2026-27 Project (Moore & Bixby & Clark)

The changing incidence of Urinary Tract Infections and community prescribing across the UK to inform co-creation of future interventions

SUPERVISORY TEAM

Supervisor

Dr Catrin Moore at City St George’s
School of Health & Medical Sciences, Department of Medicine
Email: camoore@sgul.ac.uk

Co-Supervisor

Dr Honor Bixby at City St George’s
School of Health & Medical Sciences, Department of Global, Public and Population Health and Policy
Email: hbixby@sgul.ac.uk

Co-Supervisor

Professor Charlotte Clark at City St George’s
School of Health & Medical Sciences, Department of Global, Public and Population Health and Policy
Email: chclark@sgul.ac.uk

PROJECT SUMMARY

Project Summary

Approximately 10% of women in the UK experience a urinary tract infection (UTI) each year and over half experience one in their lifetime. UTI are among the most common reasons people seek antibiotics in the community. In the absence of accurate out-of-hospital diagnostic tools, prescriptions are usually given based on symptoms alone and with broad spectrum antibiotics, thereby fuelling resistance – a growing global health threat. In this project you will map how urinary tract infections (UTIs) present and are treated in communities across the UK and over time. You will estimate incidence; describe symptoms, diagnostics and first-line prescribing; quantify recurrence; and examine any patterns in seasonality. Using advanced epidemiology, you will examine the data for regional inequalities, generating actionable evidence for antimicrobial stewardship and diagnostic policy. This project is ideal for candidates excited by big health data, antimicrobial resistance, and research that changes clinical practice.

Project Key Words

Antimicrobial resistance, urinary tract infections, community disease modelling

MRC LID Themes

  1. Health Data Science
  2. Infectious Disease
  3. Global Health
  4. Translational and Implementation Research

Skills

MRC Core Skills

  1. Quantitative skills
  2. Interdisciplinary skills

Skills we expect a student to develop/acquire whilst pursuing this project:

  • R programming
  • Bayesian spatio-temporal statistical analysis
  • quantitative policy analysis
  • scientific paper writing
  • scientific engagement

Routes

Which route/s are available with this project?

  • 1+4 = Yes
  • +4 = Yes

Possible Master’s programme options identified by supervisory team for 1+4 applicants:

  • City St Georges – Master of Public Health MPH
  • City St Georges – MRes Biomedical Science – Clinical Biomedical Research
  • City St Georges – MRes Biomedical Science – Infection and Immunity
  • City St Georges – MSc Applied Biomedical Science
  • City St Georges – MSc Global Health
  • LSHTM – MSc Climate Change & Planetary Health
  • LSHTM – MSc Control of Infectious Diseases
  • LSHTM – MSc Epidemiology
  • LSHTM – MSc Health Data Science
  • LSHTM – MSc Medical Microbiology
  • LSHTM – MSc Public Health
  • LSHTM – MSc Public Health for Global Practice
  • LSHTM – MSc Tropical Medicine & International Health

Full-time/Part-time Study

Is this project available for full-time study? Yes
Is this project available for part-time study? Yes

Location & Travel

Students funded through MRC LID are expected to work on site at their primary institution. At a minimum, all students must meet the institutional research degree regulations and expectations about onsite working and under this scheme they may be expected to work onsite (in-person) more frequently. Students may also be required to travel for conferences (up to 3 over the duration of the studentship), and for any required training for research degree study and training. Other travel expectations and opportunities highlighted by the supervisory team are noted below.

Day-to-day work (primary location) for the duration of this research degree project will be at: City St George’s – Tooting campus, London

Travel requirements for this project: None

Eligibility/Requirements

Particular prior educational requirements for a student undertaking this project

  • Minimum standard institutional eligibility criteria for doctoral study at City St George’s

Other useful information

  • Potential Industrial CASE (iCASE) conversion? = No

PROJECT IN MORE DETAIL

Scientific description of this research project

Approximately 10% of women in the UK experience a urinary tract infection (UTI) each year and over half experience one in their lifetime. UTI are among the most common reasons people seek antibiotics in the community. In the absence of accurate out-of-hospital diagnostic tools, prescriptions are usually given based on symptoms alone and with broad spectrum antibiotics, thereby fuelling resistance – a growing global health threat. Recent changes to prescribing policies in England, through the introduction of Pharmacy First, threaten to exacerbate these problems. This project will provide crucial and timely evidence to guide appropriate antibiotic use for UTIs.

Project objectives, building evidence: 

  1. Estimate levels and trends in the incidence of UTIs in the UK community overall and by age, sex, deprivation score and region; 
  2. Describe presenting symptoms and any testing performed;  
  3. Determine the antibiotics used eg dose/duration, and switching;  
  4. Analyse any regional and temporal variation in antibiotic use together with local guidelines. 
  5. Measure recurrence, and how treatment changes. 
  6. Assess the causes of disease where available and determine any seasonality 
  7. Map spatiotemporal clusters and any inequalities in incidence, diagnostics, and prescribing. 
  8. Assess the impact of the Pharmacy First initiative on UTI prescribing practices, including regional variability.

Techniques:
This is a retrospective data analysis based on the IQVIA IMRD, ESPAUR antibiotic use report from the UK HSA and SPSS database containing microorganism data. The community data may be supplemented with hospital data from St George’s Hospital where needed. We will analyse the data using multivariable logistic/multinomial models and geospatial techniques.

Databases:
The IQVIA IMRD is available for 12 months free of charge after which time we will pay for use, all other databases are freely available or through a collaboration with the UK HSA and NHS (Dr Moore holds honorary contracts with the UK HSA and St George’s NHS). This work will inform co-creation workshops with people affected (clinicians, patients, laboratory staff) to devise new future interventions.

Risks to the project:

  1. Difficulty having access to the data which should be reduced through the honorary contracts which are in place. 
  2. Limits linking the data from disparate sources 
  3. Missing data. The student may need to model some of the data using tools such as AI. 
  4. Confounders – there may be unknown confounders hidden within the data 
  5. The affected populations do not engage with the research team.

Further reading

Relevant preprints and/or open access articles:
(DOI = Digital Object Identifier)

Other pre-application materials: None

Additional information from the supervisory team

The supervisory team has provided a recording for prospective applicants who are interested in their project. This recording should be watched before any discussions begin with the supervisory team.

Moore & Bixby & Clark Recording

MRC LID LINKS

To apply for a studentship: MRC LID How to Apply
Full list of available projects: MRC LID Projects
For more information about the DTP: MRC LID About Us

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