Saturday, June 7, 2025
6/7/2025
Pathogen and patient determinants of Candida gut colonization in critically ill patients - PROJECT SUMMARY/ABSTRACT This K23 proposal outlines a five-year research and training plan that will accelerate Dr. Max Adelman's career as an independent physician-scientist with expertise in Candida colonization and infection in critically ill patients. Dr. Adelman is an infectious diseases and critical care clinician whose translational research focuses on severe infections among patients in the intensive care unit (ICU), a population at high risk of infectionrelated morbidity and mortality. These patients are particularly susceptible to infections with Candida spp., which are the second-leading cause of ICU-onset bloodstream infection and are associated with up to 60% mortality. Before developing infection, patients are first colonized with Candida, and the primary site of Candida colonization is the gut. Importantly, while gut colonization is a risk factor for Candida bloodstream infection, there is little data on the host and Candida characteristics that predispose to gut colonization itself. Additionally, Candida bloodstream infections are increasingly caused by multidrug-resistant species including C. glabrata and C. auris, but whether these species consistently colonize the gastrointestinal tracts of ICU patients has not been determined. In this proposal, Dr. Adelman will test the hypothesis that several host and pathogen-specific factors facilitate gut colonization with Candida, which in tum affects important clinical outcomes. In Specific Aim 1, he will (a) determine whether broad-spectrum antibiotics commonly used in the ICU predispose to Candida colonization, (b) evaluate the impact of colonization on clinically important outcomes using a desirability of outcomes ranking (DOOR) analysis, and (c) determine the genomic epidemiology of gut colonizing antifungal-resistant Candida spp. In Specific Aim 2, he will examine the immune pathology that facilitates Candida colonization in the ICU by expanding on his preliminary data linking defective IFN-y production with colonization. To accomplish these goals, Dr. Adelman has designed a training plan that builds on his strong clinical research background with advanced training in data science, Candida genomics, and host-pathogen interactions. Dr. Adelman's research will be overseen by dedicated mentors from Houston Methodist Hospital and surrounding institutions in the Texas Medical Center with complimentary expertise in translational research, microbial genomics, Candida pathogenesis, and immune control of Candida. Additionally, this project will leverage extensive data and sample collection from an NIH-funded P01 project of gut bacterial colonization in ICU patients (Al152999) led by Dr. Adelman's primary mentor, Cesar A Arias, MD, PhD. Overall, this integrated training and mentorship plan will support Dr. Adelman in his discovery of factors that lead to Candida colonization in critically ill patients. Through the proposed award, Dr. Adelman will develop into an independent physician-scientist with clinical infectious diseases and critical care expertise poised to improve care for patients at high risk of Candida infection.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).