Biography

David Livermore gained his BSc in 1978 and his PhD in 1983. He worked at the London Hospital Medical College from 1980 until 1997, when he joined the Health Protection Agency (now Public Health England), becoming Director of its Antibiotic Resistance Monitoring and Reference Laboratory in 1998. In October 2011, he became Professor of Medical Microbiology at UEA, but with 30% of this time supplied back to Public Health England as its Lead on Antibiotic Resistance.

Prof Livermore has broad interests on the evolution and dissemination of antibiotic resistance and its relationship to antibiotic prescribing. Beta-Lactamases are a particular interest, with recent work on the proliferation of ‘CTX-M’ extended-spectrum enzymes and carbapenemases, particularly NDM-1, which received extensive media coverage in 2010.

He sits on the British Society for Antimicrobial Chemotherapy working parties on resistance surveillance, multi-resistant pathogens and susceptibility testing and its Antibiotic Action advisory board, also on the Society for General Microbiology working group on sexually transmitted infections. He is also a member of the UK Government’s Antimicrobial Resistance and Healthcare Associated Infections Advisory Committee and has contributed extensively to the Chief Medical Offer for England’s  Annual Report for 2011. He publishes and speaks widely on resistance and has edited for several journals including Journal of Antimicrobial Chemotherapy and Journal of Medical Microbiology and, currently, International Journal of Antimicrobial Agents.

Outside of work, he is a keen walker, has walked the perimeter of Norfolk and almost half the English Coastline.

 

Career History

9/78 to 6/80         QC Microbiology Devt., Wellcome Foundation, Dartford, Kent

 

6/80 to 8/97         Department of Medical Microbiology, London Hospital Medical College

                            6/80-11/83    Research Assistant

                            11/83-2/87    Postdoctoral Fellow (Wellcome Trust)

                            11/85-5/86    Secondment, Lecturer, University of Hong Kong

                            2/87-12/94    Lecturer in Medical Microbiology

                            12/94-8/97    Senior Lecturer in Medical Microbiology

                              9/97-9/00    Hon Senior Lecturer

 

   9/98-10/11        Public Health England (formerly HPA), Microbiology Services

                              9/97-9/98   Head, Antibiotic Reference Unit, Colindale

                              9/98-date   Director, Antibiotic Resistance Monitoring & Reference  

                                                 Laboratory, Colindale

 

    10/11-date       Professor of Medical Microbiology, University of East Anglia (primary employer, `70% time, with 30% of this subcontracted to Public Health England )

                              Lead on Antibiotic Resistance, Public Health England Microbiology Services, Colindale

                              Visiting Professor, King Saud University, Riyadh, Saudi Arabia

                              Honorary Professor of Medical Microbiology, Queen Mary University, London

                              Consultant on Antibiotic Resistance – advisory work for numerous diagnostic and pharmaceutical companies and potential investors

 

Academic Background

1978   BSc, (1st. Class Hons) Microbiology, Heriot-Watt University, Edinburgh.

1983   PhD, Medical Microbiology, University of London. Thesis: Resistance mechanisms of Pseudomonas aeruginosa to ?-lactam antibiotics.

2003   State-Registered Clinical Scientist, Health Professions Council (CS1358).

All Publications

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Wilson, A., Livermore, D., Otter, J., Warren, R., Jenks, P., Enoch, D., Newsholme, W., Oppenheim, B., Leanord, A., McNulty, C., Tanner, G., Bennett, S., Cann, M., Bostock, J., Collins, E., Peckitt, S., Ritchie, L., Fry, C., Hawkey, P.

(2016)

Prevention and control of multi-drug-resistant Gram-negative bacteria: recommendations from a Joint Working Party

in Journal of Hospital Infection

92.

pp. S1–S44

Full Text UEA Repository

(Article)


Livermore, D. M., Warner, M., Mushtaq, S., Woodford, N.

(2016)

Interactions of OP0595, a novel triple-action diazabicyclooctane, with β-lactams against OP0595-resistant Enterobacteriaceae mutants

in Antimicrobial Agents and Chemotherapy

60.

pp. 554-560

Full Text UEA Repository

(Article)


Findlay, J., Hopkins, K. L., Doumith, M., Meunier, D., Wiuff, C., Hill, R., Pike, R., Loy, R., Mustafa, N., Livermore, D. M., Woodford, N.

