DOCSLIB.ORG

5 Surveillance of the Antibiotic Susceptibility of Bacteria Found in the Urinary Tract in the West Midlands Over a Four Year Period

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
5 Surveillance of the Antibiotic Susceptibility of Bacteria Found in the Urinary Tract in the West Midlands Over a Four Year Period An investigation into the relationship between antimicrobial prescribing and antimicrobial resistance in urinary tract infections at a population level By Dean Ironmonger A thesis submitted to The University of Birmingham for the degree of DOCTOR OF PHILOSOPHY Institute of Microbiology and Infection College of Medical and Dental Sciences University of Birmingham December 2017 University of Birmingham Research Archive e-theses repository This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder. Abstract Inappropriate use of antibiotics is a key factor in the development of antimicrobial resistance (AMR). UK national guidance has been ineffective in standardising the management of infections in the community. Many community prescribers are sceptical that their actions have an effect on AMR in their locality. As part of this study, routine surveillance of AMR in a large regional population was established. To help interpret surveillance data, two surveys were undertaken: a survey of laboratory methods, and a survey of GP sampling and prescribing protocols. Using these survey results, surveillance tools were developed to provide hospital and community prescribers with data on antibiotic resistance in bacteria within their locality; and enable laboratories to compare methods for determining antibiotic susceptibility. The results of this thesis demonstrated that routine AMR surveillance can be used to monitor key antibiotic resistance, detect emergence of new or unusual resistance mechanisms, and enable the bench-marking of laboratory methods. This study was also able to demonstrate that small increases in antibiotic prescribing by individual GPs increases the number of non-susceptible bacteria isolated from specimens taken from their practice population. Results from this thesis provides supporting evidence to those developing strategies to combat AMR in the community. Dedication To Harry and Margaret Acknowledgements I am extremely grateful to my PhD supervisors, Professor Peter Hawkey and Dr. Savita Gossain for providing guidance and supporting my work during the course of this thesis. I would also like to thank Dr. Carolyne Horner for providing editorial advice and proof reading in the write-up of this study. I would like to thank all the consultant microbiologists and scientists working in West Midland diagnostic microbiology laboratories. Routine AMR surveillance would not have been possible without their cooperation and support. The studies that make up this thesis were funded by Public Health England, and I am very grateful for the additional time granted by my line managers over the period of this PhD study, namely; Dr. Obaghe Edeghere, Professor Jeremy Hawker and Dr. Susan Hopkins. I would particularly like to thank Professor Hawker for providing me the opportunity to work with the Birmingham regional epidemiology team, and allowing me the freedom to pursue various surveillance initiatives. Dr Obaghe Edeghere, Dr. Savita Gossain, Dr. Susan Hopkins and Professor Hawkey provided study design guidance and helped with the interpretation of data for the studies reported in Chapters 3 to 6. Mr. Amardeep Bains produced the SQL databases and software processes required for the development of the AmWeb surveillance application reported in Chapter 3; and also helped extract AMR data for the analysis performed in Chapter 5. Dr. Richard Loy and Professor Neil Woodford provided data from the PHE AMRHAI reference laboratory used in the analysis presented in Chapter 5. Mrs. Bridget Hilton helped with the extraction of antibiotic prescribing data and created datasheets used to build the statistical models described in Chapter 6. Mr. Neville Verlander designed the statistical models described in Chapter 6, supervised the modelling process and provided guidance in the interpretation of the statistical model results. I would also like to thank PHE colleagues in the Field Epidemiology Service and AMR/HCAI team for their continuous encouragement and support. Finally I would like to thank my family. Without their understanding this study would not have been possible. Table of Contents 1 Introduction .................................................................................................................. 1 1.1 Background............................................................................................................. 2 1.2 Antibiotics ............................................................................................................... 6 1.2.1 Discovery and development ............................................................................. 6 1.2.2 Mechanisms of action ...................................................................................... 9 1.2.3 Antimicrobial resistance ................................................................................. 15 1.3 Epidemiology of Gram-negative antimicrobial resistance ...................................... 24 1.3.1 Background ................................................................................................... 24 1.3.2 Extended spectrum beta-lactamases ............................................................. 24 1.3.3 Carbapenemases .......................................................................................... 