Antimicrobial Stewardship in Hospitals, Resistance Selection and Transfer in a One Health Context
Antimicrobial Stewardship interventions will be introduced across Queen Elizabeth Central Hospital in Blantyre, Malawi.
Hospital wastewater acquisition
Bespoke hospital wastewater sewage samplers will be used to acquire samples before and during the hospital wide antimicrobial stewardship interventions.
Microbiological analysis of hospital wastewater
Susceptible and resistant bacteria will be grown, identified and enumerated. The mechanisms of resistance will be determined.
Chemical analysis of hospital wastewater
The hospital wastewater will be analysed by chemists to determine the levels of antibiotics that are leaving the hospital ground in the hospital wastewater.
Analysis of horizontal gene transfer of antimicrobial resistance genes
Rates of transfer by conjugation will be determined in the presence of different concentrations of antimicrobials found in the hospital wastewater by using state of the art fermenters which allow us to model the chicken caecum.
Analysis of intracellular transposition of antimicrobial resistance genes
The ability of mobile genetic elements to jump between plasmids or between plasmids and the chromosome inside a bacterial cell will be determined using newly developed molecular biology assays.
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