure - research support staff such as clinical research nurses, and research support services such as pharmacy, pathology and radiology - to support organisations seeking to conduct clinical research in the NHS in England. Some of this research is funded by the NIHR, but most of it is funded by NHS non-commercial partners and industry.
We support the set up and delivery of clinical research in the NHS through our Study Support Service and our Research Design Service helps researchers develop proposals to secure funding from our research programmes.
The Infection Specialty is one of 30 specialties that bring together communities of clinical practice to provide national networks of research expertise. Our membership is made up of research-interested clinicians and practitioners at both national and local levels. Our role is to ensure that the Infection studies included in our national portfolio of research receives the right support to ensure they are delivered successfully in the NHS - to time and target.
The Infection Specialty oversees research relating to the pathogenesis, diagnosis, treatment and prevention of infectious diseases. This means that we support a wide range of research studies such as those which look at HIV, pneumonia and meningitis
The Clinical Research Network is made up of 15 localities. Each one has at least one nominated local lead for Infection research. These clinicians lead research groups to promote and support infectious diseases and microbiology research within the NHS Trusts in their area.
At a national level the local leads come together to manage the national infectious diseases and microbiology research portfolio overall. This involves regularly reviewing the progress of studies, identifying barriers to recruitment, and coming up with solutions and strategies to help overcome those barriers.
The Infection Specialty supports investigators and other stakeholders planning new Infection, microbiology and genitourinary medicine research studies to ensure that those studies will address patients’ needs and can be successfully delivered in the NHS. We currently support research studies in the following areas:
Research is the innovation that brings better healthcare and treatments to patients in the NHS and it is part of the NIHR’s role to ensure the talent pool of research active clinicians continues to thrive. The NIHR Clinical Research Network (CRN) Infection Specialty Group is helping do just that by making it a focus for their work.
Dr Jane Minton, NIHR CRN National Specialty Lead for Infection, is leading an initiative aimed at supporting more infection clinicians in developing their research career, says:
“It’s really important that research takes places in all medical specialties and that all patients have the opportunity to take part. Infection is a tricky area to conduct research for many reasons. For example, some patients are very ill when they come into hospital or perhaps there’s some stigma attached to their condition so these are real barriers that can affect the ability to deliver research. These are areas in which we need to provide additional support to researchers to help them overcome these issues, while developing their careers.”
Watch the short films below to find out more.
Dr Jane Minton
National Specialty Lead
Professor Jonathan Ross
Specialty Lead - CRN West Midlands
Dr Fiona McGill
Infection - Early Career Researcher
The NIHR Clinical Research Network (CRN) Infection National Specialty Group membership includes representatives from Public Health England and The MRC Clinical Trials Unit. It works closely with its stakeholders to support the delivery of research in infectious diseases and microbiology including Urgent Public Health research and initiatives to improve the design and delivery of clinical trials for antibiotics.
Urgent public health outbreaks can cause serious risk to human health. In the event of an urgent public health outbreak (e.g. a pandemic) the National Institute for Health Research (NIHR) Clinical Research Network must be able to rapidly set-up relevant research studies and ensure that these studies are successfully conducted so that their findings can inform the on-going care of patients during the outbreak. The aim of the Clinical Research Network during an urgent public health outbreak will be to deliver identified research studies in an efficient and timely manner. This will involve both the national Clinical Research Network Coordinating Centre and the Local Clinical Research Networks.
Combating Bacterial Resistance in Europe – improving clinical trials for antibiotics.
The challenge of antimicrobial development is so great that no organisation could take it on alone. COMBACTE will give antibiotic development in Europe a major boost by bringing together leading experts from universities, hospitals, and pharmaceutical companies who are skilled in microbiology, epidemiology, drug development, and clinical trial design.
The objective of BASHH is to promote, encourage and improve the study and practice of diagnosing, treating and managing sexually transmitted infections, HIV and other sexual health problems.
BHIVA is a leading UK association representing professionals in HIV care. Since 1995, they have been committed to providing excellent care for people living with and affected by HIV. BHIVA is a national advisory body on all aspects of HIV care and they provide a national platform for HIV care issues.
The BIA’s aims are to enhance the prevention, management, and control of infection and to improve professional representation on national bodies formulating policy about training, continuing professional development and delivering health care in the field of infection.
