The main research focus for Fabrice’s group is antimicrobial resistance, primarily in gram-negative bacteria, and in particular extended-spectrum beta-lactamase-producing and carbapenem-resistant E. coli and K. pneumoniae.
They study and seek to understand complex molecular mechanisms of antimicrobial resistance including re-emerging susceptibility, hard-to-predict antimicrobial resistance phenotypes based on genomic data, genotype-phenotype mismatches and collateral sensitivity, and how to translate this knowledge into clinical practice.
They aim to improve surveillance – a key objective of the World Health Organisation Global Action Plan on antimicrobial resistance. Understanding transmission of antimicrobial resistance -bacteria – where and how these bacteria are acquired by patients – is crucial to informing intervention studies aiming at interrupting transmission and thereby reducing infections. In addition, fewer infections will concurrently reduce the use of antibiotics and decrease the selection pressure on bacteria to evolve resistance.
As part of the TRacking AMR across Care Settings Liverpool study the group is investigating the transmission dynamics of extended spectrum beta-lactamase and CR E. coli and K. pneumoniae in hospitals and care homes in Liverpool. This knowledge will allow them to inform the design, implementation and evaluation of pilot heath systems intervention aiming to reduce antimicrobial resistance acquisition in care settings.
In their Defining E. coli Diversity in Complex Samples: Methods for Surveillance & Transmission project they are optimising laboratory and bioinformatics methods for describing and quantifying E. coli diversity based on the identification of epidemiologically informative single nucleotide variants to support One Health genomic antimicrobial resistance surveillance and to inform transmission modelling.