Multimorbidity, Antimicrobial Resistance and Infection Associations
Multimorbidity refers to people living with two or more long-term, or chronic, conditions at the same time. When we talk about ‘chronic conditions’ we mean a whole lot of different conditions that might include diabetes, stroke, heart problems, epilepsy, liver problems, thyroid problems, kidney problems and more.
Socioeconomic deprivation means people living with financial and social disadvantages, such as lower incomes, unemployment, poor housing, or limited access to services. These things can make it harder for people to stay healthy and access the support they need. It can be associated with chronic conditions, as well as more antibiotics for infections.
Some infections are caused by bacteria that are resistant to antibiotics, meaning that commonly used antibiotics no longer work effectively against them. We think that people living with multimorbidity may be at greater risk of developing infections and drug-resistant infections.
However, we do not yet fully understand how multimorbidity, infection, antimicrobial resistance, and socioeconomic deprivation interact and affect people’s health outcomes. The MARIA study aims to improve our understanding of these relationships. The study will consist of four linked studies:
- A review of what is currently known about the topic (systematic literature review and meta-analyses)
- A project looking back at hospital admissions in Scotland over 25 years to investigate how multimorbidity and socioeconomic deprivation interact to affect infection-related admissions and outcomes
- A study of infections in NHS Fife and NHS Tayside in individuals both living with multimorbidity and those living without multimorbidity. We will focus on urinary tract infections (UTI) s to see whether people living with multimorbidity are more likely to develop UTIs, whether these UTIs are more likely to be drug resistance, and to see whether they experience worsening health following an infection
- A study looking at how bacteria are spread using genomic data.
Team
Rebecca (Becky) Stout
PhD Student and Principal Investigator
Prof Nicholas Feasey
Director of Research and Primary Supervisor
Dr Sarah Mills
Secondary Supervisor
Professor Colin McCowan
Secondary Supervisor
Patient and Public Involvement and Engagement
Throughout the project we are keen to hear from people affected by these topics. We did an outreach activity at the Dundee Science Festival in February 2026, where we spoke to children and their caregivers about infections and drug-resistant infections as well as how we use data in research.
We are running a further public engagement activity in Methill Community Centre on Monday 10th of August 2026, where we will have free tea and coffee, a fun activity, and would love to hear from you and have a chat!
Funding
Rebecca Stout is a Wellcome clinical PhD fellow on the Multimorbidity Doctoral Training Programme for Health Professionals at the University of St Andrews (grant number 223499/Z/21/Z).
This project is part of EOSIN (East of Scotland Infection Network).