Healthcare associated infections (HAIs) caused by pathogens (infectious agents) such as MRSA, Norovirus, and Clostridium Difficile are a substantial problem in developed and developing countries and within the NHS. In addition to the distress caused to patients who are infected, the cost of HAIs to acute services in NHS Scotland was estimated in the 2007 national prevalence survey at £183 million. The World Health Organisation (2014) global surveillance report on antimicrobial resistance shows that "a post-antibiotic era - in which common infections and minor injuries can kill - far from being an apocalyptic fantasy, is instead a very real possibility for the 21st Century". Within this ambit, work to prevent and control Healthcare Associated Infections can in no way rely solely on the production of new antibiotics. Rather, new thinking, new research and development, and new knowledge transfer activities are needed, drawing on knowledge from beyond traditional biomedical science. The applicants' prior AHRC funded 'Visualising the Invisible' (vis-invis) project is a good example of the contribution that the arts and humanities can begin to make through relevant multidisciplinary working. The vis-invis project investigated ways of making pathogens 'visible' in the context of the hospital ward in a multi-disciplinary collaboration involving a team from design, art, nursing and clinical microbiology. In the study, the team explored conceptions and perceptions of pathogens in relation to clinical settings, and produced prototype digital visualisations which aimed to make the pathogens 'visible' in the context of the hospital ward. From this project, through a series of workshops with key stakeholders including infection control leads, nurses and domestic staff, one of the key findings was that the adaptation of the visualisations for use in training software for healthcare staff would have significant value. This was not foreseen at the outset of the project but emerged through the development of the prototypes and in response to feedback from the workshops. It was clear from these discussions that using the visualisations as part of training would extend the potential of this earlier work to impact in a timely and valuable way - especially given the current scale of the HAI problem and the threat of increasing resistance of pathogens to antibiotics. Working with a leading UK commercial company in the area of infection control, which specialises in the manufacture of antimicrobial products and infection-control training, two NHS Trusts and a leading microbiology specialist, this follow-on project proposal will create a visual training application, running on a tablet device, which can innovatively exploit existing context-relevant data about the nature, location and prevalence of the pathogens associated with HAIs. The visualisations will make clear the direct relationship between the ward setting and the location, behaviour, causes of spread, and prevention of spread of pathogens. The NHS project partners will be closely involved in the specification, co-design, development and evaluation of the training tool to ensure it satisfies the requirements of current NHS training programmes and to maximise the opportunities for its adoption.

Most of the world's population is now living in cities and travelling more. As a result we are more likely to come into contact with infections that we would not have been exposed to just a few decades ago due to interactions with more people. The environment plays an important role in the transmission of some infections and it is possible to reduce the transmission of such disease by better filtration of water and air. Some filtration systems are currently used which physically stop pathogens such as bacteria. However these systems cannot stop virus particles, are expensive, require frequent maintenance and careful disposal. The aim of this project is to design one air and one water filter which will actively kill bacteria and viruses, thereby reducing their numbers in the environment. These filters will require less maintenance and be inexpensive to produce. During the project, we will first test the antimicrobial effect of a variety of nanoparticles. These will then be modified chemically so that they can be incorporated into materials that are suitable for water and air filtration. The filters containing the antimicrobial nanoparticles will be produced using a new EPSRC funded spinning technology developed at UCL. Once we have produced the antimicrobial filtration materials, we will test their ability to kill viruses in air and bacteria in water. We will test filters with different concentrations of antimicrobial nanoparticles and with different depths. We will also make sure that the filters are effective at flow rates that are used in the real world. The antimicrobial filters will be of most interest to the healthcare industry in the first instance, but they will also be relevant to busy public buildings (such as schools and care homes) and transport vehicles (such as airplanes). Furthermore, the filters will be capable of oxidising non-biological materials, like tar and pollution particulates and will improve air quality in a range of indoor environments. During the project we will be collaborating with industrial partners (including Pall Corporation, the world's biggest filtration company) and clinicians to ensure that we produce a viable product. At the end of the project, the technology will be validated and ready for scale-up production and we plan to apply for further funding for a collaborative project with industry in order to do this.