MICA: Accelerating Development of Infection Diagnostics for Patient Management and Reduction of Antibiotic Misuse

Lead Research Organisation: University of Leeds
Department Name: Electronic and Electrical Engineering

Abstract

The discovery of antibiotics early in the 20th century revolutionised healthcare provision and antibiotics and other antimicrobials have become an integral part of modern healthcare. However, in recent decades, the use of antibiotics has increased massively, not only in healthcare provision but also in veterinary and agricultural (live stock) applications. This has led to an enormous rise in antimicrobial resistance (AMR), which is forming an ever-growing problem in modern healthcare, proving a serious threat to society. The number of instances where infections are resistant against common antibiotics is increasing rapidly, and bacterial infections with strains that are resistant to almost all known antibiotics (e.g. meticillin-resistant staphylococcus aureusis, MRSA) have contributed to a significant number of death (almost 300 in 2012, source: Office for National Statistics) and caused significant problems for affected patients and healthcare providers.

The solution seems simple: drastically reduce the prescriptions of antimicrobials. However, where antimicrobials are required for medical treatment, withholding prescription is dangerous for the patient and unethical, and could furthermore negatively impact on the general public through increased spreading rates.

There are two major types of infections: viral and bacterial. Only bacterial infections can be treated with antibiotics, but certain symptoms are common to both types of infections. A typical example is throat pain, which could be caused by a bacterial infection (e.g. Streptococcus pneumonia) or viral (e.g. influenza), or in fact could be caused by non-infection causes such as heart failure. More critical examples include meningitis, which, when caused by a bacterial infection (meningococcal disease) needs immediate medical attention, while viral meningitis tends to take a milder course requiring rest and observation for encephalitis.

We argue that antimicrobial prescriptions can be reduced safely and ethically if better infection diagnosis is available. Many infections are viral in origin (and hence do not benefit from antibiotics), but often antibiotics are prescribed as a precaution as without suitable diagnostics the doctor cannot be sure what the origin of the infection is. Although some laboratory-based tests are currently available, these can take several days to give a clear answer, and hence precautionary antibiotic treatments are started before the test results are available.

In this research programme we will develop rapid diagnostic tests that can be performed by the doctor her/himself, i.e. a GP in a primary care clinic or a consultant in a hospital, which will give an answer in less than 15 minutes, quick enough to inform treatment before it is prescribed.

The first diagnostic test that this programme will develop will thus be to distinguish between viral and bacterial infections. Once a bacterial infection is diagnosed, or if symptoms are encountered which indicate bacterial infections, it is important to identify the bacterial strain that causes the infection, as different strains require different antibiotic treatments. The second diagnostic test that this project aims to develop is thus to test for pathogen that causes the infections and we have chosen the example of C. difficile infections, a common infection that causes severe diarrhoea. Finally, many bacteria are now resistant to common antibiotics and if the type of resistance is known, the antibiotic treatment can be tailored to be effective. The third diagnostic test that will be developed is thus to diagnose a common subtype of Carbapenem Resistant Enterobacteriaceae (CRE), which is common type of infection with antibiotic resistance. These quick and accurate tests will reduce the prescription of the wrong antibiotics, which will not only reduce to the total amount of antibiotics used (thus reducing AMR), but will also lead to a more effective patient management.

Technical Summary

The lack of instant and accurate diagnostic tools for infectious diseases leads to inappropriate or unnecessary antibiotic prescribing. In primary care and hospital settings, this contributes directly and significantly to antimicrobial resistance (AMR). The aim of this programme is to address this challenge by developing innovative approaches for the next generation biosensors.

This programme aims to develop three biosensors that (a) distinguish between viral and bacterial infections and (b) specifically diagnose Clostridium difficile infection (CDI) and (c) detect common subtypes carbapenemases which cause the most problematic forms of Carbapenem Resistant Enterobacteriaceae (CRE) infections. Diagnostic biomarkers have been previously established to for these infection diagnosis applications and in this programme synthetic antibody mimetics (Adhirons) will be raised/selected against these biomarkers. Using the Adhirons as 'recognition elements', multiplexed, impedimetric and fluormetric biosensors will be constructed based on established and novel technologies, respectively.

Furthermore, this programme aims to develop novel biosensor platforms with improved accuracy and sensitivity. The majority of biosensors use passive capture molecules, such as antibodies or antibody mimetics, as 'recognition elements'. However, while antibody-biomarker binding is generally highly specific, changes in dielectric upon binding of biomarkers can be small, limiting the sensitivity and reproducibility of the sensor. Furthermore, non-specific binding of other molecules onto the sensor can lead to false-positive signals. Here, these bottlenecks will be targeted by designing new classes of antibody mimetics that generate an active electrochemical signal upon binding of the biomarkers.

Planned Impact

This proposal describes the development, analytical and clinical validation of point-of-care biosensors for the rapid and reliable diagnosis of infection for the reduction of antibiotic misuse and improved patient management. This programme will impact on a range of stakeholders, including: patients; healthcare providers; clinicians/clinical scientists; manufacturers of in vitro diagnostics.

