Causal pathways to colonisation with extended spectrum beta-lactamase producing Enterobacteriaceae during hospitalisation in a low-income setting (CAPSULE)

Background Production of enzymes such as extended spectrum beta-lactamases (ESBLs), which degrade all antibiotics of the betalactam class (of which penicillin is one example) is one mechanism through which bacteria become resistant to antibiotics. There is limited understanding of the routes and drivers of ESBL-producing bacteria transmission in low-income hospital settings. Approach Using mathematical modelling and bioinformatics approaches, I will analyse bacterial genetic material from in-patients and their family carers to investigate the pathways through which ESBL-producing bacteria are carried into and transmitted in a low-income hospital environment. I will qauntify roles of antibiotic use, hospital environmental contamination and patient-carer contacts in the hospital dynamics of ESBL-producing bacteria. Impact The output from this study will inform the design of interventions for controlling hospital transmission of ESBL-producing bacteria and provide a framework for understanding hospital AMR transmission to enable generalisation of methods from to this study to other sites.