The principal areas of Alison's research are in hospital epidemiology and infection prevention and control, including the field of antibiotic stewardship to address the threat of antimicrobial resistance. Her work addresses infection management, patient safety and public health within acute healthcare and provides a clear example of applied research in healthcare delivery. In particular Alison has demonstrated how patient-focused research can have a powerful and rapid impact on the health of the patients concerned, with wider implications for the NHS as a whole.
HPRU in HealthCare Associated Infections and AntiMicrobial Resistance (HPRU)
The National Institute for Health Research (NIHR) has funded the development of a number of Health Protection Research Units (HPRUs) in key priority areas. These research units are collaborations between Universities, Public Health England (PHE) and other partner organisations and aim to provide centres of excellence in multi-disciplinary health protection research.
Professor Holmes is Director of the NIHR HPRU in Healthcare Associated Infections (HCAI) and Antimicrobial Resistance (AMR) at Imperial College London, which started on 1 April 2014 and has now renewed five-year funding from 1 April 2020. The HPRU in HCAI and AMR has as its partners: Imperial College Health Partners, Cambridge University, University of Warwick.
Professor Holmes’s HPRU recognises the different skills required to address the threat of AMR and HCAIs, and it brings together researchers from a range of disciplines and professions (including doctors, engineers, epidemiologists, microbiologists, pharmacists, behavioural scientists, economists, and nurses). The approach to addressing HCAIs and AMR is via four complementary themes: (1) Priority pathogens; (2) Precision prescribing; (3) Practice, design and engineering; and (4) Population health and policy.
Centre for antimicrobial optimisation (CAMO)
The Department of Health and Social Care invested £4M towards the Centre for Antimicrobial Optimisation (CAMO) to create state-of-the-art research facilities and to strengthen the UK’s Antimicrobial Resistance (AMR) research capability in:
--Developing innovative approaches to tackling AMR;
--Establishing a body of researchers with a wide range of skills and expertise relevant to AMR;
--Encouraging external funding for AMR research.
Professor Holmes is the Director of the CAMO which brings together innovative, multidisciplinary research to optimise antimicrobial use and sustain the effectiveness of these drugs in the face of increasing antimicrobial resistance (AMR) and the absence of new treatments.
CAMO consolidates existing expertise at Imperial, encompassing research excellence in:
Antimicrobial Research Collaborative
The Antimicrobial Research Collaborative (ARC@Imperial) consolidates world leading, multidisciplinary research across Imperial College London to synergistically address the urgent global threat of antimicrobial resistance from a 'one health' perspective. Integrating research strengths at Imperial College London and within Imperial College Academic Health Sciences Centre, across healthcare partners, industrial collaborations, policy makers and public health organisations, the collaborative will:
--advance basic research in antimicrobial resistance
--translate research into novel prevention strategies and healthcare interventions
--inform public health policy
Recently, Professor Holmes was commissioned by the Wellcome Trust to evaluate the research landscape a propose a research roadmap for optimising antimicrobial use in humans. This work attracted attention and a paper based off the report will be published in the Lancet Regional Health – Europe, ahead of this year’s G7 meetings.
Professor Holmes is also Principal Investigator on the ASPIRES project: Antibiotic use across Surgical Pathways - Investigating, Redesigning and Evaluating Systems
Optimising antibiotic usage along surgical pathways: addressing antimicrobial resistance and improving clinical outcomes
ASPIRES is a collaboration between:
--Imperial College London
--King’s College London
--University of Leicester
--University of Hertfordshire
--Royal College of Anaesthetists
--University of Cape Town
--Amrita Institute of Medical Sciences
--University Teaching Hospital of Butare
The funding for this 4-year project comes from the Economic and Social Research Council (ESRC) and is part of a cross-council initiative encompassing the ESRC’s Global Challenge Research Fund (GCRF) funding allocation.
This project asks: How can antibiotic use be optimised along the entire surgical pathway - that is before, during and after surgery and in the different settings (home, primary and hospital care)?