1 Patients: Our technology will provide tools for healthcare providers to determine accurately and rapidly the origin of an infection, thus benefitting patients directly. For example, if a GP or emergency physician could use a rapid point-of-care test to distinguish bacterial from viral respiratory tract infection, it would allow them to target antibiotic prescriptions to patients most likely to benefit. A similar argument applies to C. difficile infection (CDI), where rapid and accurate diagnosis of CDI is important to enable use of a broader set of antibiotics as well as quarantining patients quickly to avoid spread of the infection. Furthermore, our programme will reduce AMR, which will indirectly benefit all patients as well as the general population.

2 Clinicians and healthcare providers: This programme will lead to a reduction in AMR and therefore reducing the number of patients infected by anti-microbial resistant pathogens. This leads to significant cost savings for healthcare-service providers (reduced treatment costs, fewer quarantining of patients, etc) as well as reduced risk for their staff. Additional cost savings will result from the availability of low-cost tests which replace more expensive traditional tests.

3 Manufacturers of in vitro diagnostics (IVD): The outputs of this programme will provide manufacturers of IVD instrumentation with new technologies that have the potential to monitor biomarkers more accurately, sensitively, and reliably, and hence enable new modalities of operation (such as rapid point-of-care analysis). This will increase their capabilities and competitiveness. Our generic technology will not only find application in clinical diagnostics, but has the potential to produce an analytical technology that can be used in over-the-counter diagnostic tests (e.g. well-being testing), environmental monitoring (e.g. water pollution), veterinary practice (e.g. animal screening), and security (e.g. detection of biological/chemical agents).

4 Academics across a broad range of scientific disciplines: Research and results from this programme will find widespread use, interest, and generate impact, across the wider academic community beyond clinical science, notably in biosensors, clinical microbiology, microfluidics, AMR, and bionanotechnology (see 'Academic Beneficiaries for more details).

5 The PDRAs on the programme will benefit from the training and development opportunities offered through this challenging interdisciplinary programme. The project will bring together scientists from a wide range of backgrounds with industry and clinical end-users, therefore benefitting the PDRAs through networking opportunities, and significantly increasing employability in academia, industry, and regulatory bodies, inter alia (see 'Academic Beneficiaries for more details).

IP arising from this research will be exploited fully through, e.g., direct licensing, or through University spin-out companies, as appropriate. The investigators have extensive experience in both approaches, e.g. the spin-out companies Relitect Ltd (co-founder Wälti) and Elisha Ltd (co-founder Millner) (both manufacturers of biosensor technologies), or the Adhiron license to Avacta Plc for commercial exploitation of Leeds' antibody mimetics (co-inventors McPherson, Tomlinson).

Publications

10 25 50
 
Description We are contributing to the development and implementation of Leeds City Council's 'Antimicrobial Stewardship Plan 2017/20' document which has 4 specific priorities: Priority 1 - To raise awareness of antibiotic resistance targeting public, professional, targeted and vulnerable groups; Priority 2 - To utilise local Surveillance data to improve prescribing practice across the whole health economy; Priority 3 - To improve Appropriate Consumption of antibiotics across the whole health economy; and Priority 4 - To Improve Quality Prescribing.
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Membership of a guideline committee
 
Description Dean's Vacation Research Studentship
Amount £1,900 (GBP)
Organisation University of Leeds 
Sector Academic/University
Country United Kingdom
Start 07/2020 
End 08/2020
 
Description University of Leeds-Industry Engagement Academy
Amount £5,000 (GBP)
Organisation University of Leeds 
Sector Academic/University
Country United Kingdom
Start 08/2018 
End 07/2019
 
Description Leeds City Council Antimicrobial Stewardship Committee 
Organisation Community Pharmacy West Yorkshire
Country United Kingdom 
Sector Hospitals 
PI Contribution We are part of this committee as rapid infection diagnostics will be crucial in helping with appropriate antibiotic prescribing by clinicians and preventing the emergence of drug resistant infections. We and the Council are combining resources to help each other in our aims. We are contributing in developing their 'Antimicrobials Stewardship Plan 2017/20' document which has 4 specific priorities: Priority 1 - To raise awareness of antibiotic resistance targeting public, professional, targeted and vulnerable groups; Priority 2 - To utilise local Surveillance data to improve prescribing practice across the whole health economy; Priority 3 - To improve Appropriate Consumption of antibiotics across the whole health economy; and Priority 4 - To Improve Quality Prescribing. We contribute to quarterly meetings and present the progress made within our research programme for the development of the rapid infection diagnostic device. We are aiding in promotion of the AMR stewardship activities of Leeds City Council by placing news links to their activities such as the 'seriously resistant' campaign on our Programme webpage. We are also promoting Public Health England's (PHE) activities by placing links to their 'Keep Antibiotics Working' TV Ad video as well as their 'e-Bug' resource (fun games and teaching resources about microbes and antibiotics for teachers and pupils) which aims to reduce the incidence of antibiotic resistance across Europe by educating future generations. As part of implementing the AMR plan across Leeds, one of the priorities is educating children and young people regarding appropriate use of antibiotics. We are thus part of the 'AMR messages within schools' sub-committee to develop initiatives and determine what can practically be implemented within schools as ways of targeting young people. We have developed a lesson plan with Abbey Grange School in Leeds to promote the use of point of care diagnostic testing in determining bacterial vs. viral infection and a general introduction about good antibiotic use. The lesson plan has been devised and will be undertaken by one our post doctoral research associates.
Collaborator Contribution Being part of this committee has placed us in direct contact with key partners that will be crucial to the rolling out of our diagnostic device. They support our programme and the Leeds Care Commissioning Groups as well as Public Health England will facilitate and be an accelerator for bringing diagnostic tests to key end-users: primary care/GPs, pharmacists, dentists ad other key health protection personnel within the City. This committee has provided us with direct access to key individuals.
Impact We are part of Leeds City Council's 'rolling AMR messages to schools' campaign. We have generated a lesson plan for year 10 pupils for a secondary school in the City, which will be rolled out throughout all schools in the Leeds area. This lesson will inform students of issues related to antibiotic resistance and how antibiotic misuse has a role in in the development of resistance. We will introduce how a rapid diagnostic device, that discriminates between bacterial and viral infection, will help GPs with appropriate antibiotic prescribing.
Start Year 2017
 
