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• Journal article
  Freeman R, Moore LSP, Charlett A, Donaldson H, Holmes AHet al., 2015,
  , JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, Vol: 70, Pages: 1212-1218, ISSN: 0305-7453
  • Cite
  • Citations: 21
• Journal article
  Jones P, Moore LSP, Donaldson H, 2015,
  , AMERICAN JOURNAL OF INFECTION CONTROL, Vol: 43, Pages: 419-420, ISSN: 0196-6553
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• Journal article
  Castro-Sanchez E, Holmes AH, 2015,
  , JOURNAL OF HOSPITAL INFECTION, Vol: 89, Pages: 346-350, ISSN: 0195-6701
  • Cite
  • Citations: 25
• Journal article
  Drumright LN, Frost SD, Elliot AJ, Catchpole M, Pebody RG, Atkins M, Harrison J, Parker P, Holmes AHet al., 2015,
  , BMC INFECTIOUS DISEASES, Vol: 15, ISSN: 1471-2334
  • Cite
  • Citations: 7
• Journal article
  Holmes A, Castro-Sánchez E, Ahmad R, 2015,
  , British Journal of Health Care Management, Vol: 21, Pages: 275-277, ISSN: 1358-0574
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  • Citations: 5
• Journal article
  Moore LSP, Freeman R, Gilchrist MJ, Gharbi M, Brannigan ET, Donaldson H, Livermore DM, Holmes AHet al., 2014,
  , Journal of Antimicrobial Chemotherapy, Vol: 69, Pages: 3409-3422, ISSN: 1460-2091

  Objectives We examined the 4 year trend in antimicrobial susceptibilities and prescribing across levels of care at two London teaching hospitals and their multisite renal unit, and for the surrounding community.Methods Laboratory and pharmacy information management systems were interrogated, with antimicrobial use and susceptibilities analysed between hospitals, within hospitals and over time.Results A total of 108 717 isolates from 71 687 patients were identified, with significant differences (at P < 0.05) in antimicrobial susceptibility between and within hospitals. Across the 4 years, rates of ESBL-/AmpC-producing Enterobacteriaceae ranged from 6.4% to 10.7% among community isolates, 17.8% to 26.9% at ward level and 25.2% to 52.5% in critical care. Significant variations were also demonstrated in glycopeptide-resistant enterococci (ward level 6.2%–17.4%; critical care 21.9%–56.3%), MRSA (ward level 18.5%–38.2%; critical care 12.5%–47.9%) and carbapenem-resistant Pseudomonas spp. (ward level 8.3%–16.9%; critical care 19.9%–53.7%). Few instances of persistently higher resistance were seen between the hospitals in equivalent cohorts, despite persistently higher antimicrobial use in Hospital 1 than Hospital 2. We found significant fluctuations in non-susceptibility year on year across the cohorts, but with few persistent trends.Conclusions The marked heterogeneity of antimicrobial susceptibilities between hospitals, within hospitals and over time demands detailed, standardized surveillance and appropriate benchmarking to identify possible drivers and effective interventions. Homogeneous antimicrobial policies are unlikely to continue to be suitable as individual hospitals join hospital networks, and policies should be tailored to local resistance rates, at least at the hospital level, and possibly with finer resolution, particularly for critical care.

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• Journal article
  King D, Jabbar A, Charani E, Bicknell C, Wu Z, Miller G, Gilchrist M, Vlaev I, Franklin BD, Darzi Aet al., 2014,
  , BMJ OPEN, Vol: 4, ISSN: 2044-6055
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  • Citations: 14

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