Research from City St George’s, as part of the Fleming Initiative, has revealed that people who develop urinary tract infections in care homes have poorer outcomes when compared to similar adults with infections living at home
By Mr George Wigmore (Senior Communications Officer), Published
New research from City St George’s, University of London and Imperial College London has highlighted the need for coordinated approaches to infection prevention, diagnosis, and antimicrobial stewardship for older adults.
Published in The Lancet Health Longevity, the study found that older adults residing in care homes had a higher urinary tract infection (UTI) burden and worse clinical outcomes than clinically and socioeconomically comparable older adults residing outside care homes.
The researchers say that possible explanatory factors include when and how infections are identified due to a disconnect with diagnostic capabilities. This disconnect leads to a lack of information to support decisions on whether antibiotics are needed, and which antibiotics are needed. In addition, there were exacerbating effects on infection management during the COVID-19 pandemic.
As a result, the paper provides important insights into the challenges of preventing and managing UTIs among older adults in the UK, and it highlights the need for improvement in infection management in care home settings, including more appropriate diagnostic and antibiotic use.
The study, which has been conducted by academics from the Fleming Initiative, builds momentum towards the work being done as part of the research programmes called ‘Grand Challenges’ which harness some of the best scientific expertise and the latest technologies, including advanced AI, to find new ways to slow the progress of antimicrobial resistance (AMR). Established by Imperial College London, and involving researchers at City St George’s, the Fleming Initiative is a global partnership established to tackle the critical issue.
Following last year’s call for action in the Chief Medical Officer’s 2025 Annual Report, new research is also adding to the evidence that tackling infections and AMR requires coordinated action across the health and social care system.
Speaking about the paper, collaborator and co-author Dr Bethany Morgan-Brett, Research Fellow from My Home Life England, which is based at City St George’s, said:
“The findings highlight the importance of care homes having timely access to clinical support and diagnostic services, and of health and social care colleagues working together to prevent and manage infections effectively. As part of this work, we are actively engaging with the health and care sector with the aim that increased understanding of what supports effective infection prevention and management will lead to policy and practice which improves outcomes and quality of life for older people."
From evidence to coordinated action
The timing of the publication aligns well with the lessons that must be actioned from the recent UK Covid-19 Inquiry’s Module 6 report on adult social care, published on 20 October 2026, which highlights the need for social care reform.
As a result, looking ahead, social care must be afforded the same importance as health care in planning for and responding to future pandemics. The inquiry's findings on fragmented responsibilities, workforce pressures and gaps in planning and support also underline wider challenges within the sector and provide important context for the recently published study and ongoing research at the Fleming Initiative.
To help address these issues, ongoing work at City St George’s with collaborators Dr Shashi Hirani, Dr Tillman Weyde at the School of Science and Technology, the International Foundation for Integrated Care (IFIC), Tom Owen and Dr Bethany Morgan-Brett at My Home Life England – supported by the Fleming Initiative – is strengthening the evidence for addressing AMR across health and social care systems.
Professor Raheelah Ahmad, Co-lead for the Informed Policy Pillar and Research Strategy Advisor (Health Systems and Policy) at the Fleming Initiative and Professor of Health Systems at City St George’s, said:
“The research was enabled due to expertise in data linkage and analysis by the senior author, Dr Nina Zhu, and the findings reinforce a central message of the Fleming Initiative: addressing AMR requires innovations in therapies and diagnostics, which must be supported by health and care systems enabling access equitably.”
Bringing research, policy and practice together
Better systems approaches for preventing and managing infections in older adults will be discussed at the upcoming International Congress on Infectious Diseases (ICID) in Madrid, Spain in November, where the Fleming Initiative will contribute through:
- A policy discussion onInfections in the Aging Population, featuring Professor Raheelah Ahmad as an invited panellist
- A poster presentation by doctoral researcher Rishabh Jain from City St George’s, University of London: Implications of integrated care for antimicrobial stewardship and infection prevention and control: A systematic review and meta-analysis
The Fleming Initiative’s participation in the AMR Multi-Stakeholder Partnership Platform (MSPP) between 16th and 18th November at the FAO headquarters in Rome will provide a further opportunity to connect evidence with action. By bringing together stakeholders from across sectors, the platform can help identify shared priorities and practical opportunities for collaboration on AMR.
- Professor Ahmad and Research Assistants Dr Lucia Besio and Dr Malay Diwanji will co-lead a plenary on Domestic Financing with the World Economic Forum’s Global Futures Council on AMR, World Bank, ReACT, MSPP Action Group on Financing, and the Global Strategy Lab, where they will be presenting emerging research findings on "innovative domestic financing mechanisms to fund/implement AMR national action plans".
- Peter Howitt (Informed Policy Co-Lead) will co-lead a plenary on Safe, quality care for all: embedding AMR in UHC and primary health care with the WHO and the Global Self-Care Federation; and also support Country Clinic 1: One Health governance, policy and accountability for AMR with co-moderators representing Canada, Brazil and Norway
Related schools, departments and centres
Other stories you might like
-
Largest study to date finds no detectable increase in pregnancy risks following GLP-1 exposure around conception
Study offers reassurance after unintended exposure, but states more safety data is needed.
-
City St George’s academic invites public involvement in Scotland maternity services review
The independent review of maternity services in Scotland has launched today.
-
Maternal vaccines protect babies from serious infections, but unequal access limits benefits across Europe
Europe must act now to strengthen maternal vaccination in pregnancy and ensure all women and babies can benefit from a new generation of vaccines to protect against serious infections.