Description Leeds City Council Antimicrobial Stewardship Committee 
Organisation Leeds City Council
Country United Kingdom 
Sector Public 
PI Contribution We are part of this committee as rapid infection diagnostics will be crucial in helping with appropriate antibiotic prescribing by clinicians and preventing the emergence of drug resistant infections. We and the Council are combining resources to help each other in our aims. We are contributing in developing their 'Antimicrobials Stewardship Plan 2017/20' document which has 4 specific priorities: Priority 1 - To raise awareness of antibiotic resistance targeting public, professional, targeted and vulnerable groups; Priority 2 - To utilise local Surveillance data to improve prescribing practice across the whole health economy; Priority 3 - To improve Appropriate Consumption of antibiotics across the whole health economy; and Priority 4 - To Improve Quality Prescribing. We contribute to quarterly meetings and present the progress made within our research programme for the development of the rapid infection diagnostic device. We are aiding in promotion of the AMR stewardship activities of Leeds City Council by placing news links to their activities such as the 'seriously resistant' campaign on our Programme webpage. We are also promoting Public Health England's (PHE) activities by placing links to their 'Keep Antibiotics Working' TV Ad video as well as their 'e-Bug' resource (fun games and teaching resources about microbes and antibiotics for teachers and pupils) which aims to reduce the incidence of antibiotic resistance across Europe by educating future generations. As part of implementing the AMR plan across Leeds, one of the priorities is educating children and young people regarding appropriate use of antibiotics. We are thus part of the 'AMR messages within schools' sub-committee to develop initiatives and determine what can practically be implemented within schools as ways of targeting young people. We have developed a lesson plan with Abbey Grange School in Leeds to promote the use of point of care diagnostic testing in determining bacterial vs. viral infection and a general introduction about good antibiotic use. The lesson plan has been devised and will be undertaken by one our post doctoral research associates.
Collaborator Contribution Being part of this committee has placed us in direct contact with key partners that will be crucial to the rolling out of our diagnostic device. They support our programme and the Leeds Care Commissioning Groups as well as Public Health England will facilitate and be an accelerator for bringing diagnostic tests to key end-users: primary care/GPs, pharmacists, dentists ad other key health protection personnel within the City. This committee has provided us with direct access to key individuals.
Impact We are part of Leeds City Council's 'rolling AMR messages to schools' campaign. We have generated a lesson plan for year 10 pupils for a secondary school in the City, which will be rolled out throughout all schools in the Leeds area. This lesson will inform students of issues related to antibiotic resistance and how antibiotic misuse has a role in in the development of resistance. We will introduce how a rapid diagnostic device, that discriminates between bacterial and viral infection, will help GPs with appropriate antibiotic prescribing.
Start Year 2017
 