29 1.4 Urinary Tract Infections ......................................................................................... 37 1.4.1 Definitions ...................................................................................................... 37 1.4.2 Epidemiology of UTI ....................................................................................... 38 1.4.3 Host factors ................................................................................................... 40 1.4.4 Bacterial uropathogens .................................................................................. 41 1.4.5 Diagnosis and treatment ................................................................................ 42 1.5 Antibiotic Prescribing ............................................................................................ 44 1.5.1 Background ................................................................................................... 44 1.5.2 Antimicrobial stewardship .............................................................................. 48 1.6 Surveillance of Antimicrobial Resistance ............................................................... 52 1.6.1 Surveillance systems ..................................................................................... 52 1.6.2 Interpretation of surveillance data .................................................................. 57 1.7 Study population ................................................................................................... 61 1.8 Hypothesis ............................................................................................................ 62 1.9 Aim and objectives ................................................................................................ 63 1.10 Ethics .................................................................................................................... 63 2 A survey of methodologies for the identification and antibiotic susceptibility testing of bacterial isolates from urine samples submitted to laboratories based in the West Midlands ......................................................................................................................... 65 2.1 Background........................................................................................................... 66 2.1.1 Laboratory testing protocols for urine specimens ........................................... 66 2.1.2 Initial examination .......................................................................................... 66 2.1.3 Urine culture .................................................................................................. 67 2.1.4 Identification of bacteria isolated from urine specimens ................................. 68 2.1.5 Antibiotic susceptibility tests ........................................................................... 68 2.2 Objectives ............................................................................................................. 74 2.3 Methods ................................................................................................................ 74 2.3.1 Survey protocol .............................................................................................. 74 2.3.2 Survey format ................................................................................................ 76 2.3.3 Survey follow-up questions ............................................................................ 76 2.4 Results .................................................................................................................. 79 2.4.1 Response ...................................................................................................... 79 2.4.2 Number of urines tested by
Load more

Recommended publications
  • Wivey and the Hills Churches
    Wivey and the Hills Magazine June 2019 Price 50p Contents and about the magazine Wivey and the Hills magazine is published 10 times a year by the Benefice of the seven parishes of Wiveliscombe, Brompton Ralph, Clatworthy, Chipstable, Huish Champflower, Raddington and Tolland. Its purpose is to promote the life of all the Christian churches in this area and that of the wider communities which they serve. Contents Contents and magazine information 2 Letter from the Rector 3 What’s Been Happening 4-10 (including On the allotment/ Cuttings from the Garden Wildlife - what to look out for/ Monthly Recipe) Looking ahead - Wivey and the Hills 11-24 Regular Events 25 Quick view - Events for June 26-27 Growing in Faith 28-29 Ways to help your community 30 Adverts for local businesses 31-49, 52 Useful Contacts 50-51 Welcome to your June edition of the Wivey and the Hills magazine! As ever, there is masses going on in our beautiful area. New Subscribers: Would you like to The next issue will be for two months, July and August, so if you have any receive regular copies of the magazine? If contributions then please send them to us before 16th June. so please email [email protected] Lorna Thorne, Peter Pearson, Acting editorial team with your name, address, contact number and email, along with your BACs payment A year’s subscription is £5 (50p / copy) and Articles and events, comments and feedback: [email protected] runs from January to December. Advertising: Lorna Thorne [email protected] 01984 629423 BACS details are Magazine Distribution: Janet Hughes, 12 Lion d’Angers, 01984 624213 ‘WHOF’ 09-01-29 20101213 Or ring 01984 629423 for more details.
