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Roger Bayston

Professor of Surgical Infection, Faculty of Medicine & Health Sciences

Contact

  • workRoom Division of Rheumatology, Orthopaedics and Dermatology, C Floor West Block QMC
    Queen's Medical Centre
    Nottingham
    NG7 2UH
    UK
  • work0115 823 1115
  • fax0115 823 1118

Biography

After general training in pathology at the University of Sheffield, UK, I specialised in Medical Microbiology. I began my research interests at this time though my first paper (1972) was published while a student. After periods in paediatric surgery and paediatrics, further training and two postgraduate Higher Degrees from the University of Sheffield Medical School, I moved to London where he was Lecturer and later Senior Lecturer in Medical Microbiology at Great Ormond Street Hospital, and Honorary Microbiologist to the National Hospital for Neurology and Neurosurgery, Queen Square. Here I took another Higher Degree and gained my Diploma in Clinical Microbiology at the London Hospital Medical College. I then moved to Nottingham, where I am now Professor of Surgical Infection in the School of Medicine. I am a Fellow of the Royal College of Pathologists. My research interests are in infections associated with implantable biomaterials. My interest in surgical infection dates from the 1960's and I have been active in this field ever since, publishing over 15 book chapters, one textbook, and over 120 peer-reviewed research papers. My clinical interests cover infections in neurosurgery, spinal surgery, orthopaedics, dialysis, urology and ENT. I have postgraduate teaching commitments in Medical Microbiology, Biomaterials, Orthopaedics and national postgraduate clinical training programmes and I was until recently Course Convenor for a popular course in Surgical Infection which is now an integrated part of the undergraduate Medical Curriculum in Nottingham. I also contribute a session in infection to the annual Basic Science course for FRCS Orth. I am invited Faculty speaker for two spinal surgery courses and one neurosurgery course, and I give annual lectures on the MSc Clinical Microbiology course at Barts & The London. I review approximately 25 papers a year for approximately 15 international journals, and I review grant applications for RCUK.

I am currently Division Academic Lead for Postgraduate Research, and as a member of the School of Medicine Doctoral Programmes Executive I am Academic Lead for Postgraduate Research admissions. I also convene and chair the Sue Watson Postgraduate Presentation events at which our PGR students compete for prizes.

My non -professional interests are experimental gardening (creating habitats for UK-native plants that have become rare), film and reading (much of it Scandinavian but from before it became fashionable), and brushing up my Swedish.

Expertise Summary

My expertise lies in aspects of surgical infection and microbiology. I have extensive experience of practical studies of surgical infection and its causes and prevention, across several disciplines. My early research was in construction of case definitions for post -operative complications in order to distinguish infection from non -infective problems, and I set up an outpatient clinic to allow me to assess patients postoperatively for early indications of infection. I underwent a long and intensive training in clinical microbiology, and I am fully conversant with microbiology laboratory techniques. My particular microbiological interests lie in modelling biofilms in order to study ways of eradicating them in different clinical settings. I also have expertise in some aspects of polymers and behaviour of bioactive molecules in polymers, and I have three patents in the field of antimicrobial biomaterials.

I also have expertise in teaching and examining, and I review for several national and international journals.

Teaching Summary

Teaching and examining of Principles of Surgical Infection, Yr 3 Medical Course

Teaching on MOL MSc Cinical Microbiology, and MOL MSc Molecular Medical Microbiology

Teaching on MM3BAB Biomaterials (Faculty of Engineering)

Teaching on FRCS Orth Basic Science Course, Univ Nottingham

Teaching on MSc Clinical Microbiology Course, Barts and the London (Univ London)

Teaching on International Neurosurgical Faculty on causes, treatment and prevention of surgical infection

Numerous guest lectures at conferences

Lectures to carers and parents of people with hydrocephalus and spina bifida

Lectures to people who have undergone arthroplasty (new)

Research Summary

My research interests are in surgical infection, and particularly that involving implantable devices (Biomaterials - Related Infection, BRI). This involves research into causation and pathogenesis of… read more