Description Leeds City Council Antimicrobial Stewardship Committee 
Organisation NHS Leeds North CCG
Country United Kingdom 
Sector Public 
PI Contribution We are part of this committee as rapid infection diagnostics will be crucial in helping with appropriate antibiotic prescribing by clinicians and preventing the emergence of drug resistant infections. We and the Council are combining resources to help each other in our aims. We are contributing in developing their 'Antimicrobials Stewardship Plan 2017/20' document which has 4 specific priorities: Priority 1 - To raise awareness of antibiotic resistance targeting public, professional, targeted and vulnerable groups; Priority 2 - To utilise local Surveillance data to improve prescribing practice across the whole health economy; Priority 3 - To improve Appropriate Consumption of antibiotics across the whole health economy; and Priority 4 - To Improve Quality Prescribing. We contribute to quarterly meetings and present the progress made within our research programme for the development of the rapid infection diagnostic device. We are aiding in promotion of the AMR stewardship activities of Leeds City Council by placing news links to their activities such as the 'seriously resistant' campaign on our Programme webpage. We are also promoting Public Health England's (PHE) activities by placing links to their 'Keep Antibiotics Working' TV Ad video as well as their 'e-Bug' resource (fun games and teaching resources about microbes and antibiotics for teachers and pupils) which aims to reduce the incidence of antibiotic resistance across Europe by educating future generations. As part of implementing the AMR plan across Leeds, one of the priorities is educating children and young people regarding appropriate use of antibiotics. We are thus part of the 'AMR messages within schools' sub-committee to develop initiatives and determine what can practically be implemented within schools as ways of targeting young people. We have developed a lesson plan with Abbey Grange School in Leeds to promote the use of point of care diagnostic testing in determining bacterial vs. viral infection and a general introduction about good antibiotic use. The lesson plan has been devised and will be undertaken by one our post doctoral research associates.
Collaborator Contribution Being part of this committee has placed us in direct contact with key partners that will be crucial to the rolling out of our diagnostic device. They support our programme and the Leeds Care Commissioning Groups as well as Public Health England will facilitate and be an accelerator for bringing diagnostic tests to key end-users: primary care/GPs, pharmacists, dentists ad other key health protection personnel within the City. This committee has provided us with direct access to key individuals.
Impact We are part of Leeds City Council's 'rolling AMR messages to schools' campaign. We have generated a lesson plan for year 10 pupils for a secondary school in the City, which will be rolled out throughout all schools in the Leeds area. This lesson will inform students of issues related to antibiotic resistance and how antibiotic misuse has a role in in the development of resistance. We will introduce how a rapid diagnostic device, that discriminates between bacterial and viral infection, will help GPs with appropriate antibiotic prescribing.
Start Year 2017
 
Description Leeds City Council Antimicrobial Stewardship Committee 
Organisation NHS Leeds West CCG
Country United Kingdom 
Sector Public 
PI Contribution We are part of this committee as rapid infection diagnostics will be crucial in helping with appropriate antibiotic prescribing by clinicians and preventing the emergence of drug resistant infections. We and the Council are combining resources to help each other in our aims. We are contributing in developing their 'Antimicrobials Stewardship Plan 2017/20' document which has 4 specific priorities: Priority 1 - To raise awareness of antibiotic resistance targeting public, professional, targeted and vulnerable groups; Priority 2 - To utilise local Surveillance data to improve prescribing practice across the whole health economy; Priority 3 - To improve Appropriate Consumption of antibiotics across the whole health economy; and Priority 4 - To Improve Quality Prescribing. We contribute to quarterly meetings and present the progress made within our research programme for the development of the rapid infection diagnostic device. We are aiding in promotion of the AMR stewardship activities of Leeds City Council by placing news links to their activities such as the 'seriously resistant' campaign on our Programme webpage. We are also promoting Public Health England's (PHE) activities by placing links to their 'Keep Antibiotics Working' TV Ad video as well as their 'e-Bug' resource (fun games and teaching resources about microbes and antibiotics for teachers and pupils) which aims to reduce the incidence of antibiotic resistance across Europe by educating future generations. As part of implementing the AMR plan across Leeds, one of the priorities is educating children and young people regarding appropriate use of antibiotics. We are thus part of the 'AMR messages within schools' sub-committee to develop initiatives and determine what can practically be implemented within schools as ways of targeting young people. We have developed a lesson plan with Abbey Grange School in Leeds to promote the use of point of care diagnostic testing in determining bacterial vs. viral infection and a general introduction about good antibiotic use. The lesson plan has been devised and will be undertaken by one our post doctoral research associates.
Collaborator Contribution Being part of this committee has placed us in direct contact with key partners that will be crucial to the rolling out of our diagnostic device. They support our programme and the Leeds Care Commissioning Groups as well as Public Health England will facilitate and be an accelerator for bringing diagnostic tests to key end-users: primary care/GPs, pharmacists, dentists ad other key health protection personnel within the City. This committee has provided us with direct access to key individuals.
Impact We are part of Leeds City Council's 'rolling AMR messages to schools' campaign. We have generated a lesson plan for year 10 pupils for a secondary school in the City, which will be rolled out throughout all schools in the Leeds area. This lesson will inform students of issues related to antibiotic resistance and how antibiotic misuse has a role in in the development of resistance. We will introduce how a rapid diagnostic device, that discriminates between bacterial and viral infection, will help GPs with appropriate antibiotic prescribing.
Start Year 2017
 
