Blood cancers and their treatments can make people uniquely vulnerable to infection because of damage to the immune system. Improving the management of infections in these patients is therefore a key priority to improve blood cancer survival.
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I am interested in how patient healthcare data can be combined with microbial genetics and statistical methods, to improve the prevention, detection and treatment of infection in patients with blood cancer.
Prevention
During the Covid-19 pandemic, I saw first-hand how clinical and epidemiological data could be combined with viral genome data to track how SARS-CoV-2 was spreading and causing disease. (Picture on the left shows the computer I liked to work at in the hospital at the time). The data generated was incorporated into investigations of SARS-CoV-2 outbreaks in hospitals, care homes, and Cambridge University; we identified a 'super-spreader' pattern of dispersal, in which around 20% of infected individuals caused around 80% of the transmission events (depicted on the right). These studies illustrate how data can inform infection prevention and control (IPC) practices; for example, by supporting optimal use of personal protective equipment (PPE) to limit respiratory virus transmission. This is especially important for people with forms of immune compromise, who can remain very vulnerable to respiratory viral infections such as Covid-19, RSV and influenza.
Detection
These are three species of the mould Aspergillus, growing on agar plates (my hand, my pics!).
Aspergillus is found in the environment, but for certain patients with immune deficiencies, Aspergillus can cause deadly infections. One of these three species is generally resistant to an important antifungal drug, amphotericin B, and the others are generally susceptible. Being able to quickly work out whether someone has a mould infection, and to identify the species, is important to ensure that the correct life-saving treatment is initiated promptly. I am interested in how molecular tools can be used in the diagnosis of invasive fungal infections.
(Left to right: A. flavus, A. terreus (generally amphotericin B resistant), A. fumigatus.)
Treatment
Antimicrobial resistance (AMR) threatens our treatment options for serious infections. People with immune compromise may get multiple infections requiring treatment with antimicrobial drugs such as broad-spectrum antibiotics and antivirals, which can select for resistance. Being able to detect resistance quickly and to tailor antimicrobials to each patient and for each infection is therefore essential.
(Note: there is nothing patient identifiable in any of these images. The agar plates were growing cultured isolates; they are not clinical samples).