    [Show full text]
  • Scoping Opinion
    SCOPING OPINION: Proposed A358 Taunton to Southfields Dualling Scheme Case Reference: TR010061 Adopted by the Planning Inspectorate (on behalf of the Secretary of State) pursuant to Regulation 10 of The Infrastructure Planning (Environmental Impact Assessment) Regulations 2017 May 2021 [This page has been intentionally left blank] ii Scoping Opinion for Proposed A358 Taunton to Southfields Dualling Scheme CONTENTS 1. INTRODUCTION ............................................................................ 1 1.1 Background .................................................................................... 1 1.2 The Planning Inspectorate’s Consultation............................................. 2 2. THE PROPOSED DEVELOPMENT ..................................................... 4 2.1 Introduction ................................................................................... 4 2.2 Description of the Proposed Development ............................................ 4 2.3 The Planning Inspectorate’s Comments ............................................... 6 3. ES APPROACH............................................................................... 9 3.1 Introduction ................................................................................... 9 3.2 Relevant National Policy Statements (NPSs)....................................... 10 3.3 Scope of Assessment ..................................................................... 10 3.4 Coronavirus (COVID-19) Environmental Information and Data Collection 14 3.5 Confidential and Sensitive
    [Show full text]
  • The Church Bells of Somerset and an Olla Podrida of Bell Matters of General Interest
    The Church Bells of Somerset and An Olla Podrida of Bell Matters of General Interest BY Rev. H. T. Ellacombe File 02 : Appendix A (Inscriptions) Appendix B Pages 21 to 100 This document is provided for you by The Whiting Society of Ringers visit www.whitingsociety.org.uk for the full range of publications and articles about bells and change ringing . Purchased from ebay store retromedia PAEISH CIIUECHES OF SOMEESET. 21 APPENDIX A. THE INSCRIPTIONS ON THE BELLS with the Diameter many lit the Toivers of all the Old Pansh Churches in Somerset, of and the Note of the Tenor, including Neiu Toivers with Rings, and Old Parish Turrets or Bell Cots, with the Name of the Saint to whom the Church is Dedicated. refer t;-> the Cuts. The Date is when reported. yote.—The Numbers between [ ] |°'^'"- ^-l 1. ABBAS (OR TE:\IPLE) C0:\IBE. 4. ALFORD. ''"I A/l SniHlx. 1 IOHX U.\ZZAKD | Mit lOHX BRINE Mk 31J I BILBIE ITM CH.WARDEXS T \ Inscription . 24 1 O ® O ® O Roses No 3Ii-. lOHN 34 2 Mr IOHN VIXCENT VICAR i ^v 36 2 AN } NO § DO § MI NI ^^ 1673 ^ C § L BRINE 5Iu lOIiN HAZZAUU CH. I C j W § T § P AVARDENS THO. BILBIE CAST ME I Mk THOMAS ROVCH CH. WARDEN. AMOS HALLETT PUT ME UP 3 I m. T. BILBIE 17.jy 3 * ,^ { DOMINI 1 16.5fi TP } TR 1 37 AN NO v^ Jamianj GK 5 GW 28, 1871. I 5 LORD HAVE MERCIE VPON VS W.C. 1SS6 42 O. ALLER. Error doubt for 1595.
    [Show full text]
  • BY E. GREEN (Eon. Sec.)
    ftoios mt the Jistorg «f £)uluft[ion. BY E. GREEN (Eon. Sec.) pUT a few years ago the history of any parish would have ^ commenced with some extract from Domesday book, now, thanks to one, alas ! lately departed from us, two years earlier can be included, and much new matter gained. Still all is rather complex, and future workers may yet find room for their investigations. In the Gheld Inquest then, taken in 1084, Dul- vertona is found as part of Williton Hundred, and, with Netelcoma and Uinnesforda, was rated at six hides, one virgate and one fertin, the dues on which were in arrear. The Domesday measurement is about a third more. But although Dulverton is here found already in Williton, it for a time, it would seem, gave the name to the Hundred. It here included Potesdona(Pixton), Holma (Hollam), and certain lands owned by thirteen Taini, the value, £-3. 4s. 2d., making uipthe Domesday measurement of 8,337 acres, held by the King in capite. Be- fore the Conquest it was owned by Earl Harold, who received a rent from Brigeford, from the Earl of Moretain, of twenty- “ four sheep ; a custom, says the Inquest, now discontinued.” The rental was eleven pounds ten shillings, paid in white money. Within the manor was a still uncertain holding of one virgate of land, called Widepolla, the same spelling as for Withypool, held by Robert de Odburvilla, formerly owned by one Dodo in the time of King Eadward. D'Auberville, as the name next becomes, and Dodo, were both King’s foresters, but D’Auber- ville, by a suit at law, managed to secure the property, and then to separate it from Dulverton, holding it by what was considered the more honourable tenure, by service, instead of, as before, by a money rent.
