Supervisors and Projects

Coinfection and antimicrobial use in populations with influenza- or SARS-CoV-2-associated admissions in Scotland to inform targeted antimicrobial prescribing

Supervisors

Antonia Ho, School of Infection and Immunity, University of Glasgow 

Ting Shi, Usher Institute, University of Edinburgh

Michael Murphy, College of Medical, Veterinary and Life Sciences, University of Glasgow 

 

Summary

Bacterial co-infections (≤48 hours of admission) are identified in up to 23% patients with hospitalised influenza (flu) but only 6% in hospitalised patients with COVID-19. Despite this, a high proportion of patients with COVID-19 were prescribed antimicrobials in the 2022/23 winter season, and the proportion did not significantly differ from patients with influenza infection (70% vs. 62%). Over-prescription of antimicrobials not only leads to an increasing prevalence of resistant bacteria, it also increases the risk of Clostridioides difficile infection which causes significant morbidity and mortality, particularly in vulnerable patients. It is estimated that antimicrobial resistance (AMR) contributes to ~700,000 deaths globally each year.

We propose to use a precision medicine approach to first characterise the epidemiology of coinfection and antimicrobial prescription in individuals with influenza or SARS-CoV-2-associated hospitalisation in Scotland, and identify biomarkers associated with coinfection, by using Scotland-wide national surveillance dataset. This knowledge will allow us to develop a streamlined management pathway, with differing thresholds to prescribe empirical antimicrobials in patients with severe influenza or COVID-19, and to tailor the choice of empirical antimicrobials, thereby augmenting antimicrobial stewardship.

The student will be trained in a combination of epidemiology, respiratory virology, microbiology, data science and statistical analysis.