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Scottish Infection Research Network

Established in 2014, SHAIPI is a national consortium focused on healthcare associated infection (HAI) research. With the goal of addressing the threat of emergent HAIs and antimicrobial resistance, SHAIPI utilizes rapid knowledge transfer, state-of-the-art laboratory techniques, informatics, novel interventions, and evidence optimization. The consortium is comprised of 19 Co-Investigators from 5 HEIs and strategic partners, including the PHIs, Farr Institute, IPS, HENs, SMVN, SICSAG, Scottish Reference laboratories, SAPG, and the Sanger Centre.

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Scottish Infection Research Network

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  1. Scottish Infection ResearchNetwork Research Consortia

  2. Background • HAI costs £183M annually • Occurs in 5% of the acute hospital population • Major priority policy area for SGHD (VOL etc) • SIRN formed 2006 • £200K in 2011 for HAI research • £2M to support Scottish HAI research in 2012 • £4M Consortia grant 2013. Open ended funding. • Need for a 'step change" from individual project focused to a "themed" consortium approach

  3. Biosciences Informatics • Behavioural science (Practice based interventions) National HAI Institute?

  4. Consortium • A National consortium • Translational • Developing, concentrating on 3 areas Informatics (eHealth investment) Science (Omics) Practice based interventions • Based on 9 key priority areas identified by SGHD

  5. SGHD key priorities • Informatics-based approaches and economic evaluation. • Antibiotic resistance and the public health threat posed by antimicrobial resistance. • The role of screening for MRSA, MSSA (and other organisms of potential concern: VRE, NDM-1 etc) and decolonisation in reducing HAI. • Point of care testing and new diagnostic methods that allow for the identification of infection. • Infections within high risk areas and methods of infection prevention. • Emerging pathogens and alert organisms including Enterobacteriaceaebacteraemias, MRSA, MSSA, C difficile, Norovirus. • Barriers to the implementation of Standard Infection Control Precautions/ behavioural research. • Research to support evidence based standard infection control precautions. • Decontamination of equipment, endoscopes and the environment including water quality.

  6. Consortium Call • Call October 2013 • December deadline • 4 proposals: 3 progressed to form one combined group • Award December 2014

  7. Scottish Healthcare Associated Infection Prevention Institute (SHAIPI)Strategic vision To become an internationally recognised Institute for excellence in HAI Research utilising • Rapid knowledge transfer • State of the art laboratory techniques • Informatics • Novel interventions • Optimising evidence for existing interventions and compliance with these To tackle the threat to public health from emergent HAI and antimicrobial resistance for patient benefit in a co-ordinated fashion

  8. SHAIPI 19 CoIs, 5 HEIs ( Glasgow University (genomics, informatics); Glasgow Caledonian University (applied infection prevention, patient experience); Strathclyde University (clinical informatics, statistics), Dundee University (informatics, pharmacology), St Andrews University (genomics,informatics) 3 HBs Grampian, Tayside, Fife Strategic partners working with this consortium include: • PHI: epidemiology and access to European network of 28 countries • Farr institute: access to UK health informatics research network, health policy advice • IPS: Infection control practitioners and potential for CARC capacity building in Scotland through internships and international partnerships through the Society • HENs (Health economics network): developing health economic analysis of interventions • SMVN (Scottish Microbiology and Virology Network): microbiology samples, isolates and laboratory data • SICSAG (Scottish Intensive Care Society Audit group) and Scottish Critical Care Trials Group: provide a network to develop a National clinical dataset, identify and trial interventions. • Scottish Reference laboratories: organism specific expertise, national collections and datasets • SAPG (Scottish Antimicrobial Prescribing Group): focussed on optimising prescribing practice and reducing antimicrobial resistance. • Sanger Centre

  9. Years 1 and 2: Laying the Foundations • Develop an understanding of the epidemiology of the key organisms causing HAI in Scotland. • Delivery of national linked data from National datasets; SMR, PIS, ECOSS, NRS by PHI/IIP • Enhanced IIP databases in Tayside/Fife/Greater Glasgow and Clyde Health Boards including hospital clinical and laboratory data • Phase 1 risk modelling using existing IIP national data providing initial risk estimates for being a case and risk modelling for the outcome of cases for C.difficile, S.aureus and E.coli • Evidence for standard infection control precautions: hand hygiene and glove use. • Evidence for transmission based precautions : risk assessment, screening and isolation

  10. Years 3 to 5: Patient centred outputs •  Provide a responsive typing facility that will be used for outbreak control • Development of typing tools to support and interpret IC intervention practices within the Hospital setting • Understanding the effect of targeted interventions on the epidemiology of causative HAI organisms and how such knowledge can be used for focussed patient management • Phase 2 risk modelling highlighting patients at highest risk of HAI. • Integration of risk models in service delivery, for patient benefit, through translation of research into IIP by PHI. • Risk estimates of E.coli / S.aureus outcomes in infected patients as a direct result of strain identification. These will be used to developing targeted interventions (evidence based, behavioural based and cost effective) for optimising infection prevention and control • Evidence of the patient experience and acceptability of IPC related interventions

  11. Wider Deliverables at the end of the Consortium programme • Strengthened HAI translational applied research capacity within Scotland via development of researchers at various career stages • Improved capacity to capture externally funded research grants • Produce REF 2020 returnable research outputs of 3 and 4 star • Translate research into learning opportunities for under-and postgraduate students and NHS practitioners • Build international research reputation and collaboration in HAI • To translate findings from basic science research into clinical practice • To demonstrate impact on public health by economic and social benefits of reducing HAI • Influence SGHSCD policy to implement safe, effective, patient centred clinical practice related to key HAI and emerging antimicrobial resistance (AMR) • European and international collaboration in world leading research 

  12. Interconnections of Workstreams Feedback loop for WS1,2&3

  13. Example of Patient Analysis Pathway • Patient with UTI • CHI identification SMR1 ECOSS Data linkage Analytic platform Risk modelling Validated models nRTS High resolution typing AMR genotyping • E. coli Targeted IPC Interventions Targeted prevention and Management SICPs/TBPs evidence for generic Interventions Evaluation of Patient and practitioner Experience

  14. FIN

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