NIHR | Manchester Biomedical Research Centre
Our Research: Respiratory


Antimicrobial resistance is a huge issue facing the world today. How will we revolutionise the way we diagnose and treat patients with respiratory disease?

About one third of all antibiotic prescriptions are for chest infections. Our research focuses on providing more accurate, rapid diagnosis for patients with severe respiratory infections and better management of fungal infections – the areas where we believe our work can have the greatest impact.

We know that there is a link between respiratory disease and an imbalance of microorganisms (bacteria, fungi and viruses) in the lung.

We are:

  • Analysing the microbiome and mycobiome (genetic material of these bacteria and fungi) to better understand the dynamic relationships of different pathogens and commensal organisms in different conditions and under the influence of antimicrobials and corticosteroids – the lungs are not sterile, as previously thought. We anticipate more accurate diagnosis of lung infection.
  • We are developing and evaluating software algorithms to process information about the patient’s condition in collaboration with The Health eResearch Centre, to help clinicians make timely, efficient and effective decisions on the antibiotics they use to treat patients in hospitals with serious infections. This will optimise antibiotic treatments going forward and ultimately improve patient safety for future generations.

Fungal diseases are among the more difficult to treat, particularly in patients with complex medical needs. Antifungal resistance is increasing – a Citizen Science project across the UK with numerous patients from the National Aspergillosis Centre participating, for a 13 per cent overall rate of resistance and higher in compost. Rapid detection and a switch to alternative therapies is required.

We are:

  • Able to detect antifungal resistance using molecular methods even when fungi do not grow, and continue to evaluate the impact of this new technology in routine clinical care. Evaluating the ability to detect Azole resistance using molecular methods that can be applied as part of routine clinical care.
  • Validating a small number of genetic markers that can accurately distinguish aspergillosis (diseases caused by the Aspergillus fungi) from underlying lung diseases, to allow early diagnostic screening in the future and stratify patients by risk.
  • Extending the reach of our research globally, given the few experts in fungal disease and limited diagnostic capacity in many countries
Antimicrobial response

NIHR Infrastructure Award:  Antimicrobial Resistance (AMR) Centre Award, 2019

Our Respiratory Theme leads Manchester’s NIHR Infrastructure grant to accelerate our expertise in the rapid diagnosis of bacterial infections, AMR and sepsis. To support personalised care, we are identifying individualised antimicrobial dosing and rapid assessment of antimicrobial response with the aim to reduce emerging AMR.  The new Centre will support large-scale clinical studies and leverage further funding in this area of global importance and immediate clinical need.

Research funded by NIHR Manchester Biomedical Research Centre and the Connected Health Cities Programme has discovered an association between the number of prescriptions for antibiotics and a higher risk of hospital admissions.

Blog:  Approximately 50,000 patients in the UK die from sepsis each year. On World Sepsis Day Dr Tim Felton discusses the challenge of tackling sepsis in the face of the increasing challenge posed by antibiotic resistance.

Blog:  On world sepsis day Professor Paul Dark, sub-theme project lead in respiratory infections discusses the challenge of antibiotic resistance and how his Manchester BRC research will drive faster clinical decisions about antibiotic treatment of hospitalised patients with serious infections.

Fungal research

Research funded by NIHR Manchester Biomedical Research Centre has led to UK-wide implementation of a novel NHS diagnostic test that uses pyrosequencing (a method of identifying genetic markers in DNA), to identify the right treatment for people with aspergillosis.

Scientists at The University of Manchester have discovered a genetic mutation in humans linked to a 17-fold increase in the amount of dangerous fungal spores in the lungs.

Indonesian Study reveals missed diagnosis of fungal infections in treated TB patients, with global implications