Description Leeds City Council Antimicrobial Stewardship Committee 
Organisation Nuffield Health Ltd
Country United Kingdom 
Sector Private 
PI Contribution We are part of this committee as rapid infection diagnostics will be crucial in helping with appropriate antibiotic prescribing by clinicians and preventing the emergence of drug resistant infections. We and the Council are combining resources to help each other in our aims. We are contributing in developing their 'Antimicrobials Stewardship Plan 2017/20' document which has 4 specific priorities: Priority 1 - To raise awareness of antibiotic resistance targeting public, professional, targeted and vulnerable groups; Priority 2 - To utilise local Surveillance data to improve prescribing practice across the whole health economy; Priority 3 - To improve Appropriate Consumption of antibiotics across the whole health economy; and Priority 4 - To Improve Quality Prescribing. We contribute to quarterly meetings and present the progress made within our research programme for the development of the rapid infection diagnostic device. We are aiding in promotion of the AMR stewardship activities of Leeds City Council by placing news links to their activities such as the 'seriously resistant' campaign on our Programme webpage. We are also promoting Public Health England's (PHE) activities by placing links to their 'Keep Antibiotics Working' TV Ad video as well as their 'e-Bug' resource (fun games and teaching resources about microbes and antibiotics for teachers and pupils) which aims to reduce the incidence of antibiotic resistance across Europe by educating future generations. As part of implementing the AMR plan across Leeds, one of the priorities is educating children and young people regarding appropriate use of antibiotics. We are thus part of the 'AMR messages within schools' sub-committee to develop initiatives and determine what can practically be implemented within schools as ways of targeting young people. We have developed a lesson plan with Abbey Grange School in Leeds to promote the use of point of care diagnostic testing in determining bacterial vs. viral infection and a general introduction about good antibiotic use. The lesson plan has been devised and will be undertaken by one our post doctoral research associates.
Collaborator Contribution Being part of this committee has placed us in direct contact with key partners that will be crucial to the rolling out of our diagnostic device. They support our programme and the Leeds Care Commissioning Groups as well as Public Health England will facilitate and be an accelerator for bringing diagnostic tests to key end-users: primary care/GPs, pharmacists, dentists ad other key health protection personnel within the City. This committee has provided us with direct access to key individuals.
Impact We are part of Leeds City Council's 'rolling AMR messages to schools' campaign. We have generated a lesson plan for year 10 pupils for a secondary school in the City, which will be rolled out throughout all schools in the Leeds area. This lesson will inform students of issues related to antibiotic resistance and how antibiotic misuse has a role in in the development of resistance. We will introduce how a rapid diagnostic device, that discriminates between bacterial and viral infection, will help GPs with appropriate antibiotic prescribing.
Start Year 2017
 
Description Leeds City Council Antimicrobial Stewardship Committee 
Organisation Public Health England
Country United Kingdom 
Sector Public 
PI Contribution We are part of this committee as rapid infection diagnostics will be crucial in helping with appropriate antibiotic prescribing by clinicians and preventing the emergence of drug resistant infections. We and the Council are combining resources to help each other in our aims. We are contributing in developing their 'Antimicrobials Stewardship Plan 2017/20' document which has 4 specific priorities: Priority 1 - To raise awareness of antibiotic resistance targeting public, professional, targeted and vulnerable groups; Priority 2 - To utilise local Surveillance data to improve prescribing practice across the whole health economy; Priority 3 - To improve Appropriate Consumption of antibiotics across the whole health economy; and Priority 4 - To Improve Quality Prescribing. We contribute to quarterly meetings and present the progress made within our research programme for the development of the rapid infection diagnostic device. We are aiding in promotion of the AMR stewardship activities of Leeds City Council by placing news links to their activities such as the 'seriously resistant' campaign on our Programme webpage. We are also promoting Public Health England's (PHE) activities by placing links to their 'Keep Antibiotics Working' TV Ad video as well as their 'e-Bug' resource (fun games and teaching resources about microbes and antibiotics for teachers and pupils) which aims to reduce the incidence of antibiotic resistance across Europe by educating future generations. As part of implementing the AMR plan across Leeds, one of the priorities is educating children and young people regarding appropriate use of antibiotics. We are thus part of the 'AMR messages within schools' sub-committee to develop initiatives and determine what can practically be implemented within schools as ways of targeting young people. We have developed a lesson plan with Abbey Grange School in Leeds to promote the use of point of care diagnostic testing in determining bacterial vs. viral infection and a general introduction about good antibiotic use. The lesson plan has been devised and will be undertaken by one our post doctoral research associates.
Collaborator Contribution Being part of this committee has placed us in direct contact with key partners that will be crucial to the rolling out of our diagnostic device. They support our programme and the Leeds Care Commissioning Groups as well as Public Health England will facilitate and be an accelerator for bringing diagnostic tests to key end-users: primary care/GPs, pharmacists, dentists ad other key health protection personnel within the City. This committee has provided us with direct access to key individuals.
Impact We are part of Leeds City Council's 'rolling AMR messages to schools' campaign. We have generated a lesson plan for year 10 pupils for a secondary school in the City, which will be rolled out throughout all schools in the Leeds area. This lesson will inform students of issues related to antibiotic resistance and how antibiotic misuse has a role in in the development of resistance. We will introduce how a rapid diagnostic device, that discriminates between bacterial and viral infection, will help GPs with appropriate antibiotic prescribing.
Start Year 2017
 
Description Rapid Infection Diagnostic Device: Advisory Committee 
Organisation British Society for Antimicrobial Chemotherapy
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution The president of the British Society of Antimicrobial Chemotherapy and the Head of Pharmacy Development of the Leeds CCG have formed part of our advisory group for our consortium along with a pharmacist, community nurse and GP to aid determining patient and GP acceptability and feasibility of use of our device in primary care.
Collaborator Contribution Leeds CCG has placed us in to direct contact with Leeds GP Federation and so a 'test bed' for our device in primary care. They have advised us of possible routes to roll out and trials of our device.They have advised us of the minimum clinical criteria for our device for possible roll out.
Impact We have a devised a pathway for our device for use in primary care, in particular the route defined would be via GP surgeries with an integral pharmacy, so to act as a triage for appointments. The President of BSAC had placed our research activities to the attention of the incoming Chief Medical Officer to gain advice on our device.
Start Year 2019
 