(2016)

KPC enzymes in the UK: an analysis of the first 160 cases outside the North-West region

in Journal of Antimicrobial Chemotherapy

71.

pp. 1199-1206

Full Text UEA Repository

(Article)


Doumith, M., Day, M., Ciesielczuk, H., Hope, R., Underwood, A., Reynolds, R., Wain, J., Livermore, D. M., Woodford, N.

(2015)

Rapid identification of major Escherichia coli sequence types causing urinary tract and bloodstream infections

in Journal of Clinical Microbiology

53.

pp. 160-166

Full Text UEA Repository

(Article)


Morinaka, A., Tsutsumi, Y., Yamada, M., Suzuki, K., Watanabe, T., Ida, T., Furuuchi, T., Inamura, S., Sakamaki, Y., Mitsuhashi, N., Mitsuhashi, N., Ida, T., Livermore, D.

(2015)

OP0595, a new diazabicyclooctane: Mode of action as a serine beta-lactamase inhibitor, antibiotic and beta-lactam 'enhancer'

in Journal of Antimicrobial Chemotherapy

70.

pp. 2779-2786

Full Text UEA Repository

(Article)


Livermore, D., Warner, M., Jamrozy, D., Mushtaq, S., Nichols, W. W., Mustafa, N., Woodford, N.

(2015)

In-vitro selection of ceftazidime-avibactam resistance in Enterobacteriaceae with KPC-3 carbapenemase

in Antimicrobial Agents and Chemotherapy

59.

pp. 5324-5330

Full Text UEA Repository

(Article)


Orasch, C., Averbuch, D., Mikulska, M., Cordonnier, C., Livermore, D. M., Gyssens, I. C., Klyasova, G., Engelhard, D., Kern, W., Viscoli, C., Akova, M., Marchetti, O.

(2015)

Discontinuation of empirical antibiotic therapy in neutropenic leukaemia patients with fever of unknown origin is ethical

in Clinical Microbiology and Infection

21.

pp. e25-e27

Full Text UEA Repository

(Article)


Livermore, D. M., Mushtaq, S., Warner, M., James, D., Woodford, N.

(2015)

Susceptibility testing challenges with ceftaroline, MRSA, and a 1-mg/L breakpoint

in Journal of Antimicrobial Chemotherapy

70.

pp. 3259-3266

Full Text UEA Repository

(Article)


Wright, L., Turton, J. F., Hopkins, K. L., Livermore, D., Woodford, N.

(2015)

Genetic environment of metallo-β-lactamase genes in Pseudomonas aeruginosa isolates from the UK

in Journal of Antimicrobial Chemotherapy

70.

pp. 3250-3258

Full Text UEA Repository

(Article)


Cooke, J., Butler, C., Hopstaken, R., Dryden, M. S., McNulty, C., Hurding, S., Moore, M., Livermore, D. M.

(2015)

Narrative review of primary care point-of-care testing (POCT) and antibacterial use in respiratory tract infection (RTI)

in BMJ Open Respiratory Research

2.

Full Text UEA Repository

(Article)


Soliman, R., Lynch, S., Meader, E., Pike, R., Turton, J. F., Hill, R. L., Woodford, N., Livermore, D.

(2015)

Successful ceftolozane/tazobactam treatment of chronic pulmonary infection with pan‐resistant Pseudomonas aeruginosa

in JMM Case Reports

Full Text UEA Repository

(Article)


Stentz, R., Horn, N., Cross, K., Salt, L., Brearley, C., Livermore, D. M., Carding, S. R.

(2015)

Cephalosporinases associated with outer membrane vesicles released by Bacteroides spp. protect gut pathogens and commensals against beta-lactam antibiotics

in Journal of Antimicrobial Chemotherapy

70.

pp. 701-709

Full Text UEA Repository

(Article)


Yazbek Hanna, M., Tremlett, C., Josan, G., Mills, R., Rochester, M., Livermore, D.

(2015)

Prevalence of ciprofloxacin-resistant Enterobacteriaceae in the intestinal flora of patients undergoing trans-rectal prostate biopsy in Norwich, UK

in BJU International

116.

pp. 131–134

Full Text UEA Repository

(Article)


Wright, L., Turton, J. F., Livermore, D., Hopkins, K. L., Woodford, N.

