Antimicrobial resistance (AMR) is the ability of microbes to evolve resistance against an antimicrobial treatment. For example, a bacterium can develop resistance to an antibiotic medicine, rendering that medicine ineffective in treating and containing the infection. The loss of effective antibiotics will have a significant impact on our lives, not only increasing the chances of developing a serious infection but also increasing the risk associated with medical procedures. The recent O'Neill review predicts "If we fail to act, we are looking at an almost unthinkable scenario where antibiotics no longer work and we are cast back into the dark ages of medicine". While AMR in bacteria occurs naturally over time, the misuse and overuse of antibiotics is accelerating this process. For example, many infections such as tonsillitis are predominantly (80%) viral and can thus not be treated with antibiotics, yet antibiotics are still prescribed. An obvious solution is to introduce new drugs. However, this is not only very costly but it is also inevitable that resistance to any new medicine will develop. A promising and sustainable solution to the AMR problem is the introduction of diagnostic tests that not only confirm a bacterial infection but also identify the best antibiotic for treating the infection. The aim of this project is to develop a diagnostic that will ensure the right drugs are prescribed at the right time. The technology, called MAPS, is based on silicon photonics. Although developed originally for use in the communications industry, we have shown that this same technology can be used to monitor biology, including bacteria and proteins, with very high sensitivity. We will exploit this technology to create a diagnostic that will identify the type of bacterium and severity of infection, the presence of resistance mechanisms and the most promising antibiotic for treatment. Working with clinical and industrial collaborators, we will demonstrate and validate the technology for the treatment of urinary tract infections and determine a route for taking it to the market.

Light has been used for centuries to image the world around us, and continues to provide profound insights across physics, chemistry, biology, materials science and medicine. However, what are the limits of light as a measurement tool? For example, we can use light to image single bacteria, but can we also use light to trap a single bacterium, identify the bacterial strain and assess its susceptibility to antibiotics? How can we image over multiple length scales, from single cells to multiple cellular tissue, in order to comprehensively map all the neuronal connections in the brain? Can we use a combination of resonance with the wave nature and momentum of light to measure the forces associated with the natural and stimulated motion of a single neuronal cell, or even the extremely small forces associated with phenomena at the classical-quantum interface? This proposal aims to answer these questions by exploring new and innovative ways in which we can use light to measure the natural world. This research builds on our recent advances in photonics - the science of generating, controlling and detecting light - and in particular will exploit resonant structures and shaped light. These provide us with tools for controlling the interaction of light and matter with exquisite sensitivity and accuracy. We will run three research strands in parallel and by combining their outputs, we aim to address major Global Challenges in antimicrobial resistance, neurodegenerative disease, multimodal functional imaging and next generation force, torque and microrheology. Our work is supported by a suite of UK and International project partners (both academic and industry) who are enthused to work with us and have committed over £0.5M in kind to the programme.