Description Rapid Infection Diagnostic Device: Advisory Committee 
Organisation NHS Leeds West CCG
Country United Kingdom 
Sector Public 
PI Contribution The president of the British Society of Antimicrobial Chemotherapy and the Head of Pharmacy Development of the Leeds CCG have formed part of our advisory group for our consortium along with a pharmacist, community nurse and GP to aid determining patient and GP acceptability and feasibility of use of our device in primary care.
Collaborator Contribution Leeds CCG has placed us in to direct contact with Leeds GP Federation and so a 'test bed' for our device in primary care. They have advised us of possible routes to roll out and trials of our device.They have advised us of the minimum clinical criteria for our device for possible roll out.
Impact We have a devised a pathway for our device for use in primary care, in particular the route defined would be via GP surgeries with an integral pharmacy, so to act as a triage for appointments. The President of BSAC had placed our research activities to the attention of the incoming Chief Medical Officer to gain advice on our device.
Start Year 2019
 
Title Affimer-enzyme-inhibitor switch assay 
Description We have developed a novel affimer-enzyme-inhibitor switch assay for a point-of-care application. The assay is rapid, using a simple wash-free assay format and is sensitive for the detection of C-reactive protein. We are exploring how this may be commercialised. 
Type Diagnostic Tool - Non-Imaging
Current Stage Of Development Initial development
Year Development Stage Completed 2020
Development Status Under active development/distribution
Impact Publication: Adamson, H.; Ajayi, M. O.; Campbell, E.; Brachi, E.; Tiede, C.; Tang, A. A.; Adams, T. L.; Ford, R.; Davidson, A.; Johnson, M.; McPherson, M. J.; Tomlinson, D. C.; Jeuken, L. J. C., Affimer-Enzyme-Inhibitor Switch Sensor for Rapid Wash-free Assays of Multimeric Proteins. ACS Sensors 2019, 4 (11), 3014-3022. 
 
Title Our Helpful Bacteria Animation 
Description Funded jointly by the MRC AMR Programme and BSAC, we have produced a short stop frame animation film to help reduce public demand for antibiotics and better inform patients. As part of a behavioural study, 200 adults watched the animation and 200 adults watched a control video. They completed questionnaires before and after viewing and the questionnaire completion was repeated after 6 weeks. The questionnaire was used to assess motivations for the use of antibiotics. 
Type Therapeutic Intervention - Psychological/Behavioural
Current Stage Of Development Initial development
Year Development Stage Completed 2019
Development Status Under active development/distribution
Impact Audience reported change in views, opinions or behaviours 
URL https://youtu.be/r_50QNX0-t0
 
Description 1.30pm, 6.30pm and 10.30 pm BBC Yorkshire news (lead story): Christoph Walti 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Media (as a channel to the public)
Results and Impact Professor Christoph Walti explained that antibiotics can treat bacterial infections only, and discussed the importance of the development a diagnostic device to help GPs determine if an infection is bacterial or viral to help them prescribe antibiotics appropriately. He discussed the activities of the research programme, facilities at Leeds were shown as well as a description of the technology that the device will be based on.
Year(s) Of Engagement Activity 2017
 
Description 11am - BBC Radio 5 Live: Lars Jeuken interviewd by Adrian Charles 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Professor Jeuken discussed in an interview the problem with drug resistant infections associated with antibiotic misuse. He promoted the activities of the research programme and explained that a diagnostic device was being generated to differentiate between bacterial and viral infections. This would help GPs decide if antibiotics were appropriate i.e.. if the infection was bacterial.
Year(s) Of Engagement Activity 2017
URL http://www.bbc.co.uk/programmes/b099vz8n#playt=*1*0*0
 
Description 5 News Tonight : 24th January, 18:46 PM GMT FIVE 24th January - Broadcast Professor Lars Jeuken (Astbury) was interviewed about how Leeds researchers are developing diagnostic devices so that GPs can test blood and find out almost instantly if you have a virus or a bacterial infection. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact FIVE LIVE, 24th January 2019 - Broadcast
Professor Lars Jeuken (Astbury) was interviewed about how Leeds researchers are developing diagnostic devices so that GPs can test blood and find out almost instantly if you have a virus or a bacterial infection.
Year(s) Of Engagement Activity 2018
 
Description 6pm Made In Leeds TV Channel: Interview with Christoph Walti 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Media (as a channel to the public)
Results and Impact Professor Walti discussed the activities of this research programme and the different technologies that the device will be based on. He the importance of a diagnostic device to help GPs determine if an infection is bacterial or viral to help them prescribe antibiotics appropriately.
Year(s) Of Engagement Activity 2017
 