The Healthcare Infection Society (HIS) is a charity whose objectives are to advance knowledge of, foster scientific interest in and disseminate information about the prevention and control of hospital and other healthcare associated infections (HCAIs), to medical and allied professionals for the benefit of the public. HIS membership is largely medical, especially consultant microbiologists and trainees, and associate members (nurses and other health professionals with a professional interest in infection control).
The Medical Research Council improves human health through world-class medical research. The MRC fund research across the biomedical spectrum, from fundamental lab-based science to clinical trials, and in all major disease areas. Their research has resulted in life-changing discoveries for over a hundred years.
PHE is an executive agency, sponsored by the Department of Health and Social Care. PHE protect and improve the nation's health and wellbeing, and reduce health inequalities.
The RSTMH is dedicated to changing the face of global health through its network of Fellows across the world by facilitating training, education and the exchange of information. The RSTMH work at the cutting edge of the study, control and prevention of human and animal diseases worldwide, charting changing patterns and pioneering new interpretations of modern tropical medicine and global health.
The British Society for Antimicrobial Chemotherapy exists to facilitate the acquisition and dissemination of knowledge in the field of antimicrobial chemotherapy. They are at the forefront of the antimicrobial chemotherapy field, the Society meets its aims by setting standards for antimicrobial susceptibility testing and use, both within the UK and overseas, supporting microbiologists in their practice, and the promotion and provision of channels through which its Members can ensure their continuing professional development.
Wellcome exists to improve health for everyone by helping great ideas to thrive. They’re a global charitable foundation, both politically and financially independent. They support scientists and researchers, take on big problems, fuel imaginations, and spark debate.
Meningitis Research Foundation funds research into the prevention, detection and treatment of meningitis and septicaemia and shares the knowledge gained by research so everyone can benefit. They raise awareness of meningitis and septicaemia, as well as supporting those affected by meningitis and septicaemia.
The NIHR provides the support and facilities the NHS needs for first-class research by funding a range of infrastructure.
NIHR Biomedical Research Centres (BRCs), partnerships between England’s leading NHS organisations and universities, conduct translational research to transform scientific breakthroughs into life-saving treatments for patients with infectious diseases. The following BRCs undertake infection research:
NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) are collaborations between local providers of NHS services and NHS commissioners, universities, other local organisations and the relevant Academic Health Science Network. The primary focus of CLAHRCs is research targeted at chronic disease and public health interventions. The following CLAHRCs undertake research in infection:
NIHR Medtech and In vitro diagnostics Co-operatives (MICs) build expertise and capacity in the NHS to develop new medical technologies and provide evidence on commercially-supplied in vitro diagnostic tests. The following MICs undertake research in infection:
NIHR Health Protection Research Units (HPRUs) are research partnerships between universities and Public Health England and act as centres of excellence in multidisciplinary health protection research in England. The following HPRUs undertake research in infection:
All of the NIHR facilities and centres are opening to working with the public, charities, industry and other partners. If you are interested in collaborating with the NIHR please contact the NIHR Office for Clinical Research infrastructure: email@example.com
Our experts in the NIHR Clinical Research Network National Specialty Group can advise on delivering your infection study in the NHS.
Jane Minton is a Consultant in Infectious Diseases based at St James’s University Hospital in Leeds, and Honorary Associate Clinical Professor at the University of Leeds. She is National Lead for the NIHR Clinical Research Network Infection Specialty Group and local Infection Specialty Lead for Yorkshire & Humber Clinical Research Network
She studied medicine at the University of Edinburgh and trained in Infectious Diseases at Edinburgh, the Brigham and Women’s Hospital in Boston, USA, Nottingham and Sheffield. As an MRC training fellow, she undertook doctoral and post-doctoral research in persistent viral infections at Cambridge and Harvard Medical School.
Personal research interests include antimicrobials and applied health research, including work evaluating the cost-effectiveness of and patient preferences for different models of care delivering IV antibiotics outside hospital, funded by the NIHR Health Services and Delivery programme. She has been UK Chief Investigator for clinical trials on antimicrobials and Clostridium difficile infection, and principal investigator for a number of NIHR Portfolio multicentre studies including brain infection, influenza, and HIV.
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