Resistance to antimicrobial agents is one of the most important emerging threats to global health. low and middle-income countries, such as Kenya will suffer disproportionately from the effects of antimicrobial resistance (AMR), due to restricted access to 3^rd/4^th line antimicrobials, (drugs given when standard treatment fails), and limited resources for supportive care. In addition, a lack of infection control activities means that if a resistant strain is introduced into a healthcare facility, it is likely to spread easily from patient to patient.

We are conducting studies to investigate

1. the trends in AMR infections over time;
2. whether patients with drug resistant infections have higher morbidity and mortality;
3. the molecular mechanisms of resistance in multi-drug resistant Gram negative infections, including E. coli and Klebsiella pneumoniae;
4. the patterns of transmission and spread of multi-drug resistant infections in hospitals.

We aim to understand the major factors driving the emergence of AMR in the region, so that we can determine which interventions will be most effective.

Investigators: Anthony Scott, Esther Muthumbi, Etienne Villiers,Jay Berkley, Julie Jemutai, Kathryn Maitland, Mainga Hamaluba, Michuki Maina, Sarah Atkinson, Olivia Lucey