Antibiotic Resistance in Bacteria, 'Hospital Superbugs', Response to COVID Pandemic, Enterobacter Infections, Antibiotic Resistance, Microbiology, Bacteria, Antimicrobial Agents

Video: BSAC Spring Conference 2018 - Day2 - Professor David Livermore

David Livermore gained his BSc in 1978 and his PhD in 1983. He worked at the London Hospital Medical College from 1980 until 1997, when he joined the Health Protection Agency (now Public Health England), becoming Director of its Antibiotic Resistance Monitoring and Reference Laboratory in 1998. In October 2011, he became Professor of Medical Microbiology at UEA, but with 30% of this time supplied back to Public Health England as its Lead on Antibiotic Resistance.

Prof Livermore has broad interests on the evolution and dissemination of antibiotic resistance and its relationship to antibiotic prescribing. Beta-Lactamases are a particular interest, with recent work on the proliferation of ‘CTX-M’ extended-spectrum enzymes and carbapenemases, particularly NDM-1, which received extensive media coverage in 2010.

He sits on the British Society for Antimicrobial Chemotherapy working parties on resistance surveillance, multi-resistant pathogens and susceptibility testing and its Antibiotic Action advisory board, also on the Society for General Microbiology working group on sexually transmitted infections. He is also a member of the UK Government’s Antimicrobial Resistance and Healthcare Associated Infections Advisory Committee and has contributed extensively to the Chief Medical Offer for England’s  Annual Report for 2011. He publishes and speaks widely on resistance and has edited for several journals including Journal of Antimicrobial Chemotherapy and Journal of Medical Microbiology and, currently, International Journal of Antimicrobial Agents.

Outside of work, he is a keen walker, has walked the perimeter of Norfolk and almost half the English Coastline.

9/78 to 6/80         QC Microbiology Devt., Wellcome Foundation, Dartford, Kent

6/80 to 8/97         Department of Medical Microbiology, London Hospital Medical College

                            6/80-11/83    Research Assistant

                            11/83-2/87    Postdoctoral Fellow (Wellcome Trust)

                            11/85-5/86    Secondment, Lecturer, University of Hong Kong

                            2/87-12/94    Lecturer in Medical Microbiology

                            12/94-8/97    Senior Lecturer in Medical Microbiology

                              9/97-9/00    Hon Senior Lecturer

   9/98-10/11        Public Health England (formerly HPA), Microbiology Services

                              9/97-9/98   Head, Antibiotic Reference Unit, Colindale

                              9/98-date   Director, Antibiotic Resistance Monitoring & Reference  

                                                 Laboratory, Colindale

    10/11-date       Professor of Medical Microbiology, University of East Anglia (primary employer, `70% time, with 30% of this subcontracted to Public Health England )

                              Lead on Antibiotic Resistance, Public Health England Microbiology Services, Colindale

                              Visiting Professor, King Saud University, Riyadh, Saudi Arabia

                              Honorary Professor of Medical Microbiology, Queen Mary University, London

                              Consultant on Antibiotic Resistance – advisory work for numerous diagnostic and pharmaceutical companies and potential investors

My early research centred on ?-lactamases, and I showed how an apparently weak activity could protect a bacterium if the enzyme had high affinity and the ?-lactam permeated only slowly. This led to showing that models describing the interplay of ?-lactamase and permeability were adequate for Escherichia coli but not Pseudomonas aeruginosa, and I contributed to work revealing that this inadequacy was because P. aeruginosa also effluxes ?-lactams. Other early work explored the induction of AmpC ?-lactamases and the selection of AmpC-derepressed mutants from AmpC-inducible populations of Enterobacter and P. aeruginosa, showing selection to be the more important factor. I have been responsible for describing and investigating the properties of many new ?-lactamases, including those conferring resistance to carbapenems – the last reserve ?-lactams against many otherwise multiresistant bacteria.

My work increasingly spread from the mechanisms of resistance to its epidemiology. At the UK Health Protection Agency (Public Health England) I led groups that demonstrated the dramatic rises in MRSA in the late 1990s, ciprofloxacin-resistant gonococci around 2002-3, carbapenemase-resistant Acinetobacter spp. and cephalosporin-resistant E. coli from around 2003 and the recent rise in carbapenemases, partly linked to the repeated import of strains with NDM-1 enzyme via patients previously hospitalised in the Indian subcontinent.

My current major areas of research interest at UEA centre on the development of methods to rapidly detect antibiotic resistant bacteria in patient specimens. Such tests would allow the swifter optimisation of a patient’s therapy, benefitting both the individual and antibiotic stewardship – thus meeting key objectives highlighted in the Chief Medical Officer’s Annual Report for 2013.   Other areas of interest are gut carriage of resistant bacteria and the relationship between in-vitro resistance and treatment outcome, Through on-going links with Public Health England I remain deeply involved in the surveillance of antibiotic resistance, the investigation of emerging resistance types and the in-vitro evaluation of new antibiotics against these organisms.

Research Keywords: Antibiotic resistance, ?-Lactamase, Carbapenem, Antibiotic development

Research Topics for PGR Supervision: Epidemiology of antibiotic resistance, Mechanisms of antibiotic resistance, Detection of antibiotic resistance

In a research career of 30 years I have lecture widely and supervised or co-supervised 15 PhD student to successful completion. I currently supervise one PhD student, working on rapid microbiological investigation of urinary tract infections and co-supervise two others, one working on the strain structure of carbapenemase-producing Pseudomonas aeruginosa in the UK and the other on gen expression in P, aeruginosa biofilms.