This unit was established in January 2012.
Research in the Sexually Transmitted Infections (STI) Unit is focussed on improving the detection and management of STIs as well as preventing the emergence of antimicrobial resistance (AMR) in STIs. Key activities include:
- Evaluate the efficacy of novel STI prevention interventions in the Belgian context eg doxycycline post exposure prophylaxis
- Develop novel treatment strategies for resistant STIs such as N. gonorrhoeae and M. genitalium
- Ecological studies of the association between network conectivity + antimicrobial consumption vs. AMR
- Observational studies of changes in antimicrobial consumption in high network connectivity populations and subequent changes in AMR
- PReGo Study - Preventing the emergence of resistance in gonorrhoea Study. We aim to assess in this RCT if we can reduce the cumulative incidence of gonorrhoea, chlamydia and syphilis throught he use of a commercially available mouthwash product
- Gonoscreen RCT of 3 site 3monthly screening for N. gonorrhoea/C. trachomatis vs no screening in higher risk MSM
- ResistAZM RCT: RCT comparing ceftriaxone Vs. ceftriaxone + azithromycin for the management of N. gonorrhoeae infection
- In vitro testing of the theory in an N. gonorrhoea morbidostat
- We have developed a mathematical (STERGM) model of N gonorrhoeae transmission that enables include probability of the emergence of AMR depending on screening and treatment strategy. We are using this to better optimise STI screening and treatment strategies to minimize the risk of emergence of antimicrobial resistance
- Develop a surveillance system using commensal Neisseria species as an early warning system of excessive antimicrobial consumption in key populations
- Evaluate the lowest concentrations of various antimicrobials that can select for AMR in a range of bacterial species (minimum selection concentrations – MSC). Our results reveal that residual antimicrobial concentrations in food could select for AMR.
- Testing the pharmacoecological theory of AMR. This theory postulates that the reason why AMR in organisms such as Neisseria gonorrhoeae frequently emerges in core-groups such as sex workers and MSM is due to a combination of a dense sex network and high rates of consumption of antimicrobials. The high network connectivity generates a high prevalence of the STI and the antimicrobial consumption then places a selection pressure for the emergence of AMR. We are testing this theory through the following strategies:
- We are evaluating alternative antibiotic combinations, screening policies on the emergence of resistance in Neisseria gonorrhoeae.
- We are investigating the utility of various bacteriocins to treat N. gonorrhoeae and other pathogens
- We have developed a Galleria mellonella model of N. gonorrhoeae infection which enables us to test treatment combinations
- SeTPAT. The search for a Treponema pallidum antigen test. We are using MS/MS and MRM to detect the presence of various T pallidum antigens in the sera of 120 patients with a new diagnosis of syphilis. We aim to develop an ELISA that can detect T pallidum antigen via this approach
His teaching assignments include :
- Teaching the STI topics of TMCDM
- Teaching MPH at the University of Cape Town
- Teaching the I3DC course at the University of Antwerp
- Supervision of Masters andPhD candidates at ITM and UWC.