The risk of antimicrobial resistance (AMR) across many bacteria and antibiotic combinations varies across by age and sex, as do other factors such as antibiotic usage, contact patterns, healthcare utilisation and the immune system. Understanding how AMR and the potential influencing factors vary by age and sex and between countries such as between the UK and Japan can give us further power to understand the drivers for the development of drug-resistant infections. In particular, it can help to determine who is most at risk of drug-resistant infections leading to improved patient care.

This PhD aims to work towards understanding these questions, with the potential to work on a diverse range of data available both in the UK and Japan. Key methods will be the use of statistical and mathematical models, as well as epidemiology. The following focus areas could be considered:

National level

How does the level of AMR vary by age and sex across Japan? How does this compare to the UK?
What are the comparative age and sex trends of antibiotic usage in Japan and UK?
What is the relationship between antimicrobial consumption and the prevalence of antibiotic resistance and does this relationship vary between the UK and Japan? 

Hospital level (working with reference hospitals in Japan and the UK)

Does antibiotic usage in hospital increase a patient’s risk of a subsequent resistant infection?
What other factors predict the development of drug-resistant Infections (DRI)?
Using longitudinal samples from the same patient, can we untangle whether transmission of or selection for resistance is the dominant pathway to DRI? 

Working across different hospitals will give further power to answer these questions.

The PhD will initially involve exploring a range of bacteria and antibiotic combinations to map the AMR landscape. Detailed investigations will then focus on one or two specific bacteria-antibiotic combinations based on the epidemiology or clinical problem and data availability.