    [Show full text]
  • Environment Agency Plan
    EA-South West L E A P s /* 13 local environment agency plan RIVER TONE FIRST ANNUAL REVIEW M a rc h 2 0 0 2 UNTON En v i r o n m e n t Ag e n c y E n v ir o n m e n t Ag e n c y NATIONAL LIBRARY & INFORMATION SERVICE SOUTH WEST REGION Manley House, Kestrel Way, Exeter EX2 7LQ £-4 . UCAl^ / 105 CONTENTS Map 1: The River Tone Catchment Map 2: The Somerset Levels and Moors and River Catchments 1 Introduction 1 1.1 The River Tone First Annual Review 1 1.2 The Environment Agency 1 1.3 Local Environment Agency Plans (LEAPs) 1 1.4 The River Tone LEAP 2 1.5 The Annual Review Process 2 1.6 The River Tone LEAP Steering Group 3 1.7 The Environmental Vision 4 1.8 Making It Happen - Local Contributions 4 1.9 The River Tone Catchment Overview 5 1.10 Resources 6 1.11 Priorities 6 2 Legislation, Initiatives & Organisations Update 7 2.1 The Department for Environment, Food & Rural Affairs (DEFRA) 7 2.2 The Natura 2000 Network 7 2.3 The Countryside and Rights of Way Act 2000 9 2.4 Biodiversity Action Plans 10 2.5 Fisheries 11 2.6 The Water Framework Directive: River Basin Management Plans 11 2.7 The Regional Water Resources Development Strategy 12 2.8 Catchment Abstraction Management Strategies (CAMS) 12 2.8.1 The Tone CAMS 13 2.9 Flood Management 13 2.9.1 Floodplain Mapping - PPG 25 and Section 105 Plans 14 2.9.2 Catchment Flood Management Plans (CFMPs) 15 2.10 Flood Warning 15 2.10.1 The Taunton Major Incident Plan 16 2.11 The Parrett Catchment Project - Countryside Partnership , 17 2.11.1 The Tone Land Use Project 18 2.11.2 The Area Diffuse Pollution
    [Show full text]
  • Walk 43A Wiveliscombe and Brompton Ralph
    Walking on Exmoor and the Quantock Hills The lane brings you into the hamlet or small village of Whitefield. exmoorwalker.uk Ignore a road and then a bridleway on the right, but where the road bends sharply le at Whitefield Farm (1hr, [3]), connue ahead on an Walk 43A. Wiveliscombe and Brompton Ralph. unsurfaced lane (marked with an inconspicuous purple byway sign). Keep le through a gate, then follow the track around and to the 8.3 miles with ascents and descents of 385 metres. 3 hours 20 minutes constant walk- right. You will soon be walking downhill on exposed bedrock; this can ing, allow 4½ hours. be diabolically slippery . The path levels out and comes alongside a Terrain: Paths, tracks and fields. Some paths will be very muddy and slippery outside of stream on the le . Look for a conspicuous sle on the le summer, parcularly during forestry operaons. Lots of sles to negoate. (1hr20mins, [4]; the short walk connues straight ahead here). Access: By car, park in the free town car park off the B3227 in Wiveliscombe (ST 080 277, For the main walk, go over the sle, cross the field and head over near TA4 2BF). If it is full there is an alternave car park in North Street (ST 080 280). By bus, no. 25 runs Monday to Saturday between Taunton and Dulverton via Wiveliscombe. another sle and a footbridge, turning le alongside a stream. The path enters a forestry plantaon; at the me of wring, many of the Map: OS Explorer OL9 Exmoor. trees had been clear-felled.
    [Show full text]
  • Full Council – 16 July 2019
    Full Council – 16 July 2019 Motion to declare Somerset West and Taunton a Frack- Free Zone Motion proposed by Councillor Caroline Ellis, seconded by Councillor Dixie Darch Preamble:- This Council notes that: 1. Parts of Somerset West and Taunton i.e. areas around Minehead and Watchet and a section of Exmoor National Park have been licensed by central government for onshore unconventional shale oil and shale gas development (PEDL 344), which could include hydraulic fracturing or “fracking” for short. 2. Shale gas and shale oil are fossil fuels and emit greenhouse gases (methane, via fugitive emissions and carbon dioxide via production processes and when burnt). 3. Fracking in the US, Canada and Australia has produced unacceptable risks including ground water contamination and adverse impacts on air quality (with the release, treatment and disposal of radioactive toxins), agriculture, public health and safety, climate stability, economic vitality, the rural economy (farming & tourism), landscape and property values as well as earthquakesi. While England is said to have a more robust regulatory system, there are weaknesses; much of the monitoring of pollution, leaks etc. is left to the companies themselves and the regulators are often under budgetary pressures.ii 4. The latest scientific evidence demonstrates that fracking has no role to play in the transition to a zero carbon economy and would thwart the UK’s climate change mitigation efforts.iii 5. Popular opposition to fracking across Somerset West and Taunton is evidenced by strong support for groups such as ‘Frack Free Somerset’ and ‘Frack Free EQS’ (Exmoor, Quantocks and Sedgemoor) and motions to declare Frack-Free Zones passed by Watchet and Wiveliscombe Town Councils and Parish Councils including Bishops Lydeard and Cothelstone, Clatworthy, Dulverton, Exton, Old Cleeve, Selworthy and Minehead Without and Stogumber.
    [Show full text]
  • Notice of Uncontested Parish Elections
    NOTICE OF UNCONTESTED ELECTION Somerset West and Taunton Council Election of a Parish Councillor for Minehead (Alcombe North Ward) on Thursday 2 May 2019 I, James Hassett, being the Returning Officer at the above election, report that no candidates were nominated for Minehead (Alcombe North Ward). A new election will be held within 35 days of Thursday 2 May 2019. Dated Friday 5 April 2019 James Hassett Returning Officer Printed and published by the Returning Officer, Somerset West and Taunton Council, West Somerset House, Killick Way, Williton TA4 4QA, NOTICE OF UNCONTESTED ELECTION Somerset West and Taunton Election of Parish Councillors for Ashbrittle on Thursday 2 May 2019 I, being the Returning Officer at the above election, report that the persons whose names appear below were duly elected Parish Councillors for Ashbrittle. Name of Candidate Home Address Description (if any) DOBLE The Old Rectory, Ashbrittle, Charles Somersetshire, TA21 0LQ HUGHES (Address in Ashbrittle, Somerset) Victoria MASSIE Venture Cottage, Ashbrittle, TA21 Helèna 0LG ROBBINS Greywells House, Ashbrittle, TA21 Jeremy Matthew Francis 0LE SIMPSON Myrtle Cottage, Ashbrittle, Rob Wellington, Somerset, TA21 0LE Dated Friday 5 April 2019 James Hassett Returning Officer Printed and published by the Returning Officer, West Somerset House, Killick Way, Williton, Somerset, TA4 4QA NOTICE OF UNCONTESTED ELECTION Somerset West and Taunton Election of Parish Councillors for Bathealton on Thursday 2 May 2019 I, being the Returning Officer at the above election, report that
    [Show full text]
  • Clatworthy and Brompton Ralph 2012
    Exmoor House, Dulverton, Somerset. TA22 9HL Telephone: 01398 322249/45 Fax: 01398 323150 E-mail: [email protected] HOUSING NEEDS SURVEY BBRROOMMPPTTOONN RRAALLPPHH aanndd CCLLAATTWWOORRTTHHYY WWeesstt SSoommeerrsseett August 2012 http://www.streetmap.co.uk RURAL HOUSING PROJECT Exmoor, North Devon & West Somerset The Rural Housing Project has been running since 2002 and is a partnership between Exmoor National Park Authority, North Devon Council, West Somerset Council, English Rural Housing Association, Falcon Rural Housing, Hastoe Housing Association, North Devon Homes, Devon and Cornwall Housing Association and Magna Housing Association. It has been working hard to address the shortage of affordable housing within a predominantly rural area. The area covered by the project displays an extreme disparity between incomes and house prices, which makes it hard for many to gain secure footing within the housing market. The Rural Housing Project is designed to help promote and deliver affordable rural housing strategically across the project area and helps deliver Exmoor National Park housing policies within the Park. This is being achieved by informing people about affordable rural housing, providing help and advice, carrying out research at parish level to assess the affordable housing need and bringing together the community and various partners to help deliver housing where it is needed. One of the tasks for the project is to work with the Parish Council and the local community to assist them in carrying out a housing needs survey, in order to identify whether there is a need for affordable housing for local people in the parish. Colin Savage, Rural Housing Enabler Page 2 BROMPTON RALPH AND CLATWORTHY HOUSING NEEDS SURVEY Introduction Brompton Ralph is a village and civil parish in West Somerset, about 11 miles west of Taunton, and 3 miles north of Wiveliscombe.
    [Show full text]
  • Strategic Flood Risk Assessment Level 1
    West Somerset Council & Exmoor National Park Authority Strategic Flood Risk Assessment Level 1 Final Report March 2009 Prepared for: West Somerset Council and Exmoor National Park Authority Level 1 Strategic Flood Risk Assessment Revision Schedule Level 1 Strategic Flood Risk Assessment March 2009 Project Rev Date Details Prepared by Reviewed by Approved by Number 01 January D122558 Draft Level 1 Mark Crussell Dr Rob Sweet Jon Robinson 2009 SFRA Assistant Hydrologist Senior Flood Risk Associate Director Dr Rob Sweet Specialist Senior Flood Risk Specialist 02 March D122558 Final Level 1 Dr Rob Sweet Dr Rob Sweet Jon Robinson 2009 SFRA – Senior Flood Risk Senior Flood Risk Associate Director Incorporating Specialist Specialist ENPA, WSC and EA comments Scott Wilson Mayflower House Armada Way This document has been prepared in accordance with the scope of Scott Wilson's appointment with its client and is subject to the terms of that appointment. It is addressed Plymouth to and for the sole use and reliance of Scott Wilson's client. Scott Wils on accepts no liability for any use of this document other than by its client and only for the purposes, PL1 1LD stated in the document, for which it was prepared and provided. No person other than the client may copy (in whole or in part) use or rely on the conte nts of this document, without the prior written permission of the Company Secretary of Scott Wilson Ltd. Any advice, Tel 01752 676733 opinions, or recommendations within this document should be read and relied upon only in the context of the document as a whole.
