HerpeZ

Patients who develop serious illness due to COVID-19 are more likely to have bacterial co-infections and the World Health Organization therefore recommends treatment with antibiotics. As a result, many countries are observing a change in antimicrobial stewardship, in addition to changes in infection prevention and control practices such as the use of personal protective equipment, on COVID-19 wards. Few data on COVID-19 and its impact on antimicrobial resistance (AMR) have come from low and middle-income countries (LMICs). As these countries often have higher rates of AMR, and COVID-19 cases are still increasing across many sub-Saharan African countries, it is vital to report on how COVID-19 is affecting antimicrobial stewardship, to direct clinical practice moving forward.

This pilot study, based in hospitals in Sudan and Zambia, will identify infection prevention and control (IPC) guidelines for COVID-19 and non-COVID-19 wards. We will then compare the secondary bacterial infections acquired by patients, as well as from the ward environment, on COVID-19 and non-COVID-19 wards, using microbiological and sequencing methods to identify species, as well as identifying AMR transmission patterns using phylogenetic analysis. This project will enable an Oxford Nanopore Sequencing platform to be set up in Sudan (one has recently been installed in Zambia), with UCL providing sequencing training. These platforms and the training programme will enable the teams in both countries to not only undertake sequencing for this project, but also set up a sequencing pipeline for the identification of multi-drug resistant bacteria in clinical settings.

The results of this study will provide evidence that can inform policy on IPC measures put in place on COVID-19 wards. You can follow the progress of our study on twitter (@AmrCovid).