Staff profiles

I am a clinical academic in intensive care medicine. My research focuses on improving antibiotic stewardship in critically ill patients. I am an honorary consultant in intensive care medicine at the Royal Victoria Infirmary, general adult intensive care (ward 38).

I was previously an NIHR Clinical Lecturer in Intensive Care Medicine. I was awarded the Gold Medal (2018) from the Intensive Care Society, in recognition of the work undertaken during my PhD, evaluating novel diagnostics for ventilator-associated pneumonia (VAPrapid project).

My current research is funded by the NIHR EME and HTA programmes.   

The overarching objective of my research is to improve antibiotic stewardship in critically ill patients and thereby reduce the harms associated with antibiotic overuse and antimicrobial resistance. Antibiotics are life-saving in critically ill patients but the high rates of infection and severity of illness means there is a high risk of antibiotic overuse, exposing patients to harmful adverse effects.

This is a broad problem and my research takes different approaches to address this clinical need:

To identify different antibiotic approaches based on immune phenotyping

I am chief investigator for RISC-sepsis, an EME funded project, which performs flow cytometry-based immune phenotyping in patients with sepsis. This is a mechanistic study embedded in a large pragmatic trial and aims to determine whether patients with sepsis-induced immune dysfunction have different responses to biomarker-guided (PCT/CRP) antibiotic durations. This project aims to understand the practical application of PCT/CRP-guide antibiotic use based on patients immune status and potentially lead to a precision-medicine approach to antibiotic durations.

To determine whether short-duration antibiotic courses can be used in critically ill patients with sepsis

I am chief investigator for the SHORTER trial, a HTA funded project. This will be a large, pragmatic trial (2244 patients, 50 ICUs) of short, fixed-course antibiotics (5 days) versus standard of care for critically ill patients with sepsis. The co-primary outcomes will be 28-day all-cause mortality (non-inferiority) and total antibiotic treatment days to 28 days (superiority). In addition the trial will have an embedded process evaluation to understand the implementation of the intervention. If this trial shows that antibiotic durations can be safely and effectively shortened through this simple and broadly applicable intervention, then this could result in significant antibiotic reductions and avoidance of antibiotic-associated harms.

