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Factors affecting timely initiation of Clostridioidies difficile infection treatment and management in hospitalised and community patients

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  • Full or part time
    Prof M Wilcox
    Dr J Freeman
  • Application Deadline
    No more applications being accepted
  • Competition Funded PhD Project (European/UK Students Only)
    Competition Funded PhD Project (European/UK Students Only)

Project Description

Clostridioidies difficile infection (CDI) is the leading cause of hospital associated diarrhoea in the western world, but there is increasing recognition of cases within the community setting. Although current diagnostic and treatment guidelines include some information on community cases, this is based on weak evidence. Inequalities potentially exist for CDI patients both in hospitals and the community. We know that diarrhoea sampling and CDI testing practices vary widely across institutions. A recent European study of CDI also found that 50% of cases in the community were never tested for the infection by their original healthcare provider; lack of suspicion is largely based on the assumption that CDI is a hospital associated infection. In addition to lack of testing for the infection in the community, availability of treatment may also be an issue. Patient feedback has highlighted delays in getting appropriate treatment in the community; many community pharmacies do not stock the required antibiotics, with additional delays caused by weekends.

This project will examine in detail the potential inequalities between hospital and community CDI patients. 

Work package 1: A survey will be used to gather information from both community and hospital based UK clinicians on current guidelines and practices, with regard to propensity to test, time to test, time to treatment, access to treatment (e.g. availability of drugs in the community)

Work package 2: Data will be gathered from hospital(s) and community practices on time from patient presentation to test, time to diagnosis, time to treatment, treatment given, continuation or start of concomitant antibiotics, and when were (hospitalised) patients isolated?

Work package 3: Will examine what factors influence the results found in work package 2. This will be qualitative research using focus group of both patients and clinicians.

Research environment
The successful candidate will be based with the Healthcare Associated Infections (HCAI) research group within the School of Medicine at the University of Leeds. The HCAI research group is world-leading in the area of CDI, with previous studies influencing the current UK, European, US and Australasian diagnostic guidelines and continues to research CDI diagnosis, treatment, epidemiology, pathogenesis and relation to the gut microbiota using our innovative in vitro gut models.  The group has members from Leeds Teaching Hospitals NHS Trust, The University of Leeds and Public Health England, ensuring that the candidate will benefit from a broad range of knowledge and support.   

The group is based at the Old Medical School at Leeds general Infirmary but travel to the main University campus and St James’s campus may be required; a shuttle bus service runs between sites. 

Applicants must hold a First Degree at undergraduate level equivalent to at least a UK First Class Honours degree. Applicants should either have graduated with the appropriate First Degree or be in their final year of study.

Candidates with a lower mark in their undergraduate degree will be considered if they have or are expected to receive a Distinction in a Masters programme relevant to their field of research, or if they can demonstrate relevant alternative experience (eg in industry, business)

The minimum requirements for candidates whose first language is not English are:
• British Council IELTS - score of 6.5 overall, with no element less than 6.0
• TOEFL iBT - overall score of 92 with the listening and reading element no less than 21, writing element no less than 22 and the speaking element no less than 23

How to apply
Stage 1 
First of all apply for a research programme of study by completing the online application form ( Please state clearly in the research information section the project title, supervisors linked to it and that you are applying as part of the Leeds Doctoral Scholarship.

Stage 2
After submitting your first application you will receive an email containing your Student ID number. Once you are in receipt of your 9 digit Student ID complete the online scholarships application form (

If you have any queries about the application process please contact [Email Address Removed]

Funding Notes

This project is available as part of the Leeds Doctoral Scholarships, will attract an annual tax-free stipend of £15,009 for up to 3 years, subject to satisfactory progress and will cover the UK/EU tuition fees. Please note you must submit both a PhD degree application and a Scholarship application to be considered for this award.

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