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Previous Research

Since my undergraduate degree I have been very interested in infectious diseases and immunology.  My undergraduate supervisor approached me and asked if I would like to do a PhD in Medical and Molecular Microbiology. I started my PhD in 2010 and carried out field work in Egypt, collecting samples from hospitals.

Current Research

I am currently researching antibiotic resistance.
I look at two types of Gram-negative bacteria, Acintobacter baumannii and Klebsiella pneumoniae, which are highly resistant to antibiotics and cause hospital acquired infections.  I’m interested in the diversity and epidemiology (the distribution and possible control) of these bacteria within a hospital, within a country and also within different regions in Africa.  I’m also investigating the genetics of resistance; bacteria exchange genetic information amongst themselves to assist each other to survive, so I’m looking at how this is exchanged and what they have acquired.

I don’t think you can stop bugs from becoming resistant because it’s in their nature.
Bacteria want to survive so they are going to develop resistance no matter what. The major antibiotics are derived from the environment, from fungi and plants. The bacteria have lived and been exposed to these environments and these antibiotic compounds through the soil for millions of years, so they’ve developed resistance mechanisms.  You can’t stop it, but you can limit the rates massively through infection control and monitoring the use of antibiotics.  

I’d like to raise awareness that other countries have alarmingly high antibiotic resistance rates. A bug here, in the UK, may have a 20% antibiotic resistance rate, compared to in Egypt or Sudan where this bug may have up to a 90% resistance rate. I think this is due to the infection control within hospitals. In some instances clones of bacteria have been allowed to accumulate over the months and years, without any surveillance. This leads to a larger diversity of organisms present within a single hospital in the countries we work with compared to the UK.

One of the issues is that in lower and middle income countries antibiotic resistance is not reported and a lot of the times there’s no research done.
There is a lack of awareness of infection control within many hospitals. Because of the lack of data they don’t know what the resistance pattern looks like within their hospitals, so they don’t know whether they are prescribing the right antibiotics. Also bacteria can look very similar so identification can be wrong and doctors may prescribe the wrong medicine. It’s not their fault, it’s back to the lack of resources.

Through the Global Health Centre we have built links with partner countries, Sudan, Ethiopia, Cameroon and Egypt. I’ve visited these countries and applied for the Sussex Research Development Fund to start up this study to collect bacterial samples from hospitals in our partner countries and look at their epidemiology and resistance profiles. The hospital routinely take a sample from the patient with an infection, and culture it in a microbiology lab. They store the bacteria we’re interested in, and also send it here to do further work to identify how these bacteria are gaining resistance. We work with local scientists in the partner countries to build capacity locally in molecular microbiology, by providing mentorship and training.

The results that I get give an insight into what is actually happening and the evolution of these bacteria in Africa. 
Because of the limited surveillance in these countries, it’s important for us to understand the genetics of resistance and how these bacteria are acquiring foreign DNA throughout their life within a hospital. It’s also important to determine the extent to which these resistant bacteria are being transported throughout the world.

We’re trying to help these countries to start a strategy for solving these problems on a small scale at first. Hopefully this will lead to bigger projects and involvement from these partners.  We have a PhD student registered in Sudan, one of our partner countries and we want to help more PhDs and postdocs and do more capacity building.

I get a lot exposure both on the academic level and the cultural level.
My research is challenging in a good way, I get to work with people, from different disciplines and different countries.  We’re now collaborating with the Centre for Global Health Policy within Sussex’s School of Global Studies, creating a network on antibiotic resistance to look at how social and political aspects correlate with the emergence of resistance globally.  One study is looking at the policy of accessibility of antibiotics and then correlating this with the biomedical results that we get.

The Future

I think the more people are involved, the more value the project will have. 
I hope to get a bigger grant to be able to do my work on a larger scale and to work with a bigger team. I am interested to expand the number of institutions we are working with internationally. I’m getting in contact with the University of Ghana, medical school as they work with antibiotic resistance and they’re interested in hospital acquired infections to see how we could collaborate. 

I’d also be interested in working with partners in the Middle East as well, I speak Arabic, I’m half Iraqi, half Danish.  We have been awarded a Sussex International Research Partnerships and Networks fund to set up a formal Antimicrobial Resistance Research Network in collaboration with the Centre for Global Health Policy at Sussex, the Institute for Global Health in the University of Barcelona, and the Institute of Medical Microbiology, Immunology and Hygiene at the University of Cologne. The aim is to assemble an international partnership that brings together world leaders in the field of antibiotic  resistance  across  interdisciplinary aspects. This will see social and biomedical scientists working together towards a common research goal: understanding antibiotic resistance globally.

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