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Centre for Evaluation and Treatment of Resistant Infection (CENTRI)

The Centre for Evaluation and Treatment of Resistant Infection was founded in 2022.

The centre combines state-of-the-art phenotypic and genotypic diagnosis of drug resistance with world leading clinical, microbiology, virology, mycology and pharmaceutical advice. Our aim is to improve the diagnosis and treatment of drug resistant infection and thereby minimize drug toxicity, improve efficacy and thereby decrease the development of drug resistance.

Patients referred to CENTRI – either to our virtual MDT or in person - will be reviewed by our multidisciplinary team that comprises:

  • Consultant in Paediatric Infectious Diseases
  • Consultant Microbiologist
  • Consultant Virologist
  • Consultant Mycologist
  • Consultant Pharmacometrics Specialist Infectious Diseases Pharmacist
CENTRI Co-directors

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Dr Louis Grandjean

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Dr James Hatcher

 

Is an Associate Professor in Infectious Diseases at UCL and Consultant in Paediatric Infectious Diseases at Great Ormond Street Hospital. Dr Grandjean is a Wellcome Trust Career Development Fellow with 10-years’ experience working with highly drug resistant organisms.

 

 

 

Is a dual trained consultant in microbiology and infectious diseases. Dr. Hatcher is a specialist with 10-years’ experience of managing both adult and paediatric complex infectious diseases. Dr. Hatcher has a particular interest in the application and combination of novel antimicrobial agents for the treatment of highly drug resistance organisms.

CENTRI Key Team Members

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Prof Joe Standing

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Orlagh McGarrity

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Professor Judith Breuer

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Professor Adilia Warris 

 

Professor Joe Standing is the director of the UCL Hollow Fibre facility and is a leader in the field of pharmacokinetic modelling and pharmacometrics. Professor Standing has led many pharmaceutical trials of novel antimicrobial, antifungal and antiviral agents. This makes him ideally placed to advise on combination therapies of last line antimicrobials.

 

 

Is a specialist pharmacist in infectious diseases with 5-years experience in paediatric infectious diseases. Orlagh has developed our latest antimicrobial guidelines and works with industry to ensure access to a wide range of novel pharmaceutical agents.

 

 

 

Is the director of the UCL Pathogen Genomics Unit as part of UCL Genomics. This state-of-the-art laboratory has enabled high throughput whole genome sequencing of a wide range of bacterial and fungal pathogens. CENTRI sends all pathogens with unexplained resistance to last line antimicrobials for sequencing at UCL genomics/GOSH microbiology.

 

 

Professor Warris leads a clinical-academic fungal research group at Exeter University and undertakes clnical work at Great Ormond Street Hospital. Professor Warris has a wide ranging knowledge and depth experience in the treatment of complex fungal infections. 

Latest in Diagnostic Technology

Phenotypic Methods: CENTRI combines wet lab microbiology with the latest in phenotypic testing with everything from benchtop culture to automated broth microdilution to last line antimicrobials using the ARIS-AIQ. This enables disc diffusion testing, minimum inhibitory concentrations and immunochromatographic testing for highly drug resistant gram-negative infections. This level of evaluation is critical to optimize the care of those colonized pre-chemotherapy, pre-transplant or infected with difficult to treat pathogens. In addition to phenotypic testing of gram-negatives CENTRI will also provide MIC testing of fungal pathogens and non-tuberculous mycobacteria. Resistant fungal and non-tuberculous mycobacterial infections are increasing among immunocompromised patients increasing the need for rapid and comprehensive phenotyping to ensure appropriate treatment decisions are made.

Genotyping Methods: Together with UCL Genomics and Great Ormond Street Hospital we have developed rapid and optimized bioinformatic pipelines to enable GridIon Oxford Nanopore Technology Long-Read Sequencing of gram-negative organisms. This will enable characterization of novel resistance mechanisms, confirmation of resistance to last line antimicrobials and identification of plasmid mediated resistance elements (critical for infection control). CENTRI also has Illumina sequencing capabilities with the latest Novaseq 6000, capable of longer read high throughput sequencing on the Illumina platform.

Pharmacometrics: Through the bacterial hub at UCL Institute of Child Health, CENTRI has access to the new Hollow Fibre Facility led by Professor Joe Standing. This enables us to evaluate combination therapies under physiological conditions predictive of likely clearance in vivo.

Clinical Trials: Our directors and multidisciplinary team are PI’s on antimicrobial clinical trials such as Isavuconazole (Pfizer) and Rezafungin (Mundipharma) among others. This often enables us to enrol referred patients into the latest trials of novel pharmaceuticals. How to Refer a Patient: