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Higher Education Academy (SFHEA) : Senior Fellow

Institute of Biomedical Science (FIBMS) : Fellow

Acid Fast Club, UK : Member

Royal Society of Biology (MRSB) : Member

Biochemical Society : Member

Microbiology Society : Member

British Society for Antimicrobial Chemotherapy (BSAC) : Member

Aston University's Antimicrobial Resistance (AMR) Roadshow: raising awareness and embedding knowledge of AMR in key stage 4 learners

Identification and validation of the mode of action of the chalcone anti-mycobacterial compounds

Effect of Amoxicillin in combination with Imipenem-Relebactam against Mycobacterium abscessus

The drugs don't work: evaluation of educational theatre to gauge and influence public opinion on antimicrobial resistance

Dissecting the Antimicrobial Composition of Honey

Dr Jonathan A. G. Cox's research interests surround the discovery of new antibiotics and identifying the exact mechanism by which those antibiotics kill bacteria. Finding new “mechanisms of action” reveals new drug targets that can be exploited in the battle against antimicrobial resistance (AMR). AMR accounts for around 700,000 deaths per annum globally and that number is predicted to rise to 10 million by 2050. The current economic burden of AMR is estimated to be at least €1.5 billion per year in the EU. New antibiotics and an improved understanding of how to use them will help to slow the progression of AMR, saving countless lives in the future.

In his current role, Jonathan leads the Mycobacterial Research Group at Aston University. His group consists of three PhD students and one post-doctoral researcher, along with a number of master’s students and undergraduate students who decide to study with them. They are a multidisciplinary team with a diverse skill-set, spanning microbiology, biochemistry, molecular genetics, structural biology and drug discovery. The Mycobacterial Research Group's main focus is to study the physiology of various pathogenic mycobacteria (such as Mycobacterium abscessus, Mycobacterium tuberculosis and Mycobacterium bovis) and to discover new ways to treat infections. By using the physiology to inform antibiotic drug discovery, they can develop new treatment regimens that are able to overcome factors contributing to antibiotic resistance in these highly antibiotic-tolerant bacteria. The Mycobacterial Research Group collaborates with several other research groups around the UK, including The University of Bradford, University of Hertfordshire and University of Plymouth, as well as clinicians at Birmingham Children’s Hospital. Jonathan was recently interviewed by the Microbiology Society about his research.

Jonathan also teaches at Aston and currently leads teaching for first year microbiology on their Biomedical Science, Biology and Biochemistry courses, as well as contributing to teaching across other parts of their program. Jonathan currently serves as Biomedical Science Top Up Modules Course Director. 

Jonathan regularly engages with the press to comment on news stories and issues related to microbiology, infectious diseases and antibiotic resistance. He has experience of both written and broadcast media.

Health Sciences

Biochemistry

Antibiotics

Antimicrobial Resistance

Micro-Organisms

Aston Research Explorer Profile

Aston University Birmingham Faculty Profile

Google Scholar Citations

Treating multi-drug resistant Mycobacterium abscessus: three’s a charm

Antibiotic Combination Kills Resistant Bacteria Affecting CF Patients, Study Reports

New treatment kills off infection that can be deadly to cystic fibrosis patients

New drug combination destroys bacterial infection that can be fatal to cystic fibrosis patients

manuka-honey-could-help-to-clear-deadly-drugresistant-lung-infection-research

Lecturer in Microbiology

  • Scientists develop a potential nebulisation treatment using manuka honey to clear a drug resistant lung infection that can be fatal in cystic fibrosis patients • Aston University researchers combined the antibiotic amikacin with manuka honey as a novel treatment for Mycobacterium abscessus • Using the manuka honey combination resulted in an eight-fold reduction in the dosage of the antibiotic A potential new treatment combining natural manuka honey with a widely used drug has been developed by scientists at Aston University to treat a potentially lethal lung infection and greatly reduce side effects of one of the current drugs used for its treatment. 

The findings, which are published in the journal Microbiology, show that the scientists in the Mycobacterial Research Group in the College of Health and Life Sciences at Aston University were able to combine manuka honey and the drug amikacin in a lab-based nebulisation formulation to treat the harmful bacterial lung infection Mycobacterium abscessus. 

Manuka honey is long known to have wide ranging medicinal properties, but more recently has been identified for its broad spectrum antimicrobial activity. Now scientists have found that manuka honey has the potential to kill a number of drug resistant bacterial infections such as Mycobacterium abscessus – which usually affects patients with cystic fibrosis (CF) or bronchiectasis.   

According to the Cystic Fibrosis Trust, CF is a genetic condition affecting around 10,800 people - one in every 2,500 babies born in the UK -and there are more than 100,000 people with the condition worldwide. The NHS defines bronchiectasis  as a long-term condition where the airways of the lungs become widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection..
In the study, the researchers used samples of the bacteria Mycobacterium abscessus taken from 16 infected CF patients. They then tested the antibiotic amikacin, combined with manuka honey, to discover what dosage was required to kill the bacteria.

As part of the study the team used a lab-based lung model and nebuliser - a device that produces a fine spray of liquid often used for inhaling a medicinal drug. By nebulising manuka honey and amikacin together, it was found they could improve bacterial clearance, even when using lower doses of amikacin, which would result in less life-changing side-effects to the patient. 

In the UK, of the 10,800 people living with CF, Mycobacterium abscessus infects 13% of all patients with the condition. This new approach is advantageous not only because it has the potential to kill off a highly drug resistant infection, but because of the reduced side effects, benefitting quality of life and greatly improving survival chances for infected CF patients.  

Mycobacterium abscessus is a bacterial pathogen from the same family that causes tuberculosis, but this bug differs by causing serious lung infections in people (particularly children) with pre-existing lung conditions, such as CF and bronchiectasis, as well as causing skin and soft tissue infections. The bacteria is also highly drug resistant. 

Currently, patients are given a cocktail of antibiotics, consisting of 12 months or more of antimicrobial chemotherapy and often doesn’t result in a cure. The dosage of amikacin usually used on a patient to kill the infection is 16 micrograms per millilitre. But the researchers found that the new combination using manuka honey, required a dosage of just 2 micrograms per millitre of amikacin - resulting in a one eighth reduction in the dosage of the drug. 

Until now Mycobacterium abscessus has been virtually impossible to eradicate in people with cystic fibrosis. It can also be deadly if the patient requires a lung transplant because they are not eligible for surgery if the infection is present. 

Commenting on their findings, lead author and PhD researcher Victoria Nolan said: 

"So far treatment of Mycobacterium abscessus pulmonary infections can be problematic due to its drug resistant nature. The variety of antibiotics required to combat infection result in severe side effects. "However, the use of this potential treatment combining amikacin and manuka honey shows great promise as an improved therapy for these terrible pulmonary infections. “There is a need for better treatment outcomes and in the future we hope that this potential treatment can be tested further.”  Dr Jonathan Cox, senior lecturer in microbiology, Aston University said:

“By combining a totally natural ingredient such as manuka honey with amikacin, one of the most important yet toxic drugs used for treating Mycobacterium abscessus, we have found a way to potentially kill off these bacteria with eight times less drug than before. This has the potential to significantly reduce amikacin-associated hearing loss and greatly improve the quality of life of so many patients – particularly those with cystic fibrosis. “I am delighted with the outcome of this research because it paves the way for future experiments and we hope that with funding we can move towards clinical trials that could result in a change in strategy for the treatment of this debilitating infection.”   Dr Peter Cotgreave, chief executive of the Microbiology Society said: 

"The Microbiology Society is proud to support the scientific community as it explores innovative solutions to overcome the growing global challenge of antimicrobial resistance. This study demonstrates one of many ways in which microbiologists are pioneering new methods to tackle drug-resistant infections, by incorporating natural products, like manuka honey, into existing therapies."  For more information about the School of Biosciences, please visit our website. 

Manuka honey could help to clear deadly drug-resistant lung infection – research

antimicrobial-resistance-now-causes-more-deaths-than-hivaids-and-malaria-worldwide-new-study

  Antimicrobial resistance is spreading rapidly worldwide, and has even been likened to the next pandemic – one that many people may not even be aware is happening. A recent paper, published in Lancet, has revealed that antimicrobial resistant infections caused 1.27 millions deaths and were associated with 4.95 million deaths in 2019. This is greater than the number of people who died from HIV/AIDS and malaria that year combined.

Antimicobial resistance happens when infection-causing microbes (such as bacteria, viruses or fungi) evolve to become resistant to the drug designed to kill them. This means than an antibiotic will no longer work to treat that infection anymore.

The new findings makes it clear that antimicrobial resistance is progressing faster than the previous worst-case scenario estimates – which is of concern for everyone. The simple fact is that we’re running out of antibiotics that work. This could mean everyday bacterial infections become life-threatening again.

While antimicrobial resistance has been a problem since penicillin was discovered in 1928, our continued exposure to antibiotics has enabled bacteria and other pathogens to evolve powerful resistance. In some cases, these microbes are resistant even to multiple different drugs. This latest study now shows the current scale of this problem globally – and the harm it’s causing.

Global problem
The study involved 204 countries around the world, looking at data from 471 million individual patient records. By looking at deaths due to and associated with antimicrobial resistance, the team was then able to estimate the impact antimicrobial resistance had in each country.

Antimicrobial resistance was directly responsible for an estimated 1.27 million deaths worldwide and was associated with an estimated 4.95 millions deaths. In comparison, HIV/AIDS and malaria were estimated to have caused 860,000 and 640,000 deaths respectively the same year. The researchers also found that low- and middle-income countries were worst hit by antimicrobial resistance – although higher income countries also face alarmingly high levels.

They also found that of the 23 different types of bacteria studied, drug resistance in only six types of bacteria contributed to 3.57 million deaths. The report also shows that 70% of deaths that resulted from antimicrobial resistance were caused by resistance to antibiotics often considered the first line of defence against severe infections. These included beta-lactams and fluoroquinolones, which are commonly prescribed for many infections, such as urinary tract, upper- and lower-respiratory and bone and joint infections.

This study highlights a very clear message that global antimicrobial resistance could make everyday bacterial infections untreatable. By some estimates, antimicrobial resistance could cause 10 million deaths per year by 2050. This would overtake cancer as a leading cause of death worldwide.

Next pandemic
Bacteria can develop antimicrobial resistance in a number of ways.

First, bacteria develop antimicrobial resistance naturally. It’s part of the normal push and pull observed throughout the natural world. As we get stronger, bacteria will get stronger too. It’s part of our co-evolution with bacteria – they’re just quicker at evolving than we are, partly because they replicate faster and get more genetic mutations than we do.

But the way we use antibiotics can also cause resistance.

For example, one common cause is if people fail to complete a course of antibiotics. Although people may feel better a few days after starting antibiotics, not all bacteria are made equal. Some may be slower to be affected by the antibiotic than others. This means that if you stop taking the antibiotic early, the bacteria that were initially able to avoid the effect of the antibiotics will be able to multiply, thus passing their resistance on.

Likewise, taking antibiotics unnecessarily can help bacteria to evolve resistance to antibiotics faster. This is why it’s important not to take antibiotics unless they’re prescribed, and to only use them for the infection they’re prescribed for.

Resistance can also be spread from person to person. For example, if someone who has antibiotic-resistant bacteria in their nose sneezes or coughs, it may be spread to people nearby. Research also shows that antimicrobial resistance can be spread through the environment, such as in unclean drinking water.

The causes driving this global antimicrobial resistance crisis are complex. Everything from how we take antibiotics to environmental pollution with antimicrobial chemicals, use of antibiotics in agriculture and even preservatives in our shampoo and toothpaste are all contributing to resistance. This is why a global, unified effort will be needed to make a difference.

Urgent change is needed in many industries to slow the spread of antimicrobial resistance. Of the greatest importance is using the antibiotics we have smarter. Combination therapy could hold the answer to slowing down antimicrobial resistance. This involves using several drugs in combination, rather than one drug on its own – making it more difficult for bacteria to evolve resistance, while still successfully treating an infection.

The next pandemic is already here – so further investment in research that looks at how we can stop this problem will be key.


Antimicrobial resistance now causes more deaths than HIV/AIDS and malaria worldwide – new study

senior-lecturer-at-aston-university-appointed-as-a-champion-of-the-microbiology-society

Dr Jonathan Cox, a senior lecturer in microbiology at Aston University, has been made a Champion of the Microbiology Society for the Midlands area, U.K.

 Microbiology Society Champions are members who help to raise the Society’s profile in their local area by initiating activities and events of their own or participating in Society-led events. They are appointed because of their passion for their subject matter and an enthusiasm to communicate it widely. 

Jonathan’s research interests surround the discovery of new antibiotics. He leads the Mycobacterial Research Group at Aston University, a multidisciplinary team spanning microbiology, biochemistry, molecular genetics, structural biology and drug discovery. The team’s main focus is to study the physiology of various pathogenic mycobacteria and to discover new ways to treat infections. 

He also teaches at Aston University and currently leads the teaching for first year microbiology on courses in biomedical science, biology and biochemistry,

Jonathan also regularly engages with the press to comment on news stories and issues related to microbiology, infectious diseases and antibiotic resistance. 

He has been a full member of the Microbiology Society for 10 years and has already contributed in many ways, including hosting the Microbiology Society Roadshow at Aston University in 2021. He has also been featured in Microbiology Today discussing his research.

Speaking of his appointment, Jonathan said:

“Anti-microbial resistance (AMR) accounts for around 700,000 deaths per annum globally and that number is predicted to rise to 10 million by 2050. The current economic burden of AMR is estimated to be at least €1.5 billion per year in the EU. New antibiotics and an improved understanding of how to use them will help to slow the progression of AMR, saving countless lives in the future. “I am delighted to have been appointed as a Microbiology Society Champion and to use this opportunity to raise the profile of the Society and, in particular, the importance of research into AMR.” 

Senior lecturer at Aston University appointed as a Champion of the Microbiology Society

Section 2 features Dr Amreen Bashir, Dr Jonathan Cox and Professor Anthony Hilton, who will explain how bacteria can cause an infection. You will also learn about the chain of infection, the superbug MRSA and correct handwashing procedure which can help limit the spread of bacteria.

Funding for this AMR4AMR (Aston Multidisciplinary Research for Antimicrobial Resistance) research group event was via ‘Bridging the Gap’ funding (grant reference number EP/M02735X/1) from the EPSRC (Engineering & Physical Sciences Research Council) and Biomaster. 

Find out more about the project: www.aston.ac.uk/amr4amr

AMR Schools Roadshow Section 2: Infection and the superbug MRSA

In section 3 Dr Jonathan Cox will talk about antibiotics, how they work, what happens when they do not work any longer due to antimicrobial resistance, and what we can do to help stop that from happening. Dr Amreen Bashir will discuss natural antibiotics.

Funding for this AMR4AMR (Aston Multidisciplinary Research for Antimicrobial Resistance) research group event was via ‘Bridging the Gap’ funding (grant reference number EP/M02735X/1) from the EPSRC (Engineering & Physical Sciences Research Council) and Biomaster. 

Find out more about the project: www.aston.ac.uk/amr4amr

AMR Schools Roadshow Section 3: Antibiotics

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