(2015)

Dominance of international ‘high-risk clones’ among Metallo-β-Lactamase-Producing Pseudomonas aeruginosa in the United Kingdom

in Journal of Antimicrobial Chemotherapy

70.

pp. 103-110

Full Text UEA Repository

(Article)


Livermore, D., Mushtaq, S., Warner, M., James, D., Kearns, A. M., Woodford, N.

(2015)

Pathogens of skin and skin-structure infections in the UK and their susceptibility to antibiotics, including ceftaroline

in Journal of Antimicrobial Chemotherapy

70.

pp. 2844-2853

Full Text UEA Repository

(Article)


Livermore, D. M., Mushtaq, S., Warner, M., Woodford, N.

(2015)

Activity of OP0595-β-lactam combination against Gram-negative bacteria with extended-spectrum, AmpC and carbapenem-hydrolysing β-lactama

in Journal of Antimicrobial Chemotherapy

70.

pp. 3032-3041

UEA Repository

(Article)


Livermore, D. M., Mushtaq, S., Warner, M., Woodford, N.

(2014)

Comparative in vitro activity of sulfametrole/trimethoprim and sulfamethoxazole/trimethoprim and other agents against multiresistant Gram-negative bacteria

in Journal of Antimicrobial Chemotherapy

69.

pp. 1050-1056

Full Text UEA Repository

(Article)


Shibl, A. M., Memish, Z. A., Kambal, A. M., Ohaly, Y. A., Ishaq, A., Senok, A. C., Livermore, D. M.

(2014)

National surveillance of antimicrobial resistance among Gram-positive bacteria in Saudi Arabia

in Journal of Chemotherapy

26.

pp. 13-18

Full Text UEA Repository

(Article)


Jain, A., Hopkins, K. L., Turton, J., Doumith, M., Hill, R., Loy, R., Meunier, D., Pike, R., Livermore, D. M., Woodford, N.

(2014)

NDM carbapenemases in the United Kingdom: an analysis of the first 250 cases

in Journal of Antimicrobial Chemotherapy

69.

pp. 1777-1784

Full Text UEA Repository

(Article)


Hopkins, K. L., Mushtaq, S., Richardson, J. F., Doumith, M., de Pinna, E., Cheasty, T., Wain, J., Livermore, D. M., Woodford, N.

(2014)

In vitro activity of rifaximin against clinical isolates of Escherichia coli and other enteropathogenic bacteria isolated from travellers returning to the UK

in International Journal of Antimicrobial Agents

43.

pp. 431-437

Full Text UEA Repository

(Article)


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Key Research Interests

My early research centred on ?-lactamases, and I showed how an apparently weak activity could protect a bacterium if the enzyme had high affinity and the ?-lactam permeated only slowly. This led to showing that models describing the interplay of ?-lactamase and permeability were adequate for Escherichia coli but not Pseudomonas aeruginosa, and I contributed to work revealing that this inadequacy was because P. aeruginosa also effluxes ?-lactams. Other early work explored the induction of AmpC ?-lactamases and the selection of AmpC-derepressed mutants from AmpC-inducible populations of Enterobacter and P. aeruginosa, showing selection to be the more important factor. I have been responsible for describing and investigating the properties of many new ?-lactamases, including those conferring resistance to carbapenems – the last reserve ?-lactams against many otherwise multiresistant bacteria.

My work increasingly spread from the mechanisms of resistance to its epidemiology. At the UK Health Protection Agency (Public Health England) I led groups that demonstrated the dramatic rises in MRSA in the late 1990s, ciprofloxacin-resistant gonococci around 2002-3, carbapenemase-resistant Acinetobacter spp. and cephalosporin-resistant E. coli from around 2003 and the recent rise in carbapenemases, partly linked to the repeated import of strains with NDM-1 enzyme via patients previously hospitalised in the Indian subcontinent.

