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Antibiotic Resistance

Antibiotic Resistance

Antibiotic Resistance

CHARM: Development and evaluation of a ChlorHexidine gluconate bAthing pRotocol for healthcare settings in low- and Middle-income countries

PI: Ebbing Lautenbach, MD, MPH, MSCE 

Study dates: 9/1/22 – 8/31/25
 

Funding source: CDC

Specific Aims: 

Aim 1: To identify risk factors for colonization or infection with colR-CRE in LTACH patients; Aim 2: To evaluate the impact of colR-CRE colonization or infection on mortality in the LTACH setting; Aim 3: To use whole-genome sequencing to prospectively evaluate colR-CRE isolates from a regional network of LTACHs with a high baseline prevalence of CRE. 

Clinical and Molecular Epidemiology of multidrug-resistant Enterobacterales bloodstream infections in solid organ transplant recipients

PI: Judith Anesi, MD, MSCE

 

Study Dates: 12/1/2016 –  11/30/2018

 

Funding Source: Antibacterial Resistance Leadership Group / NIH

 

Area of Focus:

MDROs; Solid Organ Transplantation

 

Specific Aims: 

1. To elucidate risk factors for ESBL-EB bloodstream infection among SOT recipients. 2. To determine the impact of ESBL-EB bloodstream infection on time to mortality in SOT recipients. 3. To describe the phenotypic and genotypic characteristics of ESBL-EB causing bloodstream infections in SOT recipients

IMPALA TWO: Investigating Multidrug Resistance Prevalence in Botswana – Assessing Relatedness using Whole Genome Sequencing

PI: Ebbing Lautenbach, MD, MPH, MSCE 

 

Study dates: 07/01/21 – 06/30/22
 

Funding source: CDC 

Area of focus:
Global antibiotic resistance; MDROs; Whole genome sequencing 

 

Specific aims: 

The goals of this project are to 1) Describe the genetic diversity of circulating hospital and community ESCrE and CRE in Botswana and put in context of global strain collections, 2) Evaluate evidence of household/community transmission among ESCrE and CRE colonized individuals, and 3) Characterize the structure and prevalence of mobile elements harboring resistance determinants of interest. 

INTEGRATE: Colistin-Resistant CRE in Long Term Acute Care

PI: Ebbing Lautenbach, MD, MPH, MSCE 

 

Study dates: 06/01/18 – 05/31/23
 

Funding source: NIH 

 

Specific Aims: 

Aim 1: To identify risk factors for colonization or infection with colR-CRE in LTACH patients; Aim 2: To evaluate the impact of colR-CRE colonization or infection on mortality in the LTACH setting; Aim 3: To use whole-genome sequencing to prospectively evaluate colR-CRE isolates from a regional network of LTACHs with a high baseline prevalence of CRE. 

NEXUS: Non-residential Exposures to Multidrug-resistant Organisms

PI: Matthew Ziegler, MD, MSCE

 

Study Dates: 06/01/23 – 12/31/25

 

Funding Source: CDC Prevention Epicenter Program

 

Area of Focus:
Environmental transmission of pathogens; healthcare-associated infection

 

Specific Aims:
This project aims to define high-touch objects and to determine effectiveness of cleaning within inpatient NEXUS areas including dialysis, radiology, and physical and occupational therapy

SEMAPHORE: Study of the Evolution of MRSA, Antibiotics & Persistence Having the Outcome of Recurrence

PI:  Michael Z. David, MD, PhD


Study Dates:  2018-2023

 

Funding Source:  NIAID, NIH

 

Area of Focus:
A study of the genomic characteristics of colonizing intrasubject lineages of S. aureus, how they are impacted by antibiotic use, and which S. aureus evolutionary trajectories and genetic changes are associated with recurrent infections and/or with persistence of body colonization.

SPREAD: S. Aureus Study of Prevalence, Resistance, and Environmental Dissemination

PI:  Michael Z. David, MD, PhD

Study dates: 2022-2027

Funding source: NIAID,  NIH

Area of focus:  Hospital Epidemiology, Staphylococcus aureus, Infection Control, Molecular Epidemiology

Specific aims: 
The proposed S. aureus Study of Prevalence, Resistance, and Environmental Dissemination

(SPREAD) relies upon fine genetic discrimination of S. aureus strains with whole genome sequencing (WGS).

WGS data provide the resolution to define a population of a specific clonal variant that colonizes an individual

or that make up linked clusters of colonizing or infecting isolates in more than one person. WGS provides data

on the evolution of pathogens over short and long timescales, mechanisms of antimicrobial resistance, and

the root causes of virulence. SPREAD includes two discrete data collections. In the first, we will study the

transmission dynamics and pathogenic potential of S. aureus in a large cohort of subjects admitted to two

units at a US university hospital over two years. We will detect all S. aureus strains on four body sites and any

infected sites of admitted subjects in the study units, which enhances detection of colonization compared with

nares testing alone. We will test subjects every 7 days and on discharge for new S. aureus acquisition and

assess S. aureus contamination of fomites in unit common areas and colonization of workers on study units.

Using WGS of colonizing and infecting S. aureus, we will determine patient and microbial risk factors for S.

aureus acquisition. Then we will investigate any spread of colonizing strains, determining routes of spread on

the units for each strain isolated from >1 subject. In the second data collection for SPREAD, we will perform

WGS and examine for clustering all S. aureus isolates from infections from two hospitals for two years. We will

compare the genomes of strains that spread to those that did not. We hope to determine markers of

hospital endemicity in S. aureus to optimize preventive measures for S. aureus hospital infections.