Edward Portal
A5062823323- Antibiotic Resistance in Bacteria
- Neonatal and Maternal Infections
- Pneumonia and Respiratory Infections
- Microbial infections and disease research
- Bacterial Identification and Susceptibility Testing
- Bacterial biofilms and quorum sensing
- Vibrio bacteria research studies
- Pharmaceutical and Antibiotic Environmental Impacts
- Antibiotics Pharmacokinetics and Efficacy
- Streptococcal Infections and Treatments
- Bacteriophages and microbial interactions
- Legionella and Acanthamoeba research
- Antibiotic Use and Resistance
- Genomics and Phylogenetic Studies
- Global Maternal and Child Health
- Antimicrobial Resistance in Staphylococcus
- Mosquito-borne diseases and control
- Reproductive tract infections research
- Tuberculosis Research and Epidemiology
- Urinary Tract Infections Management
- Neonatal and fetal brain pathology
- Sepsis Diagnosis and Treatment
- Salmonella and Campylobacter epidemiology
- Insect Utilization and Effects
- Pneumocystis jirovecii pneumonia detection and treatment
Cardiff University
2017-2025
University of Oxford
2023-2025
University Hospital of Wales
2020-2025
Ineos (United Kingdom)
2023-2025
Institute of Infection and Immunity
2024
Makerere University
2024
Public Health England
2020-2021
UK Health Security Agency
2021
Antimicrobial resistance in neonatal sepsis is rising, yet mechanisms of that often spread between species via mobile genetic elements, ultimately limiting treatments low- and middle-income countries (LMICs), are poorly characterized. The Burden Antibiotic Resistance Neonates from Developing Societies (BARNARDS) network was initiated to characterize the cause burden antimicrobial for seven LMICs Africa South Asia. A total 36,285 neonates were enrolled BARNARDS study November 2015 December...
Abstract MCR-1 is a lipid A modifying enzyme that confers resistance to the antibiotic colistin. Here, we analyse impact of expression on E. coli morphology, fitness, competitiveness, immune stimulation and virulence. Increased mcr-1 results in decreased growth rate, cell viability, competitive ability significant degradation membrane cytoplasmic structures, compared catalytically inactive (E246A) or soluble component. Lipopolysaccharide (LPS) extracted from strains induces lower production...
BackgroundNeonatal sepsis is a primary cause of neonatal mortality and an urgent global health concern, especially within low-income middle-income countries (LMICs), where 99% occurs. The aims this study were to determine the incidence associations with all-cause in facility-born neonates LMICs.MethodsThe Burden Antibiotic Resistance Neonates from Developing Societies (BARNARDS) recruited mothers their into prospective observational cohort across 12 clinical sites Bangladesh, Ethiopia,...
Abstract Hospital surfaces can harbour bacterial pathogens, which may disseminate and cause nosocomial infections, contributing towards mortality in low- middle-income countries (LMICs). During the BARNARDS study, hospital from neonatal wards were sampled to assess degree of environmental surface patient care equipment colonisation by Gram-negative bacteria (GNB) carrying antibiotic resistance genes (ARGs). Here, we perform PCR screening for extended-spectrum β-lactamases ( bla CTX-M-15 )...
The polymixin colistin is a "last line" antibiotic against extensively-resistant Gram-negative bacteria. Recently, the mcr-1 gene was identified as plasmid-mediated resistance mechanism in human and animal Enterobacteriaceae, with wide geographical distribution many producer strains resistant to multiple other antibiotics. encodes membrane-bound enzyme catalysing phosphoethanolamine transfer onto bacterial lipid A. Here we present crystal structures revealing MCR-1 periplasmic, catalytic...
Sepsis is a major contributor to neonatal mortality, particularly in low-income and middle-income countries (LMICs). WHO advocates ampicillin-gentamicin as first-line therapy for the management of sepsis. In BARNARDS observational cohort study sepsis antimicrobial resistance LMICs, common pathogens were characterised via whole genome sequencing (WGS) profiles. this substudy BARNARDS, we aimed assess use efficacy empirical antibiotic therapies commonly used LMICs
Abstract Early development of the microbiome has been shown to affect general health and physical infant and, although some studies have undertaken in high-income countries, there are few from low- middle-income countries. As part BARNARDS study, we examined rectal microbiota 2,931 neonates (term used up 60 d) with clinical signs sepsis 15,217 mothers screening for bla CTX-M-15 , NDM KPC OXA-48 -like genes, which were detected 56.1%, 18.5%, 0% 4.1% neonates’ swabs 47.1%, 4.6%, 1.6% mothers’...
Abstract Background Carbapenemase-producing Klebsiella pneumoniae has become a global priority, not least in low- and middle-income countries. Here, we report the emergence clinical impact of novel carbapenemase–producing K. (KPC-KP) sequence type (ST) 16 clone clonal complex (CC) 258–endemic setting. Methods In teaching Brazilian hospital, retrospective cohort adult KPC-KP bloodstream infection (BSI) cases (January 2014 to December 2016) was established study molecular epidemiology its on...
A mobile colistin resistance gene mcr was first reported in 2016 China and has since been found with increasing prevalence across South-East Asia. Here we survey the presence of genes 4907 rectal swabs from mothers neonates three hospital sites Nigeria; a country limited availability or history use clinically. Forty mother seven neonatal carried range bacterial species: 46 Enterobacter spp. single isolates of; Shigella, E. coli Klebsiella quasipneumoniae. Ninety percent were mcr-10 (n = 45)...