My current major areas of research interest at UEA centre on the development of methods to rapidly detect antibiotic resistant bacteria in patient specimens. Such tests would allow the swifter optimisation of a patient’s therapy, benefitting both the individual and antibiotic stewardship – thus meeting key objectives highlighted in the Chief Medical Officer’s Annual Report for 2013.   Other areas of interest are gut carriage of resistant bacteria and the relationship between in-vitro resistance and treatment outcome, Through on-going links with Public Health England I remain deeply involved in the surveillance of antibiotic resistance, the investigation of emerging resistance types and the in-vitro evaluation of new antibiotics against these organisms.

Research Keywords: Antibiotic resistance, ?-Lactamase, Carbapenem, Antibiotic development

Research Topics for PGR Supervision: Epidemiology of antibiotic resistance, Mechanisms of antibiotic resistance, Detection of antibiotic resistance

External Activities and Indicators of Esteem

  • Hon. Professor, Queen Mary, University of London, 2011-date
  • Visiting Professor, King Saud University, Saudi Arabia, 2011-13
  • Assistant Editor, Journal Antimicrobial Chemotherapy, 1987-90
  • Editorial Board, European Journal of Clinical Microbiology, 1987-91
  • Editor, Journal of Medical Microbiology, 1991-2003
  • Editorial Board, Journal of Antimicrobial Chemotherapy, 1992-95
  • Editorial Board, Antimicrobial Agents and Chemotherapy, 1996-date
  • Editor, International Journal of Antimicrobial Agents, 2002-date
  • Editorial Board, Korean Journal of Internal Medicine, 2011-date
  • British Society for Antimicrobial Chemotherapy (BSAC) Working Party on Surveillance, 1997 - date
  • BSAC, Working Party on Susceptibility Testing, 1997 - date
  • Advisory Board of Asia-Pacific Research Foundation on Infectious Diseases, 1999 -date
  • Organising committee of International Symposium on Antimicrobial Agents and Resistance (ISAAR), 1999-date
  • UK Inter-Departmental Steering Group on ‘Resistance to Antibiotics and Other Antimicrobial Agents’, 1999-2002
  • UK Government Specialist Advisory Committee on Antibiotic Resistance (SACAR), 2000-7
  • Scientific Committee of 4th European Congress of Chemotherapy (Paris, May 2002), 2001-2
  • Scientific Committee of 7th European Congress of Chemotherapy (Florence, October 2005), 2004-5
  • European Commission Working Group on Antibiotic Resistance Genes in genetically modified organisms, 2003-4
  • National Steering on Healthcare Associated Infection, 2004-7
  • Joint British Society for Antimicrobial Chemotherapy/Hospital Infection Society working group on extended-spectrum #03b2-lactamases, 2005-6
  • Advisor to Govt’s Antibiotic Resistance & Healthcare Associated Infection (ARHAI) committee on new resistance development / horizon scanning, 2007-13
  • Member: UK Govt’s Antimicrobial Resistance & Healthcare Associated Infection (ARHAI) Advisory Committee, 2013-date
  • European Committee on Antimicrobial Susceptibility Testing expert rules sub-group, 2008-10
  • British Society for Antimicrobial Susceptibility Testing working party on the Urgent Need for New Antibiotics, 2009-10
  • DEFRA Antibiotic Resistance Co-ordinating group (DARC), 2010-date
  • Joint BSAC / British Infection Association / Infection Prevention Society Working Party on multiresistant pathogens, 2011-date
  • Advisory Board for British Society for Chemotherapy Antibiotic Action Initiative, 2012-date
  • Society for General Microbiology Expert Panel on Sexually Transmitted Infections2012-date
  • CMO’s working group on genomics (Science Group), 2013

Professional Activities

  • Achaogen, Consultant2008-date
  • Adenium, Scientific Advisory Board, 2013-date
  • Allecra, Scientific Advisory Board, 2013-date
  • Astellas - ad hoc advisory boards2007-date
  • AstraZeneca - ad hoc advisory boards, 2009-date
  • Bioversys, Scientific Advisory Board, 2013-date
  • Curetis - ad hoc advisory boards2012-date
  • Discuva, Scientific Advisory Board2011-date
  • GlaxoSmithKline, Consultant, 2011-date
  • Meiji, Consultant, 2011-date
  • McKinsey - ad hoc advisory boards, 2010-date
  • Roche - ad hoc advisory boards, 2012-date
  • Tetraphase, Scientific Advisory Board, 2009-date
  • Wockhardt, Global Clinical Council, 2013-date