Description 7.30pm BBC Yorkshire and Lincolnshire Inside Out documentary programme (lead story) Christoph Walti, Mark Wilcox. 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Media (as a channel to the public)
Results and Impact 7.30pm BBC Yorkshire and Lincolnshire 'Inside Out' documentary programme (lead story) - full 10 minute documentary piece charting the development of the device and featuring Lord O'Neill, Dame Sally Davies, the Chief Medical Officer and Helen McAuslane from Public Health England. Professor Christoph Walti and Professor Mark Wilcox explained that antibiotics can treat bacterial infections only, and the importance of a diagnostic device to help GPs determine if an infection is bacterial or viral to help them prescribe antibiotics appropriately. They discussed the activities of the research programme, facilities at Leeds were shown as well as a description of the technology that the device will be based on.
Year(s) Of Engagement Activity 2017
URL http://www.bbc.co.uk/news/av/uk-england-leeds-41692214/antibiotic-resistance-leeds-scientists-develo...
 
Description 7.35am: BBC Radio Humberside interview about antibiotic resistance and diagnostics - Lars Jeuken 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Media (as a channel to the public)
Results and Impact Lars Jeuken gave an interview about the issues of rising drug resistant infections and how infection diagnostics will help prevent these. He promoted the activities of our research programme.
Year(s) Of Engagement Activity 2017
 
Description Acute Kidney Injury & Sepsis: Unmet Clinical Needs Workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Patients, carers and/or patient groups
Results and Impact The workshop was chaired by Professor Mark Wilcox (and Dr Andrew Lewington) and brought together invited clinicians, healthcare professionals, academics, patients and industry partners to explore the unmet clinical needs in diagnosing Sepsis including antimicrobial resistance (and Acute Kidney Injury). By highlighting the current limitations in these areas the workshop explored how in vitro diagnostics might address these gaps.
Year(s) Of Engagement Activity 2019
 
Description Antimicrobial Resistance Workshop Programme 25 January 2017, St Hugh's College, Oxford 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Professor Mark Wilcox (Co-investigator), University of Leeds was an invited speaker and presented 'The clinical need for better antimicrobial resistance related diagnostics'.
The workshop offered clinicians in key clinical areas (urinary tract and respiratory infections, sepsis), the opportunity to meet and discuss what type of diagnostics are needed to manage the challenge of antimicrobial resistance. It allowed the sharing of knowledge between practitioners and industrial partners developing infection diagnostic point of care devices. Key industrial perspectives were provided by British In Vitro Diagnostics Association. NICE led discussions on the challenge of AMR and what types of diagnostics are needed to manage the challenge of AMR.
Year(s) Of Engagement Activity 2017
URL https://www.community.healthcare.mic.nihr.ac.uk/reports-and-resources/amr-workshop-2017
 
Description Astbury Conversation, public engagement event, April 2018. 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This academic symposium which includes prestigious talks, selected presentations and poster sessions is designed to give an insight into life in molecular detail - for researchers wanting to know about the latest developments.
It aims to bring together leading researchers from across the globe to discuss the most recent progress in the field of structural molecular biology in its broadest sense.

It is also a public engagement event, showcasing some of the University's research, followed by a wine reception.
Year(s) Of Engagement Activity 2018
URL https://astburyconversation.leeds.ac.uk/ehome/index.php?eventid=200183132&
 
Description BBC Breakfast TV: Christoph Walti 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Prof Christoph Walti discussed in an interview the problem with drug resistant infections associated with antibiotic misuse. He promoted the activities of the research programme and discussed that a diagnostic device was being developed to differentiate between bacterial and viral infections to help GPs decide if antibiotics were appropriate i.e. if the infection was bacterial.
Year(s) Of Engagement Activity 2017
 
Description Café Scientific, Chapel Allerton, Leeds: 21 November 8pm, at Seven Arts in Chapel Allerton 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Prof Lars Jeuken & Dr Jonathan Sandoe (co-investigators), spoke at a well-attended discussion on antimicrobial resistance at the 'Café Scientifique' event with a lively discussion afterwards. Both gave an informal short talk on antibiotic resistant infections, how they come about, the difficulties of diagnosing infections and how rapid diagnostics might help to reduce prescriptions of antibiotics. The talk was followed by an hour of question & answer session. Participants raised questions on how taking antibiotics inappropriately can have negative side effects, the difference between viral and bacterial infections (and antibiotics vs antivirals), the problems with detecting infections currently and how biomarkers can help distinguish between viral and bacterial infections. There was in particular a long discussion on 'good bacteria' that form part of the natural human biota and 'bad bacteria' that (can) cause infections and how antibiotics work on both.
Year(s) Of Engagement Activity 2017
URL http://www.cafe-sci.org.uk/?page_id=13
 
Description Construction of our Leeds antimicrobial resistance research programme webpage. 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact A webpage was constructed to outline our research programme on diagnostics for AMR research.
Year(s) Of Engagement Activity 2017
URL http://www.amr.leeds.ac.uk
 
Description Discovery Zone @ University of Leeds 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact 60 pupils attended for a school science fair to the university, where Declan Kohl (PhD student) delivered a stall on enzyme structure and activity. This sparked questions and discussion afterwards on the enzyme used and how they are specific to individual substrates, and the schools reported increased interest in related subject areas.
Year(s) Of Engagement Activity 2019
URL https://www.moortown.leeds.sch.uk/blog/2019/04/08/discovery-zone-at-leeds-university/
 
