2652: Investigating the impact of COVID-19 on antimicrobial resistance in Gram-negative bacteria across the South West of England
Source: gov.uk (2025-08-04)

This project aims to explore trends in resistance patterns among E. coli isolates from blood stream infections from 2016 to 2021 in the South West of England prior to and during the COIVD-19 pandemic.

About the project

What the project aims to do

This project aims to explore trends in resistance patterns among E. coli isolates from blood stream infections from 2016 to 2021 in the South West of England prior to and during the COVID-19 pandemic.

Why this project is important

Antimicrobial resistance is viewed as one of the greatest challenges facing modern healthcare. In the UK the proportion of blood stream infections caused by pathogenic bacteria (such as E. coli) with resistance to antimicrobial agents (also known as antibiotics) increased between 2016 and 2020. These infections are more difficult to treat than those without resistance and there is a risk that these infections can be transmitted to other patients within healthcare settings.

E. coli is a common cause of urinary tract infections (UTIs) which can then go on to cause blood stream infections and it is the most common pathogen causing resistant blood stream infections in the UK.

The COVID-19 pandemic has changed the way healthcare is provided, which led to reduced face to face contact with patients and changes to antibiotic prescription behaviours. Previous work in the South West of England showed that in the years prior to the COVID-19 pandemic, community antibiotic prescription for UTIs had decreased (in line with national trends), alongside changes in the pattern of resistance among E. coli.

Until 2019 the proportion of E. coli bacteraemias (bacteria in the bloodstream) with resistance to key antibiotics was increasing. In 2020 this increase stopped and in some cases was reversed. The reversal of these trends may be because of the change in healthcare provision as a result of the COVID-19 pandemic.

This project aims to look at any changes in the patterns of resistance amongst E. coli in bloodstream infections in the South West of England over time to quantify the effect of changes since the start of the COVID-19 pandemic.

Who the data is about

The data concerns:
- reported E.coli infections, as confirmed in Second Generation Surveillance System (SGSS)
- specimen type: blood
The data is restricted to:
- patient’s resident in the South West of England at date of diagnosis
- specimen date: between 1 January 2016 and 31 December 2021
- sensitivity to the following antimicrobial agents: gentamicin, ciprofloxacin, cefotaxime, ceftazidime, cefpodoxime, ceftriaxone, meropenem, imipenem, ertapenem, piperacillin/tazobactam, co-amoxiclav (amoxycillin/clavulanate)
How the data will be used

The University of Bristol will access SGSS data from UKHSA on residents in South West of England with blood culture results positive for E. coli between 1 January 2016 and 31 December 2021. This data will include information about each resident’s sociodemographic background, including their age, sex, and IMD (deprivation) score.

To do this, UKHSA will extract data from SGSS and remove all patient identifiers to generate a de-personalised dataset. UKHSA will then securely send this dataset to the University of Bristol.

The University of Bristol will then use this data to:
- describe trends in resistance patterns among E. coli isolates from blood stream infections prior to and during the COVID-19 pandemic
- describe the sociodemographic characteristics of those suffering from E. coli bacteraemias, both resistant and non-resistant
- make recommendations for public health action
How often data is needed

One off release

How this project will benefit public health and the public

The findings from this project may inform recommendations regarding antimicrobial resistance management in South West England.

Planned project outputs and communication

The research will appear in:
- peer reviewed scientific journals
- internal report (publication not intended)
- conference presentation Website
- submission to regulatory authority Press release
- software products and web tools
- other
Lawful processing of personal and special category personal data

The data needed for this project is not personal data.

Legal basis for using personal data (Article 6)

Not applicable

Legal basis for using special category personal data (Article 9)

Not applicable

Common law duty of confidentiality

The data needed for this project is not confidential patient information.

How is the duty of confidentiality set aside

Not applicable

National data opt-out

Opt-out preferences will not be applied.

This is because the national data opt-out does not apply to anonymised data.

Digital object identifier

Not assigned to this release.

Organisatons Research Organisation Registry (ROR) ID:

ROR ID (https://ror.org/0524sp257)

*IMD: index of multiple deprivation