This involves developing behavioural, structural and technological interventions which are context specific.
Professor Holmes is Co-I an international collaboration with partners in Thailand to deliver novel cutting-edge technology to diagnose and manage acute febrile illnesses, funded by the Wellcome Trust.
Professor Holmes is also a Work Package Leader on an international collaboration with partners in Vietnam to deliver novel cutting-edge technology to diagnose and manage acute febrile illnesses, funded by the Wellcome Trust. The Vietnam ICU Translational Applications Laboratory (VITAL) project aims to use state-of-the-art ways to enhance diagnosis and treatment utilizing machine learning, novel technologies and computational science in 4 specific diseases: sepsis, dengue, tetanus and tuberculous meningitis, using low-cost tools that are suitable use in the management of other life- threatening conditions and for scale-up and use in a wider setting.
MANAGEMENT AND ADMINISTRATION STAFF
RESEARCH STUDENT SUPERVISION
- Point-of-care integration and application of bioengineering, diagnostics and mobile connectivity in remote healthcare settings and communities for the detection and surveillance of dengue virus infection (start date Jan 2021, P Arkell)
- Addressing multi-morbidity in the NHS: Optimising antibiotic therapy in obesity using intelligent, personalised clinical decision support systems (Start Date Oct 2020, W Bolton Co-supervision with department of Bioengineering)
- Use of minimally invasive sensing technology and decision support in management of tropical febrile illnesses (start date Jan 2020, D. Ming)
- Optimising antimicrobial prescribing through biosensor guided precision prescribing (start date Sept 2019, J. McLeod. Co-supervision with Dept of Bioengineering)
- Analysis and Prediction of Carbapenem-Resistance in Healthcare-Associated Infections (start date Sept 2019. A. Myall. Co-supervision with Dept of Mathematics)
- A Systems Thinking Based Evaluation of Patients’ and Doctors’ Behavioural Drivers of Antimicrobial Resistance: Epidemiological and Economic Perspectives. (start date Nov 2018, N. Jadeja)
- Determining clinical prediction models for dengue severity for a primary care setting. (start date Oct 2017, S. Sangkaew)
- Epidemiology and Optimal Infection Control Measures of Carbapenemase-producing Enterobacteriaceae among hospitalised patients in Thailand and United Kingdom. (start date Oct 2017, A. Boonyasiri)
- Developing new drugs for pneumonia in the era of antimicrobial resistance. (start date Aug 2017, S. Boyd. Co-supervised with University of Liverpool)
- Factors influencing implementation of Antimicrobial Stewardship interventions at secondary level. (A. Chatterjee - 2019
- Interventions to address antimicrobial resistance: system dynamics modelling (N. Zhu - 2019)
- Investigating Surgical Site Infection Prevention through Social and Technological Innovation (R. Troughton - 2018)
- Point-of-care, integrated decision support for personalised infection management across complex patient pathways; investigating the impact on prescribing and stewardship of antimicrobial agents (T. Rawson - 2018)
- Culture and team dynamics in the implementation of antimicrobial stewardship programmes (E. Charani - 2018)
- The role of rapid diagnostics in augmented care: investigating the impact on antimicrobial prescribing and bacterial resistance (L. Moore - 2016)
- How does organisational culture affect the delivery of successful cost improvement programmes in NHS acute trusts? (A. Mottram - 2016)
- Examining organisational resilience in the UK healthcare system, focusing on infection prevention and control. (E. Murray - 2012)
- The use of statistical models and surveillance systems to understand the emergence and spread of healthcare-associated infections (C. King - 2012)
- Developing an active and responsive surveillance tool for existing and emerging healthcare associated infections using linked local databases and risk monitoring (R. Freeman - 2013)
- The impact on and use of the UK’s National Health Service by new migrants. (S. Hargreaves, co-supervised - 2007)