Recent Publications

Current Research

My research interests are in surgical infection, and particularly that involving implantable devices (Biomaterials - Related Infection, BRI). This involves research into causation and pathogenesis of BRI (including biofilms), new routes to diagnosis and treatment, and on development and evaluation of novel antimicrobial biomaterials including biodegradables

Having established the clinical and commercial viability of our platform technology for antimicrobial neurosurgical implants, we have now extended this to include broader spectrum antimicrobial catheters for external ventricular drainage in neurocritical care, dialysis catheters and an antimicrobial longterm urinary catheter with activity for more than 80 days.

Our research into biodegradables for both bone repair and prevention of infection has proved extremely successful in vivo and is continuing. We also work closely with Otorhinolaryngology (ENT) on treatment of Glue Ear, which we have shown to be a biofilm infection, using drug release polymers.

We have developed a device that can be used to protect the transcutaneous pins from infection in external fixation for fractures, and this is being investigated in vitro and clinically.

Our research into prevention of surgical infection extends to investigation of current patient skin preparation regimens using biopsies.

We carry out research into biofilm infections, including those requiring anaerobic conditions. We also investigate ways of enhancing the effects of antibiotics on biofilms, and we are carrying out a multicentre international clinical trial of non -surgical treatment of CSF shunt infection. We have a developing interest in the potential role of magnetic nanoparticles as drug carriers. We have developed a longterm antimicrobial urinary catheter for use by stroke survivors, or those with spinal injuries, and we are currently commercialising an antimicrobial catheter for use in dialysis for those with kidney failure.

Past Research

My early research (1970-2) led to the discovery that bacteria in infections involving biomaterials attach to the material surfaces and develop biofilms. This explained most of the clinical problems encountered in treatment of such infections and led to a great deal of further research as well as new thinking in treatment and prevention. I developed an antibody test for diagnosis of hydrocephalus shunt infections that allowed early diagnosis and avoidance of renal complications. We also developed an ELISA for diagnosis of infection in arthroplasty. We have since studied the action of antimicrobials on aerobic and anaerobic biofilms and defined therapeutic approaches, particularly those designed to limit resistance emergence. Our research on silver - processed biomaterials has shown their limitations, that have now been demonstrated clinically. A novel (patented) method of conferring longterm antimicrobial activity on polymeric implants (eg catheters) led to development and commercialisation of an antimicrobial hydrocephalus shunt , now in worldwide use (approx 930,000 patients) and showing a significant impact on infection rates. Further development of the technology has led to its application for dialysis. Other research on antimicrobial biomaterials has shed light on antibiotic release from bone cement, and examined ways in which this might be enhanced.

Other research included elucidation of immediately post -natal intestinal colonisation using oesophageal atresia as a model, and aetiology of necrotising enterocolitis. We have also demonstrated attachment and biofilm formation in coryneforms.

Our research on treatment failure in shunt infection led to two clinical trials (RB PI) involving the first intraventricular use of vancomycin in UK, one on prophylaxis and one on treatment. The latter led to National Guidelines for the treatment of shunt infection. Our study of infective causes of catheter loss in peritoneal dialysis led to suggestions for change of international guidelines, and to research on antimicrobial dialysis catheters.

Clinical research has included studies of treatment of community - acquired meningitis in shunted patients, leading to clear recommendations against surgery.

Future Research

Our research is expected to develop our technology platform to include a wider range of pathogens in more clinical applications. This will include the use of antimicrobial biomaterials in vascular access, neonatology and trauma. We will also extend our keen interest in ways of implementing local administration of very high concentrations of antimicrobials without systemic effects, particularly useful in chronic local biofilm infections. This strategy eradicates biofilm while avoiding systemic toxicity and selection of resistance at normal flora sites, and reduces antibiotic use. Our studies on patient skin preparation will continue with a randomised controlled clinical trial as well as novel ways of minimising procedure -related infection in implant surgery.

School of Medicine

University of Nottingham
Medical School
Nottingham, NG7 2UH

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