R-GNOSIS “Resistance in Gram-Negative Organisms: Studying Intervention Strategies" is a European collaborative research project awarded 11.9 Million Euro funding from the European Commission under the Seventh Framework Programme (FP7) for Research and technology.

Lasting 5,5 years, R-GNOSIS aimed at determining the efficacy and effectiveness of cutting-edge interventions to reduce carriage, infection and spread of Multi-Drug resistant Gram-negative Bacteria (MDR-GNB).

The project combined five international clinical studies, all supported by highly innovative microbiology, mathematical modelling and data management.

The five clinical studies investigated the following interventions:

• A Point-Of-Care-Testing guided management strategy to improve appropriate antibiotic prescription for uncomplicated UTI in primary care
• Gut decolonization followed by fecal microbiota transplantation in outpatients with intestinal carriage of MDR-GNB
• A “test and prescribe” strategy, based on rapid diagnostic testing of faeces for MDR-GNB to optimize antibiotic prophylaxis in colo-rectal surgery
• Contact Isolation of patients with ESBL-producing Enterobacteriaceae in general hospital wards
• Three Decolonization strategies in ICUs

Seven laboratories across Europe performed microbiological analyses, as well as unique quantitative experiments. All information will be integrated by three groups of mathematical modellers into highly innovative models to better understand and predict future trends and effects of interventions.

The studies and analyses proposed in R-GNOSIS will generate a step-change in identifying evidence-based preventive measures and clinical guidance for primary care and hospital-based physicians and health-care authorities, to combat the spread and impact of infections caused by MDR-GNB in Europe.

R-GNOSIS was coordinated by Marc Bonten (UMC Utrecht) and brought together a multidisciplinary team with complementary expertise of clinicians, microbiologists and epidemiologists, infectious disease specialists, caregivers in inpatient care and mathematical modellers. The R-GNOSIS consortium was made of 24 partners from 9 countries which include United Kingdom, Denmark, Germany, Netherlands, Belgium, France, Spain, Switzerland and Israel.