    [Show full text]
  • Item 11 Exmoor National Park Authority
    ITEM 11 EXMOOR NATIONAL PARK AUTHORITY 5 December 2017 PROGRESS IMPLEMENTING THE BUSINESS PLAN 2017-2020 Report of the Head of Personnel and Corporate Support PURPOSE OF THE REPORT: To inform Members about the progress made in implementing key actions within the current Business Plan for the period April 2017- September 2017. RECOMMENDATION: The Authority is recommended to: 1. NOTE the progress in implementing the Authority’s key commitments set out in the Business Plan 2017-2020 2. DELEGATE to the Finance and Performance Advisory Panel and Leadership Team further scrutiny of Authority performance across all the Business Plan actions for the next reporting period to 31 March 2018. Authority Business Plan: The Business Plan outlines the priorities for the Authority for the period to March 2020. It closely follows the priorities set out by Defra in its 2016 8-Point Plan for England’s National Parks to ensure the Authority delivers the ambitions of Defra as well as those additional priorities for this Authority. Legal and Equality Implications: Section 65(4) Environment Act 1995 – provides powers to the National Park Authority to “do anything which in the opinion of the Authority, is calculated to facilitate, or is conducive or incidental to:- (a) the accomplishment of the purposes mentioned in s. 65 (1) [National Park purposes] (b) the carrying out of any functions conferred on it by virtue of any other enactment.” The equality impact of the recommendations of this report has been assessed as follows: There are no foreseen adverse impacts on any protected group(s). Engagement through the outreach work within the plan is designed to have a positive impact on protected groups.
    [Show full text]
  • The Old Rectory Elworthy, Somerset, Ta4 3Px
    THE OLD RECTORY ELWORTHY, SOMERSET, TA4 3PX The Old Rectory ELWORTHY, SOMERSET, TA4 3PX A restored Georgian rectory on the edge of the Brendon Hills and Exmoor National Park. Taunton about 12 miles • Wellington about 12 miles • Tiverton about 23 miles Kilve Beach (North Somerset Coastline) about 9 miles. ACCOMMODATION & SUMMARY Lower Ground Floor: Kitchen/breakfast room • family sitting room • conservatory boot room • utility room • laundry room • WC & stores. Ground floor: Reception Hall & cloakroom • dining room • drawing room morning room & library • study/office & butler’s pantry. First floor: Master bedroom suite • guest bedroom suite three further bedrooms & family shower room. Second Floor: Bedroom six • bathroom & attic storage areas. Outbuildings: Coach house & studio apartment • garaging • office gym with shower & wc • stabling & storage. Gardens & Grounds: Landscaped gardens & beautiful walled garden with swimming pool & vegetable garden with raised beds. All-weather tennis court. In all about 4.4 acres. Additional Lots: There is a separate detached two bedroomed cottage (Garden Cottage) and a further 12 acres of land available by separate negotiation. EPC – Exempt. STAGS TAUNTON SAVILLS TAUNTON 5 Hammet Street York House, Taunton Blackbrook Business Park, TA1 1RZ Taunton, Somerset, TA1 2PX 01823 256625 01823 445 030 [email protected] [email protected] Your attention is drawn to the Important Notice on the last page of the text SITUATION The village of Elworthy sits in a beautiful and unspoilt rural, yet accessible location on the edge of the Brendon Hills and Exmoor National Park. The area of the Brendon Hills forms part of the Exmoor National Park renowned for its unspoilt rural landscapes and opportunities for outdoor enjoyment and recreation including shooting on the world renowned local shoots, hunting with six packs of hounds, sailing and game fishing on the nearby Wimbleball and Clatworthy reservoirs in addition to the River Exe and its tributaries.
    [Show full text]