Publications
15 results found
Pallett SJC, Trompeter A, Basarab M, et al., 2023, Multidrug-resistant infections in war victims in Ukraine, Lancet Infectious Diseases, Vol: 23, Pages: e270-e271, ISSN: 1473-3099
Boyd SE, Pallett SJC, Moore LSP, 2023, Orthopaedic preparedness for disasters must extend to infection surveillance, LANCET, Vol: 402, Pages: 290-290, ISSN: 0140-6736
Boyd S, Pallett S, Moore L, 2023, Orthopaedic care in disasters: preparedness must extend to peri-operative infection surveillance, The Lancet, Vol: 402, Pages: 290-290, ISSN: 0140-6736
Saeed K, Ahmad-Saeed N, Annett R, et al., 2022, A multicentre evaluation and expert recommendations of use of the newly developed BioFire Joint Infection polymerase chain reaction panel, European Journal of Clinical Microbiology and Infectious Diseases: an international journal on pathogenesis, diagnosis, epidemiology, therapy, and prevention of infectious diseases, Vol: 42, Pages: 169-176, ISSN: 0934-9723
Septic arthritis is a serious condition with significant morbidity and mortality, routinely diagnosed using culture. The FDA has recently approved the rapid molecular BioFire® Joint Infection Panel (BJIP) for synovial fluid. We aimed to evaluate the BJIP compared to culture and its potential use in patient management. A multicentre retrospective evaluation of BJIP was conducted in the UK and Ireland. Positive percent agreement (PPA) and negative percent agreement (NPA) were calculated between the BJIP and routine culture. A multidisciplinary team (MDT) discussion addressing the optimal or potential case use of the assay practice was facilitated. Three hundred ninety-nine surplus synovial fluid samples (~ 70% from native joints) from eight centres were processed using BJIP in addition to routine culture. An increased yield of positive results was detected using BJIP compared to routine culture (98 vs 83), giving an overall PPA of 91.6% and overall NPA of 93% for the BJIP compared to culture results. The BJIP detected resistant markers and additional organisms that could influence antibiotic choices including Neisseria gonorrhoeae and Kingella kingae. The MDT agreed that the assay could be used, in addition to standard methods, in adult and children patients with specialist advice use based on local needs. Rapid results from BJIP were assessed as having potential clinical impact on patient management. Organisms not included in the panel may be clinically significant and may limit the value of this test for PJI.
Boyd SE, Holmes A, Peck R, et al., 2022, OXA-48-like β-lactamases: global epidemiology, treatment options, and development pipeline, Antimicrobial Agents and Chemotherapy, Vol: 66, ISSN: 0066-4804
Modern medicine is threatened by the rising tide of antimicrobial resistance, especially among Gram-negative bacteria, where resistance to β-lactams is most often mediated by β-lactamases. The penicillin and cephalosporin ascendancies were, in their turn, ended by the proliferation of TEM penicillinases and CTX-M extended-spectrum β-lactamases. These class A β-lactamases have long been considered the most important. For carbapenems, however, the threat is increasingly from the insidious rise of a class D carbapenemase, OXA-48, and its close relatives. Over the past 20 years, OXA-48 and "OXA-48-like" enzymes have proliferated to become the most prevalent enterobacterial carbapenemases across much of Europe, Northern Africa, and the Middle East. OXA-48-like enzymes are notoriously difficult to detect because they often cause only low-level in vitro resistance to carbapenems, meaning that the true burden is likely underestimated. Despite this, they are associated with carbapenem treatment failures. A highly conserved incompatibility complex IncL plasmid scaffold often carries blaOXA-48 and may carry other antimicrobial resistance genes, leaving limited treatment options. High conjugation efficiency means that this plasmid is sometimes carried by multiple Enterobacterales in a single patient. Producers evade most β-lactam-β-lactamase inhibitor combinations, though promising agents have recently been licensed, notably ceftazidime-avibactam and cefiderocol. The molecular machinery enabling global spread, current treatment options, and the development pipeline of potential new therapies for Enterobacterales that produce OXA-48-like β-lactamases form the focus of this review.
