Group leader Dr. Einas Awad Ibrahim Osman
Sudanese AMR (S-AMR) Research Group in collaboration with Global Health and Infection at Brighton and Sussex Medical School.
Proposed Research Plan Jan-July 2019
The main aim of the S-AMR research group/network is to generate knowledge on AMR-related data and practices in Sudan, focusing on antibiotic resistance in healthcare settings.
We aim to create a link between clinical practice, clinical microbiology, infection prevention and control (IPC) policies, and antibiotic prescribing, thereby establishing a multidisciplinary group with the common aim of reducing and preventing AMR spread.
There is furthermore an urgent need for an active & sustainable collaborative link between clinical microbiology in hospitals and academic research centres in Sudan, hence we are proposing the establishment of a collaboration between Soba University Hospital Microbiology Department, Al Rabat Hospital Microbiology Department & The BioScience Research Institute based at Ibn Sina University. This link will facilitate the molecular microbiology work of the project locally in Sudan, which will be supported by the Department of Global Health and Infection at Brighton and Sussex Medical School.
What knowledge do we (locally) want to know?
The aim of the project is to build capacity in AMR research in Sudan by creating a link between Clinical Microbiology, IPC and prescribing practices to generate knowledge AMR locally in Sudan.
Microbiology
Bacterial data collection – Focus on problematic Gram-Negatives: Klebsiella & Acinetobacter
Gram-Negative bacteria will be collected from the microbiology laboratory (by a clinical microbiologist and a laboratory technician), for which epidemiological data will be collected from the patient records. All the data will be anonymised. The epidemiological data (CRF attached) will give us insight into the clinical manifestations of the causative organism, and also enable us to find common risk factors with acquisition and dissemination in the hospital.
Unidentified isolates will undergo genomic identification by 16s-23s rRNA typing in collaboration with The Bioscience Research Institute at Ibn Sina University.
Antimicrobial susceptibility data will be collected from the routine clinical microbiology work which is performed by disk diffusion. Some strains (e.g. MDR and part of the ESKAPE pathogen list) will furthermore undergo MIC testing by broth microdilution method. This will be decided on a case-by-case basis.
At the end of the project we aim to:
1- Have established a biobank for microorganisms in Sudan that will facilitate future research
2- Choose a subset of isolates to undergo whole genome sequencing (WGS) to determine molecular epidemiology and characterise resistance mechanisms.
Antibiotic Prescription, Stewardship, and Infection Control
A questionnaire will be distributed to healthcare workers in order to assess their understanding of the burden of AMR, and how this is affecting antimicrobial prescribing in the hospital.
We also aim to review any infection prevention and control (IPC) guidelines and/or policies present at the hospital, and how they are adapted in the clinical setting.
For efficient execution of the project we need to build a team of good researchers. The aim is to recruit bright and motivated junior researcher(s) (doctors/pharmacists/laboratory technicians) who have an interest in AMR research and who are willing to commit part of their time to the research projects. This will be a funded post for the duration of the study (February 2020-June 2020), and they will be included in the authorship of any research outputs/publication. This will help in building local capacity and engaging early-career researchers (ECRs)
The project is running for from January-July 2020 will be a startup for future work in S-AMR. We want to build capacity for AMR research in Sudan, and create a sustainable research network of committed scientists.
We will work towards using the data produced to improve IPC, establish antimicrobial stewardship programmes, thereby creating a locally-relevant intervention in the future. Furthermore, we want to emphasize the importance of national and international collaboration and the need for multidisciplinarity in AMR research.
All the project outcomes will be shared with senior hospital management to discuss how we can sustain and grow the research in AMR, and what areas need further focus.