Impact case study database

Research detailed above has generated national and international impacts in 4 major categories:

Hilton’s research into the mechanism by which triclosan stimulates antibiotic efflux from bacterial cells ( S3.1) is the pivotal underpinning evidence in the Florence Statement ( S5.1, p5, section 9) for the link between triclosan resistance and AMR. His work is also cited in US docket FDA-2015-N-0101 ( S5.2) which led to the USA-wide ban on adding triclosan to antiseptics. The EU similarly banned such use of triclosan (Biocidal Products Regulations (EU) No 528/2012). Hilton was subsequently invited as a Trustee of the International Scientific Forum on Home Hygiene (IFH) and is a co-author of its consensus white paper ( S5.3), which calls on international policy makers to recognize a targeted approach to home hygiene. This white paper prompted the Royal Society for Public Health to publish “Too clean or not too clean”, ( S5.4, p4, section 1.1 and subsequent citations); had been downloaded 757 times by December 2020 and was endorsed by the previous UK Chief Medical Officer ( S5.4).

As a consequence of Bashir’s ABMAP study ( S3.4), clinical microbiology support has been expanded at BCH to involve direct interaction between infection specialists and antibiotic prescribers ( S5.5, S5.6). Formal case-based discussions now occur across five specialities, which initially resulted in 40% of patients having their antibiotic treatment amended. The success of this approach is exemplified by a recent review of patients with positive blood cultures which determined that 100% of the target patients are now treated with appropriate antibiotics ( S5.5). Separately, owing to prescribers’ wish for instruction re. antimicrobial prescription ( S3.4), an algorithm has been developed to guide accurate prescription of meropenem (a broad-spectrum carbapenem antimicrobial) and as a consequence, meropenem usage fell for the first time in 2018-19 by ~5% against a background of continuing rise amongst specialist NHS trusts. Only patients with positive microbiology results justifying its use, now continue on meropenem treatment so reducing AMR risk. Finally, a series of antibiotic education animations have also been developed to educate staff and visitors ( S5.6). As a consequence of these combined activities, the BCH Consultant Microbiologist states "We are convinced that our collaboration with Aston University has had a significant and sustained impact on our Antimicrobial Stewardship " ( S5.5).

Worthington’s Clostridium difficile germination solution was developed at Aston under a KTP agreement. The resulting patent was granted on April 2^nd 2019 and covers EU, USA, Japan, China and Hong Kong. The Managing Director of Insight Health Ltd summarises "we are now partnering with a US-based multinational company to market the resulting products in multiple formats to the food and healthcare industries, with a market estimated to be worth £5 million thus increasing the revenue at Insight Health by 20% " ( S5.7).

Anecdotal evidence of the impact of the WoM roadshow on African IB students in 2014 e.g. S5.8 “The overall impact of this inspiring workshop had on our students was more than I could have imagined. It resulted in a significant increase in our students declaring biology as a career track. ” prompted the Aston AMR team to develop and attempt to quantitate the impact of further public interventions concerning AMR. Consequently, WoM Antimicrobial Resistance (the Antimicrobial Resistance roadshow) was presented to 159 Midlands-based young learners (years 11-12). In addition to positive qualitative feedback from both staff and students (e.g. S5.8 “l really enjoyed the handwashing activity and l still remember the correct way to wash my hands to remove potentially harmful bacteria. … the activities gave me more confidence when I started the A level required practicals ”), questionnaires before and after the roadshow and a 3-month follow-up demonstrated that awareness and knowledge of AMR was increased significantly by the roadshow and still retained 3 months later ( S3.5). Subsequently, the AMR team’s educational theatre event was performed at Birmingham Think Tank and the Cheltenham Science Festival. Its impact on 242 members of the general public (aged 6-94) was analysed via pre- and post-play questionnaires which revealed statistically-significant increases in awareness, knowledge and changes in attitude ( S3.6). The play was recorded and is available on YouTube ( S5.10). Collectively, AMR’s educational animation and videos ( S5.6, S5.9, S5.10) have received 2300+ views on YouTube.