Streptococcus agalactiae or group B streptococcus (GBS) is a leading cause of neonatal sepsis and increasingly found as an invasive pathogen in older patient populations. Beta-lactam antibiotics remain the most effective therapeutic with resistance rarely reported, while majority GBS isolates carry tetracycline gene tet(M) fixed genomic positions amongst five predominant clonal clades. In UK, to clindamycin erythromycin has increased from 3% 1991 11.9% (clindamycin) 20.2% (erythromycin),...
There is a marked paucity in our understanding of the epidemiology colistin-resistant bacterial pathogens South Asia. A report by Davies and Walsh (Lancet Infect Dis 18:256–257, https://doi.org/10.1016/S1473-3099(18)30072-0 , 2018) suggests export colistin from China to India, Vietnam, Korea 2016 was approximately 1,000 tons mainly used as poultry feed additive. few reports forecast that prevalence mcr humans livestock will increase Given high bla CTX-M-15 NDM Bangladesh, Pakistan, has...
Abstract Background The burden of antibiotic resistant infection is mainly felt in low-to-middle income countries, where the rate antimicrobial resistance largely under-surveyed and under huge pressure from unregulated, disparate often self-guided access to antimicrobials. Nosocomial infections hospital environments have been shown be a particularly prevalent source multi-drug strains, yet surveillance environmental contamination not investigated. Methods study was prospective, observational...
Long-read sequencing (LRS) can resolve repetitive regions, a limitation of short read (SR) data. Reduced cost and instrument size has led to steady increase in LRS across diagnostics research. Here, we re-basecalled FAST5 data sequenced between 2018 2021 analyzed the relation gDNA large dataset ( n = 200) spanning wide GC content (25–67%). We examined whether would improve hybrid assembly, and, for smaller cohort, compared long (LR) assemblies context antimicrobial resistance (AMR) genes...
Bacteriophages are the most abundant organisms on Earth. As there few effective treatment options against some pathogens, interest in bacteriophage control of multi-drug-resistant bacterial pathogens is escalating, especially for Klebsiella pneumoniae. This study aimed to develop a phage-based solution rising incidence extensively drug-resistant clinical pneumoniae sequence type (ST16) infections starting from set phages recently characterized this lineage. A phage-cocktail (Katrice-16)...
In low- and middle-income countries (LMIC) Staphylococcus aureus is regarded as one of the leading bacterial causes neonatal sepsis, however there limited knowledge on species diversity antimicrobial resistance caused by Gram-positive bacteria (GPB).We characterised GPB isolates from blood cultures LMICs in Africa (Ethiopia, Nigeria, Rwanda, South Africa) South-Asia (Bangladesh Pakistan) between 2015-2017. We determined minimum inhibitory concentrations performed whole genome sequencing...
Background: Streptococcus agalactiae (Group B Streptococcus, GBS) is a leading cause of neonatal sepsis in high-income countries. While intrapartum antibiotic screening reduces this risk, increasing resistance to macrolides and lincosamides Europe since the 1990s has limited therapeutic options for penicillin-allergic patients. Reports reduced beta-lactam susceptibility GBS further em-phasize need robust antimicrobial (AMR) surveillance. However, broth micro-dilution (BMD) methods are...
Background: Streptococcus agalactiae (Group B Streptococcus, GBS) is a leading cause of neonatal sepsis in high-income countries. While intrapartum antibiotic screening reduces this risk, increasing resistance to macrolides and lincosamides Europe since the 1990s has limited therapeutic options for penicillin-allergic patients. Reports reduced beta-lactam susceptibility GBS further emphasise need robust antimicrobial (AMR) surveillance. However, broth microdilution (BMD) methods are...
Abstract Background Child survival rates have improved globally, but neonatal mortality due to infections, such as group B Streptococcus (GBS), remains a significant concern. The global burden of GBS-related morbidity and is substantial. However, data from low middle-income countries lacking. Vaccination during pregnancy could be feasible strategy address disease burden. Methods We assessed maternal rectovaginal GBS colonization in prospective cohort 6062 women-infant pairs. Surveillance for...
We report a clonal outbreak of multidrug-resistant (MDR) Klebsiella variicola (sequence type [ST] 771) in Bangladeshi neonatal unit from October 2016 to January 2017, associated with high mortality (54.5%). During the outbreak, K. ST771 acquired an MDR plasmid harboring blaNDM-1, linked exposure ceftriaxone and amikacin.
Abstract Legionella pneumophila, a Gram-negative bacillus, is the causative agent of Legionnaire’s disease, form severe community-acquired pneumonia. Infection can have high morbidity, with proportion patients requiring ICU admission, and up to 10% mortality, which exacerbated by lack efficacy typical empirical antibiotic therapy against spp. The fastidious nature entire Legionellaceae family historically required inclusion activated charcoal in solid medium remove growth inhibitors,...
Abstract Background Epidemiological evidence about the etiology and antimicrobial resistance of neonatal infections remains limited in low-resource settings. We aimed to describe a prospective observational cohort study conducted at two hospital sites Kampala, Uganda. Methods Babies admitted either unit with risk factors or signs sepsis, pneumonia, meningitis had blood culture, nasopharyngeal swab, lumbar puncture (if indicated) collected. Basic demographics were collected, babies followed...
10.6% patients were CRE positive. Only 27% prescribed at least 1 antibiotic to which infecting pathogen was susceptible. Burn and ICU admission antibiotics exposures facilitate acquisition. Escherichia coli ST167 the dominant clone.Given high prevalence of multidrug resistance (MDR) across South Asian (SA) hospitals, we documented epidemiology carbapenem-resistant Enterobacterales (CRE) infections Dhaka Medical College Hospital between October 2016 September 2017.We enrolled collected...