Professor Drobniewski is Professor of Global Health and Tuberculosis at Imperial College London. He is also the Director of the WHO Supranational Reference Laboratory.
His clinical work includes roles as a Consultant Medical Microbiologist and a Consultant Physician in Clinical Tuberculosis
Our research sits firmly at the boundary of basic and translational sciences where scientific advances in for example, understanding the genetic and biochemical mechanisms of drug resistance have been developed into practical diagnostic tests, evaluated in multicenter trials and implemented into NHS and clinical practice. These have involved utlising multiple approaches including social and behavioural to address clinical problems and achieve desired goals.
Similarly the patients we typically deal with (eg TB, HIV, multi-cultural, ethnic and linguistic, frequently with major social problems including alcoholism, intra-venous drug abuse, homeless ness, prior imprisonment) require a multi-disciplinary scientific and clinical approach to address complex needs and perceptions about their illness. Addressing their major clinical needs often involves solving medically minor but patient-important issues relating to benefits, eye and foot care for example.
Specifically the basic and translational research interests of our group focuses on:
--all aspects of tuberculosis (TB) (and its interaction with HIV) locally, nationally and internationally. Since 84% of TB cases in London, for example, occur in individuals born abroad one cannot address the UK dimension without thinking internationally.
--the diagnosis of TB infection (eg using gamma-interferon release assays), active disease and other mycobacterial disease
--identifying host and pathogen (eg mRNA) markers for cure in drug resistant and other complex cases of TB;
--understanding the molecular epidemiology and global evolution/phylogeny of tuberculosis and other mycobacteria
--broader public health problems posed by TB, HIV and other diseases of poverty both in the UK and overseas; TB provides an excellent model for public health and the development of national and international health and social policy issues. Multiple medical, scientific and behavioural strategies are needed to achieve a desired outcome for the patient (cure) and the population (interruption of disease transmission).
--understanding and measuring drug resistance in TB and establishing causes of drug resistance including the fitness of drug resistant TB stains
--determining how differences in TB strains affect virulence and to what extent these differences affect the interaction between TB and HIV,
In addition to studying the biology of tuberculosis (TB) we use it as an excellent model to study clinical (eg drug resistance), behavioural and health-service programmatic issues. For example, we have created a Diagnostic and Clinical Trial Network in Eastern Europe with partners to develop and evaluate novel diagnostics (including working with the Foundation for Innovative and Novel Diagnostics FIND) and new therapies, such as our study of antimicrobial drug resistance. We have experience of working with industry as well in the development and evaluation of novel systems.
Much of our UK laboratory activity over the next 5 years will focus on the analysis of our banks of stored sera/plasma, urine and human DNA as well as pathogen DNA from our longitudinal and cross-sectional patient cohorts from Eastern Europe with our partners. We have completed a population-based bacterial genoming sequencing study within our “1000 TB Genome Project , and are analysing immunological biomarkers of cure and diagnosis within our longitudinal field cohorts and the role of innate immunity for TB and HIV together with the role of strain variation in infectivity and pathogenesis. We are working with others at Imperial, QMUL and UCL and in the PHE on latent TB infection; the stored sera and monocytes offer a resource for future diagnostic development as well as biomarker discovery and identification of new drug targets.
In the future we also want to benefit from being able to interact with so many experts at Imperial by exploring the effects of climate range on infectious diseases particularly in northern and eastern Europe and the Arctic collaborating with those in Europe.
Finally, understanding patient needs and perceptions about their health is the key to successful diagnosis and therapy in the patient population I see and these lessons can be applied to a wide range of different patient groups. We hope to learn from others at Imperial with a similar interest and contribute to a better understanding of patient requirements and needs across the multicultural groups we work with.
et al., 2018, The use of whole-genome sequencing in cluster investigation of an MDR-TB outbreak, European Respiratory Journal, Vol:51, ISSN:0903-1936
et al., 2017, Multidrug-resistant TB in Eastern region of the EU: is the shorter regimen an exception or a rule?, Thorax, Vol:72, ISSN:1468-3296, Pages:850-852
et al., 2017, A bioengineered three-dimensional cell culture platform integrated with microfluidics to address antimicrobial resistance in tuberculosis, MBIO, Vol:8, ISSN:2150-7511
et al., 2016, Whole Genome Sequence Analysis of a Large Isoniazid-Resistant Tuberculosis Outbreak in London: A Retrospective Observational Study, PLOS Medicine, Vol:13, ISSN:1549-1277
et al., 2016, Whole genome sequencing of M. tuberculosis for detection of drug resistance: a systematic review, Clinical Microbiology and Infection, Vol:23, ISSN:1469-0691, Pages:61-68