Description Health and Hygiene Workshops 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact We commissioned the Health and Well Being Service at Leeds City Council to deliver workshops to primary schools in high antibiotic prescribing areas in West Yorkshire.
By the end of the session children can:
1) Explain key terms in relation to hygiene and infection
2) Explain why hand washing is important in preventing the spread of infection/s.
3) Provide a basic explanation of why, when and how medicines (including antibiotics) are used and the importance of using them correctly.
Year(s) Of Engagement Activity 2019
 
Description International Men's Day Meeting Presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Professor Paul Millner talked about antimicrobial resistance and other health issues.
Year(s) Of Engagement Activity 2019
 
Description Leeds Creative Labs -Bradford Playhouse. Collaboration between the University of Leeds and the local creative and cultural industries of the North. Jack Goode 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Creative labs generates collaborations between academics and creative innovators to find new and inventive ways to showcase academic research and achieve broad public impact.
Increase our understanding of how the arts and technology might inform and support research relevant to contemporary society.
The Cultural Institute at the University of Leeds matched Jono Gadsby from a theatre company 'Fused Imagination' with our PDRA, Jack Goode. Jack explained his research aims, the problem of antibiotic resistance, and the challenges of discriminating between viral versus bacterial infections.
Year(s) Of Engagement Activity 2017
URL https://www.youtube.com/watch?v=NpNmvBTgTGU
 
Description Leeds Festival of Science 2017, 'Discovery Zone 2017' 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact As part of Leeds Festival of Science 2017, 450 pupils from primary and secondary school (KS2) attended the Discovery Zone during 2 day event.
There was a wide range of stalls, including one from this AMR Programme, where pupils discovered interactively how bacteria become resistant to antibiotics and how antibiotics were important for health. We also promoted the idea of 'good bacteria' and 'bad bacteria'. We were keen to make clear that taking antibiotics was not bad, but should be taken on your doctor's advice. There was a discussion session so pupils could ask questions. All PDRAs from the programme were involved in this activity.
Year(s) Of Engagement Activity 2017
URL https://www.leeds.ac.uk/forstaff/news/article/5780/discovery_zone_2017
 
Description Oral presentation at the European Biosensor Symposium, Florence, February 2019. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Oral presentation: European Biosensor Symposium, Florence, February 2019. Hope Adamson, PDRA presented progress on our novel biosensor technology.
The Symposium will cover all topics of biosensor research and will focus on:

Technologies for innovative formats: miniaturized, implantable, non-invasive, disposable, single/multiarray biosensors, paper-diagnostics

Bioengineered and biomimetic recognition elements (MIPs, aptamers, receptors, modified enzymes with increasing catalytic activity, sensor-actuator-molecules etc.)

Nanotechnology, surface engineering and bioelectronics (Single-Molecule and molecular sensors, nanoparticles and nanostructures enhancing biosensor performance etc.)

Cell biosensors: Sensors with cells (Pharma testing, cell toxicity, REACH); in the cell ("Pebbels", indicators, "biosensing"); for cell research and single cell based diagnostics (Patch-Clamp and electrodes, sensors for regenerative therapies)

Advances in applications (applications in the clinics and "traditional" areas like environment and food safety, infection diagnostics including alternative strategies (e.g. mass spec. for microbes), cultural heritage, new applications

Microfluidics for biosensing/integration

Theory and mathematics, software development: e.g. multivalence in biosensing.
Year(s) Of Engagement Activity 2018,2019
URL http://conferences.academicjournals.org/cat/biological-sciences/2nd-european-biosensor-symposium
 
Description Presentation on Rapid, Point of Care diagnostics for the reduction of AMR 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact At the National Annual AMR Conference, Declan Kohl (PhD student) presented a 10 minute presentation on his PhD project on rapid, point-of-care diagnostics to the conference audience of students, academics and industry professionals. It encompassed the strive for a test to distinguish between bacterial and viral infections to reduce antibiotic prescriptions. It sparked interest at his poster during in the conference and lead to interesting conversations with GPs about point of care CRP testing in their practices.
Year(s) Of Engagement Activity 2019
 
Description The Discovery Zone at Leeds - an interactive science session for school children 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Schools
Results and Impact We held a stall, educating children about bacterial and viral infections and the importance of good antibiotic use.We described our research via interactive activities.

Approximately 500 school children (KS2) attended the event in a sports hall with 23 stalls and 94 academic staff - from Professors to PhD students.
The goal of the event is to enable children to discover what university life is all about by meeting researchers and academics in the university premises. The aim is to break down barriers between those who are expectant of gaining higher education and those who believe it beyond their capabilities.
Feedback from school staff, children and families is obtained.
Year(s) Of Engagement Activity 2018
 
Description West Yorkshire Humanist Society Presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Professor Lars Jeuken presented a public lecture/seminar titled "Infection diagnostics and the fight against antimicrobial resistance (drug resistant infections)".
Year(s) Of Engagement Activity 2019