• Powell N, Howard P, Llewelyn MJ, Szakmany T, Albur M, Bond SE, Euden J, Brookes-Howell L, Dark P, Hellyer TP, Hopkins S, McCullagh IJ, Ogden M, Pallmann P, Parsons H, Partridge DG, Shaw DE, Shinkins B, Todd S, Thomas-Jones E, West R, Carrol ED, Sandoe JAT. Use of procalcitonin during the first wave of covid-19 in the acute nhs hospitals: A retrospective observational study. Antibiotics 2021, 10(5), 516.
• Hellyer TP, McAuley DF, Walsh TS, Anderson N, Conway Morris A, Singh S, Dark P, Roy AI, Perkins GD, McMullan R, Emerson LM, Blackwood B, Wright SE, Kefala K, O'Kane CM, Baudouin SV, Paterson RL, Rostron AJ, Agus A, Bannard-Smith J, Robin NM, Welters ID, Bassford C, Yates B, Spencer C, Laha SK, Hulme J, Bonner S, Linnett V, Sonksen J, Van Den Broeck T, Boschman G, Keenan DWJ, Scott J, Allen AJ, Phair G, Parker J, Bowett SA, Simpson AJ. Biomarker-guided antibiotic stewardship in suspected ventilator-associated pneumonia (VAPrapid2): a randomised controlled trial and process evaluation. The Lancet Respiratory Medicine 2020, 8(2), 182-191.
• Hellyer TP, Mantle T, McMullan R, Dark P. How to optimise duration of antibiotic treatment in patients with sepsis?. The BMJ 2020, 371, m4357.
• Loughlin L, Hellyer TP, White PL, McAuley DF, Conway Morris A, Posso RB, Richardson MD, Denning DW, Simpson AJ, McMullan R. Pulmonary Aspergillosis in Patients with Suspected Ventilator-associated Pneumonia in UK ICUs. American Journal of Respiratory and Critical Care Medicine 2020, 202(8), 1125-1132.
• Pinder EM, Rostron AJ, Hellyer TP, Ruchaud-Sparagano MH, Scott J, Macfarlane JG, Wiscombe S, Widdrington JD, Roy AI, Linnett VC, Baudouin SV, Wright SE, Chadwick T, Fouweather T, Juss JK, Chilvers ER, Bowett SA, Parker J, McAuley DF, Conway Morris A, Simpson AJ. Randomised controlled trial of GM-CSF in critically ill patients with impaired neutrophil phagocytosis. Thorax 2018, 73(10), 918-925.
• Morris AC, Gadsby N, McKenna JP, Hellyer TP, Dark P, Singh S, Walsh TS, McAuley DF, Templeton K, Simpson AJ, McMullan R. 16S pan-bacterial PCR can accurately identify patients with ventilator-associated pneumonia. Thorax 2017, 72(11), 1046-1048.
• Ewan V, Hellyer T, Newton J, Simpson J. New horizons in hospital acquired pneumonia in older people. Age and Ageing 2017, 46(3), 352-358.
• Hellyer TP, Anderson NH, Parker J, Dark P, Van-Den-Broeck T, Singh S, McMullan R, Agus AM, Emerson LM, Blackwood B, Gossain S, Walsh TS, Perkins GD, Conway-Morris A, McAuley DF, Simpson AJ. Effectiveness of biomarker-based exclusion of ventilator-acquired pneumonia to reduce antibiotic Use (VAPrapid-2): study protocol for a randomised controlled trial. Trials 2016, 17, 318.
• Scott J, Harris GJ, Pinder EM, Macfarlane JG, Hellyer TP, Rostron AJ, Morris AC, Thickett DR, Perkins GD, McAuley DF, Widdrington JD, Wiscombe S, Baudouin SV, Roy AI, Linnett VC, Wright SE, Ruchaud-Sparagano MH, Simpson AJ. Exchange protein directly activated by cyclic AMP (EPAC) activation reverses neutrophil dysfunction induced by beta(2)-agonists, corticosteroids, and critical illness. Journal of Allergy and Clinical Immunology 2016, 137(2), 535-544.
• Nolan TJ, Gadsby N, Hellyer TP, Templeton K, McMullan R, McKenna J, Rennie J, Robb CT, Walsh TS, Rossi AG, Conway Morris A, Simpson AJ. Low-pathogenicity Mycoplasma spp. alter human monocyte and macrophage function and are highly prevalent among patients with ventilator-acquired pneumonia. Thorax 2016, 71(7), 594-600.
• Hellyer TP, Ewan V, Wilson P, Simpson AJ. The Intensive Care Society recommended bundle of interventions for the prevention of ventilator-associated pneumonia. Journal of the Intensive Care Society 2016, 17(3), 238-243.
• Hellyer TP, Morris AC, McAuley DF, Walsh TS, Anderson NH, Singh S, Dark P, Roy AI, Baudouin SV, Wright SE, Perkins GD, Kefala K, Jeffels M, McMullan R, O'Kane CM, Spencer C, Laha S, Robin N, Gossain S, Gould K, Ruchaud-Sparagano MH, Scott J, Browne EM, MacFarlane JG, Wiscombe S, Widdrington JD, Dimmick I, Laurenson IF, Nauwelaers F, Simpson AJ. Diagnostic accuracy of pulmonary host inflammatory mediators in the exclusion of ventilator-acquired pneumonia. Thorax 2015, 70(1), 41-47.
• Browne E, Hellyer TP, Baudouin SV, Morris AC, Linnett V, McAuley DF, Perkins GD, Simpson AJ. A national survey of the diagnosis and management of suspected ventilator-associated pneumonia. BMJ Open Respiratory Research 2014, 1(1), e000066.