Harnessing Digital Technologies for Sepsis Diagnosis and Decision Support., Invited speaker at the Third World Sepsis Conference, April 2021 at the session “Novel Approaches in the Diagnosis of Sepsis and COVID-19”, Online, 2021
'Advances in antimicrobial optimisation', Antibiotic Research UK, London, 2020
“Dealing with superinfections in COVID-19”, The ESCMID Conference on Coronavirus Disease, 2020
“The future of infection prevention and control: a whole health economy approach” – February 2019, Invited speaker by the UK Research and Innovation (UKRI) in the American Association for the Advancement of Science (AAAS) meeting in Washington DC within the “Infectious disease control and prevention: the future is interdisciplinary” session, UK Research and Innovation (UKRI) in the American Association for the Advancement of Science (AAAS), 2019
New Frontiers in our Approaches to Antimicrobial Resistance - plenary at ICID 2018, 18th International Congress on Infectious Diseases 2018, Organised by International Society for Infectious Diseases, ICID took place in Buenos Aires, Argentina, 2018
"Old and new frontiers in AMS", Keynote talk at the National Forum on Antimicrobial Resistance Australia 2017, The University of Queensland, Australia; Queensland Government, Australia, Brisbane, 2017
"AMS: widening the collaborative approach", Keynote talk at the Nursing Workshop Antimicrobial Stewardship Australia., The University of Queensland, Queensland Government, Brisbane, Australia, 2017
Global Strategies in combating antimicrobial resistance. Inaugural Session Speaker, 7th Annual Conference of the Clinical Infectious Diseases Society (CIDSCON), India, Clinical Infectious Diseases Society, Nagpur, India, 2017
Interluctor and thematic group leader for “internal round-table” discussion with Chancellor Angela Merkel at 3rd International German Forum, “What matters to people – Global Health and Innovation”. Summary presentation on how better use of antibiotics can be fostered in the future. Specification on behavior change in this context and the effect of interventions to improve antibiotic prescribing., The Federal Government, Germany, The Federal Government, Berlin, Germany, 2017
Macfarlane Burnett oration presenter: ‘AMR and HCAI in the real world: Perspectives from Health Protection Research’., Australasian Society for Infectious Diseases (ASID) Inc., Tasmania, Australia, 2016
"ASP Global Scenario: How far has the world travelled ?" Keynote speaker at International Symposium in Kerala on ‘Antibiotic stewardship and infection control and prevention’ inaugurating the state’s new antibiotic policy, Amrita University, Kerala, India, 2016
"Behavioural science and behavioural change in antimicrobial stewardship and infection control." Keynote talk at 25th ECCMID 2015, ECCMID Scientific Secretariat, Switzerland, 2015
"The Health Foundation Spotlight Report: critical lessons on implementing infection prevention guidelines". Keynote speaker at MRC "Developing diagnostic tools for bacterial infection and AMR' and Infection Prevention Society Implementation Learning Laboratories Launch Event, Infection Prevention Society - MRC, London, UK, 2014
"Implementation of an Antibiotic Stewardship Programme ona National Level: Tips & Tricks". Keynote speech at the Dutch National congress on Antibiotic Stewardship, Interactie Opleidingen, The Netherlands, 2014
"Impact of organisations on healthcare associated infection". Keynote talk at Federation of Infection Societies Annual Conference organised by Healthcare Infection Society, Healthcare Infection Society, Lyon, France, 2014
"Behaviour and Social Change in Stewardship" lecture at ESCMID Study Group for Antimicrobial stewardshiP - ESGAP workshops, ESCMID, Barcelona, Spain, 2014
"How do you measure the impact of interventions: PPS, time series analysis, controlled before and after studies and other methodologies" lecture at ESCMID Study Group for Antimicrobial stewardshiP - ESGAP workshops, ESCMID, Barcelona, Spain, 2014
"Social Media for Stewardship: Progress or a Waste of Time?" speech at 16th ICID, Cape Town, 2014, ICID / ISID, Cape Town, South Africa, 2014
"Behaviour change strategies to improve infection control and antibiotic stewardship". 14th International Federation of Infection Control Congress, Malta, 2014, Mater Dei Hospital, Malta, 2014