Boyd SE, Livermore DM, Hooper DC, et al., 2020, Metallo-β-Lactamases: Structure, Function, Epidemiology, Treatment Options, and the Development Pipeline, ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Vol: 64, ISSN: 0066-4804
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Boyd SE, Vasudevan A, Moore LSP, et al., 2020, Validating a prediction tool to determine the risk of nosocomial multidrug-resistant Gram-negative bacilli infection in critically ill patients: A retrospective case-control study, Journal of Global Antimicrobial Resistance, Vol: 22, Pages: 826-831, ISSN: 2213-7165
BACKGROUND: The Singapore GSDCS score was developed to enable clinicians predict the risk of nosocomial multidrug-resistant Gram-negative bacilli (RGNB) infection in critically ill patients. We aimed to validate this score in a UK setting. METHOD: A retrospective case-control study was conducted including patients who stayed for more than 24h in intensive care units (ICUs) across two tertiary National Health Service hospitals in London, UK (April 2011-April 2016). Cases with RGNB and controls with sensitive Gram-negative bacilli (SGNB) infection were identified. RESULTS: The derived GSDCS score was calculated from when there was a step change in antimicrobial therapy in response to clinical suspicion of infection as follows: prior Gram-negative organism, Surgery, Dialysis with end-stage renal disease, prior Carbapenem use and intensive care Stay of more than 5 days. A total of 110 patients with RGNB infection (cases) were matched 1:1 to 110 geotemporally chosen patients with SGNB infection (controls). The discriminatory ability of the prediction tool by receiver operating characteristic curve analysis in our validation cohort was 0.75 (95% confidence interval 0.65-0.81), which is comparable with the area under the curve of the derivation cohort (0.77). The GSDCS score differentiated between low- (0-1.3), medium- (1.4-2.3) and high-risk (2.4-4.3) patients for RGNB infection (P<0.001) in a UK setting. CONCLUSION: A simple bedside clinical prediction tool may be used to identify and differentiate patients at low, medium and high risk of RGNB infection prior to initiation of prompt empirical antimicrobial therapy in the intensive care setting.
Chatterjee A, Modarai M, Naylor N, et al., 2018, Quantifying drivers of antibiotic resistance in humans: a systematic review, The Lancet Infectious Diseases, Vol: 18, Pages: e368-e378, ISSN: 1473-3099
Mitigating the risks of antibiotic resistance requires a horizon scan linking the quality with the quantity of data reported on drivers of antibiotic resistance in humans, arising from the human, animal, and environmental reservoirs. We did a systematic review using a One Health approach to survey the key drivers of antibiotic resistance in humans. Two sets of reviewers selected 565 studies from a total of 2819 titles and abstracts identified in Embase, MEDLINE, and Scopus (2005–18), and the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and WHO (One Health data). Study quality was assessed in accordance with Cochrane recommendations. Previous antibiotic exposure, underlying disease, and invasive procedures were the risk factors with most supporting evidence identified from the 88 risk factors retrieved. The odds ratios of antibiotic resistance were primarily reported to be between 2 and 4 for these risk factors when compared with their respective controls or baseline risk groups. Food-related transmission from the animal reservoir and water-related transmission from the environmental reservoir were frequently quantified. Uniformly quantifying relationships between risk factors will help researchers to better understand the process by which antibiotic resistance arises in human infections.
Rodvold KA, Hope WW, Boyd SE, 2017, Considerations for effect site pharmacokinetics to estimate drug exposure: concentrations of antibiotics in the lung, Current Opinion in Pharmacology, Vol: 36, Pages: 114-123, ISSN: 1471-4892
Boyd S, moore LSP, Rawson TM, et al., 2017, Combination therapy for carbapenemase-producing Entero-bacteriaceae: INCREMENT-al effect on resistance remains unclear, The Lancet Infectious Diseases, Vol: 17, Pages: 899-900, ISSN: 1473-3099
Holmes AH, Boyd SE, Moore LSP, et al., 2017, Obtaining antibiotics online from within the UK: a cross-sectional study, Journal of Antimicrobial Chemotherapy, ISSN: 1460-2091
Boyd S, Charani E, Lyons T, et al., 2016, Information provision for antibacterial dosing in the obese patient: a sizeable absence?, Journal of Antimicrobial Chemotherapy, ISSN: 1460-2091
Boyd S, Rawson T, Moore L, et al., 2016, Preventing bloodstream infection in children: What's the CATCH?, The Lancet, Vol: 388, Pages: 462-463, ISSN: 0140-6736
Law S, Boyd S, MacDonald J, et al., 2014, Predictors of survival in patients with chronic obstructive pulmonary disease receiving long-term oxygen therapy, BMJ Supportive & Palliative Care, Vol: 4, Pages: 140-145, ISSN: 2045-435X
Boyd S, Aggarwal I, Davey P, et al., 2011, Peripheral intravenous catheters: the road to quality improvement and safer patient care, Journal of Hospital Infection, Vol: 77, Pages: 37-41, ISSN: 0195-6701
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