I met the Service Users Research Forum (SURF) yesterday, and they asked me to give a presentation on the emergence and detection of multidrug-resistant Gram-negative bacteria (you can download my slides here). I found these slides by Dr Katie Hopkins (PHE) useful in preparing mine. It was my first interaction with a patient-led research group and I enjoyed the meeting very much. I found the SURF members and their academic support team from the University of West London to be engaged, engaging, knowledgeable and thirsty for knowledge. Their questions were insightful and their suggestions were thought-provoking. Informal discussions on a current research proposal (for enhanced surveillance of carbapenem-resistant Gram-negatives) gave me some useful ideas; researchers can easily lose sight of the patient perspective. I can see why funders such as NIHR now insist on seeing patient involvement in the development of research proposals and I am sure I will be SURFing again in the near future!
I put together the flow chart below to try and summarise the diagnostic approach to the lab detection of MDR-GNR. I would appreciate any thoughts you have on this flow chart…
Reflections on Infection Prevention and Control 
Thanks Jon
Excellent presentation
antimicrobial resistance increases
Best Regards
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The presentation at SURF yesterday was thought provoking, although not surprising as patients and service users who have faced antimicrobial resistance, we have a keen interest in what can be done to prevent, or at least, slow down the spread of what will always be an evoluntionary battle against these superbugs. MRSA has always grabbed the headlines, but the multi-drug resistant pathogens with the ability to cross species makes MRSA look puny in comparison (albeit a threat to health if not managed). The chart shows the complexity involved in diagnosing these pathogens, and it is good to see that Public Health England and putting resources into tackling these. I hope that the research proposals that have been put forward to test out the toolkit demonstrate just how much commitment to funding the appropriate response will be needed for the NHS. There will have to be adequate isolation facilities and staff to deal with potential outbreaks, and of course skilled laboratory staff. Good luck.
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Thanks Maria for your encouraging comment. I fear that the lack of isolation facilities in the NHS will mean that patients colonised with resistant Gram-negatives may have to be isolated on the open bay, particularly if confirmatory screens are required for screen-negative patients. This will place an additional burden on already stretched isolation facilities.
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Is the slide presented the only one you want comment on?
My experience is that ast can be unreliable and unhelpful depending upon what you test and how you test it.
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