I am an Associate Professor at the London School of Hygiene and Tropical Medicine and co-Director of the LSHTM AMR Centre. I am currently funded by an MRC Career Development Award to work on the spread of antimicrobial resistance (AMR) and how it varies by age and gender.
My research uses mathematical modelling to better understand the spread of pathogens, with a particular focus on antibacterial resistance (AbR). I work mainly with the bacterial pathogens methicillin resistant Staphylococcus aureus (MRSA) and multi-drug resistant tuberculosis (MDR-TB).
My research is split into four key themes
(1) Why does prevelance of resistance in infection vary by age and gender? This focus of my CDA will involve data analaysis and modelling to understand why simple demographic markers are not more routinely linked to AMR and what the drivers of variation might be.
(2) Why aren’t all bacteria resistant to all antibiotics? In capturing heterogeneity I am interested in the rate at which resistance genes move, which for MRSA means understanding the interaction between bacteria and bacteriophage. Can we use phage as alternatives to antibiotics? how fast do they mispackage and hence transfer resistance genes? what affects this transfer rate and how much does this shuffling of genes contribute to AMR evolution in humans?
(3) Where does transmission and selection occur? Within AMR, this means I am interested in the One Health angle of AMR and whether we can use existing data to understand where to target interventions at the farm level. Currently I am thinking about whether use of antibiotics in food-production really drives AMR within the SEFASI project. Outside of AMR, this has meant a focus on settings of transmission of SARS-CoV-2 and the contribution of the hospital environment to spread of SARS-CoV-2 in England.
(4) What can we do about AMR? We need to do better at understanding the evolution and drivers of AMR and the size of the burden in order to better target interventions. Specific projects here include work to estimate the burden of latent MDR-Mtb infection and to develop better empiric prescribing guidelines.
I was previously a recipient of an MRC Skills Development Fellowship which I based at LSHTM. Before that I worked at the NIHR funded HPRU for Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London. After my PhD I was a postdoc with the TB Modelling group at LSHTM.