et al., 2016, Survival of patients with multidrug-resistant TB in Eastern Europe: what makes a difference?, Thorax, Vol:71, ISSN:1468-3296, Pages:854-861
et al., 2016, Whole genome sequencing of Mycobacteriumtuberculosis for detection of recent transmission and tracing outbreaks: a systematic review, Tuberculosis, Vol:98, ISSN:1873-281X, Pages:77-85
et al., 2015, Systematic review, meta-analysis and economic modelling of molecular diagnostic tests for antibiotic resistance in tuberculosis, Health Technology Assessment, Vol:19, ISSN:1366-5278
et al., 2015, Susceptibility to tuberculosis is associated with variants in the ASAP1 gene encoding a regulator of dendritic cell migration, Nature Genetics, Vol:47, ISSN:1546-1718, Pages:523-527
et al., 2015, Utility of propidium monoazide viability assay as a biomarker for a tuberculosis disease, Tuberculosis, Vol:95, ISSN:1472-9792, Pages:179-185
et al., 2015, Evolutionary history and global spread of the Mycobacterium tuberculosis Beijing lineage (vol 47, pg 242, 2015), Nature Genetics, Vol:47, ISSN:1061-4036
et al., 2014, Mycobacterium tuberculosis Pyrazinamide Resistance Determinants: a Multicenter Study, MBIO, Vol:5, ISSN:2150-7511
et al., 2014, Assessment of Mycobacterium tuberculosis transmission in Oxfordshire, UK, 2007-12, with whole pathogen genome sequences: an observational study, Lancet Respiratory Medicine, Vol:2, ISSN:2213-2600, Pages:285-292
et al., 2014, Evolution and transmission of drug-resistant tuberculosis in a Russian population, Nature Genetics, Vol:46, ISSN:1546-1718, Pages:279-286
et al., 2013, Rapid diagnostics of tuberculosis and drug resistance in the industrialized world: clinical and public health benefits and barriers to implementation, BMC Medicine, Vol:11, ISSN:1741-7015
et al., 2013, Ethnic Variation in Inflammatory Profile in Tuberculosis, Plos Pathogens, Vol:9, ISSN:1553-7374
et al., 2013, Prevalence of Nontuberculous Mycobacteria in Cystic Fibrosis Clinics, United Kingdom, 2009, Emerging Infectious Diseases, Vol:19, ISSN:1080-6059, Pages:1128-1130
Gonzalo X, Drobniewski F, 2013, Is there a place for -lactams in the treatment of multidrug-resistant/extensively drug-resistant tuberculosis? Synergy between meropenem and amoxicillin/clavulanate, Journal of Antimicrobial Chemotherapy, Vol:68, ISSN:0305-7453, Pages:366-369
et al., 2013, Comparative Drug Resistance of Mycobacterium abscessus and M. chelonae Isolates from Patients with and without Cystic Fibrosis in the United Kingdom, Journal of Clinical Microbiology, Vol:51, ISSN:0095-1137, Pages:217-223
et al., 2012, Vitamin D accelerates resolution of inflammatory responses during tuberculosis treatment, Proceedings of the National Academy of Sciences of the United States of America, Vol:109, ISSN:0027-8424, Pages:15449-15454
et al., 2012, Risk factors for drug-resistant tuberculosis patients in Lithuania, 2002-2008, European Respiratory Journal, Vol:39, ISSN:0903-1936, Pages:1266-1269
et al., 2012, Microevolution of extensively drug-resistant tuberculosis in Russia, Genome Research, Vol:22, ISSN:1088-9051, Pages:735-745
et al., 2012, Rapid molecular detection of tuberculosis and rifampicin drug resistance: retrospective analysis of a national UK molecular service over the last decade, Thorax, Vol:67, ISSN:0040-6376, Pages:361-367
et al., 2012, Common variants at 11p13 are associated with susceptibility to tuberculosis, Nature Genetics, Vol:44, ISSN:1061-4036, Pages:257-259
et al., 2011, Survival of Civilian and Prisoner Drug-Sensitive, Multiand Extensive Drug- Resistant Tuberculosis Cohorts Prospectively Followed in Russia, PLOS One, Vol:6, ISSN:1932-6203
et al., 2011, High-dose vitamin D-3 during intensive-phase antimicrobial treatment of pulmonary tuberculosis: a double-blind randomised controlled trial, The Lancet, Vol:377, ISSN:0140-6736, Pages:242-250
et al., 2011, Survival of drug resistant tuberculosis patients in Lithuania: retrospective national cohort study, Bmj Open, Vol:1, ISSN:2044-6055
et al., 2009, Extensively drug-resistant tuberculosis in the UK: 1995 to 2007, Thorax, Vol:64, ISSN:0040-6376, Pages:512-515
et al., 2009, Epidemiology of antituberculosis drug resistance 2002-07: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance, The Lancet, Vol:373, ISSN:0140-6736, Pages:1861-1873
et al., 2008, Analysis of association of the TIRAP (MAL) S180L variant and tuberculosis in three populations, Nature Genetics, Vol:40, ISSN:1061-4036, Pages:261-262
et al., 2007, Resequencing and association analysis of the SP110 gene in adult pulmonary tuberculosis, Human Genetics, Vol:121, ISSN:0340-6717, Pages:155-160
et al., 2007, Rates of latent tuberculosis in health care staff in Russia, Plos Medicine, Vol:4, ISSN:1549-1676, Pages:0273-0279
et al., 2006, Recommended standards for modern tuberculosis laboratory services in Europe, European Respiratory Journal, Vol:28, ISSN:0903-1936, Pages:903-909
et al., 2005, Tuberculosis, HIV seroprevalence and intravenous drug abuse in prisoners, European Respiratory Journal, Vol:26, ISSN:0903-1936, Pages:298-304
et al., 2005, Drug-resistant, tuberculosis, clinical virulence, and the dominance of the Beijing strain family in Russia, JAMA - Journal of the American Medical Association, Vol:293, ISSN:0098-7484, Pages:2726-2731
et al., 2013, DIABETES AND LATENT TUBERCULOSIS INFECTION: NESTED CASE-CONTROL STUDY WITHIN THE PREDICT COHORT, Winter Meeting of the British-Thoracic-Society, BMJ PUBLISHING GROUP, Pages:A31-A32, ISSN:0040-6376