LSTM led consortium receives grant to investigate how human behavior impacts AMR

An LSTM led consortium called DRUM (Drivers of Resistance in Uganda and Malawi) has been awarded £3 million to investigate the way in which human behavior drives the emergence and spread of antimicrobial resistance (AMR).

The award is part of £12 million made available to the AMR in a Global Context Consortia awards, jointly funded by the cross-research council AMR initiative and the National Institute for Health Research's (NIHR) Global Health Research Program. It has been awarded to four UK University led consortia conducting interdisciplinary research into the biological, social, cultural and economic drivers behind the development of AMR in low and middle-income countries (LMICs).

The LSTM led DRUM Consortium will address how human behavior and antibacterial usage in the home, around animals and in the wider environment in urban and rural areas of Uganda and Malawi contributes to the spread of antibiotic resistance in bacteria. "The discovery and development of antibiotics is one of the great scientific achievements of the 20^th century," said Lead Investigator, LSTM's Dr Nicholas Feasey, "however it is clear that bacteria can quickly become resistant to these lifesaving agents, and the spread of antibiotic-resistant bacteria is now a problem of global concern and will disproportionately affect those in LMICs."

LMICs frequently have the greatest burden of severe and life-threatening infections, and are likely to suffer most from the spread of untreatable bacteria. Much remains unknown about how antibiotic resistance spreads globally, which is particularly true in sub-Saharan Africa, where diagnostic laboratories are not commonly available. DRUM will work collaboratively within Uganda and Malawi to identify and understand the key drivers of resistance

The consortium, made up of researchers from institutions across UK and in Uganda and Malawi, will look particularly at the common bacteria Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae). E. coli is an example of a bacteria that often causes infections in the community, but may also spread around hospitals, whereas K. pneumoniae is a key cause of hospital acquired infections, particularly among vulnerable groups such as premature babies. The group has chosen to study these closely-related bacteria as they share traits that make them resistant to antibiotics.

"The DRUM consortium will work to a broad brief, utilizing policy expertise in Uganda and Malawi and investigating which aspects of behavior are most important in spreading antibiotic resistance by surveying and exploring human behavior in relation to antibiotic use, water availability, sanitation and hygiene and by investigating bacterial behavior in response to these stimuli." Said LSTM's Russell Dacombe, co-investigator: "We plan to use cutting edge mathematical techniques to 'model' important behaviors, linking human prescribing behavior to the evolutionary biology of bacteria, using the results to feed into policy development and design interventions to prevent further development of resistance."

The award is over three years and sits alongside three other UK University led consortia who are also recipients of funding. The projects will contribute to the UK's commitment to Official Development Assistance (ODA). The Research Councils' contribution will be made through the Global Challenges Research Fund (GCRF) which supports cutting edge research addressing the problems faced by developing countries. The NIHR contribution will be made through its Global Health Research ODA allocation which is aimed at supporting internationally-outstanding applied research for the direct and primary benefit of patients and the public in LMICs.