Defining transmission pathways for sepsis-causing pathogens in low resource settings using microbiome methods and spatial epidemiology - PROJECT SUMMARY/ABSTRACT The goal of this Mentored Clinical Scientist Research Career Development Award (K23) is to prepare Carolyn McGann, MD, Clinical Instructor and Attending Physician at the Children's Hospital of Philadelphia to achieve her long-term goal of becoming an independent global health scientist focusing on neonatal sepsis prevention. Her immediate goal is to acquire the mentorship, training and research experience needed to successfully compete for R01 grants aimed at interrupting the transmission pathways identified in this work. To achieve these goals and transition to independence, Dr. McGann and her mentors have developed a comprehensive career development plan based on the following: (1) intensive mentorship from a team with complementary expertise (2) advanced training in microbiome methods and epidemiology, and (3) an innovative research plan to use microbiome methods and spatial epidemiology to evaluate risk factors for neonatal colonization with sepsis-causing pathogens. Neonatal sepsis leads to nearly one million deaths annually worldwide, but the causes of neonatal sepsis differ by resource level. Low-and-middle income countries (LMIC) have a much higher burden of disease, but little is known about the transmission of sepsis-causing pathogens in these settings. Colonization with sepsis-causing pathogens precedes invasive infection and is an important step on the causal pathway of neonatal sepsis. Hospital environmental pathogen reservoirs have been identified. Neonates who require prolonged stays are more likely to become colonized, but little is known about transmission of sepsis-causing pathogens. Kangaroo care, or skin to skin contact with a caregiver, is known to protect against sepsis but the mechanism is unknown. Leveraging an existing cohort and biobank, Dr. McGann's research will fill this knowledge gap by identifying factors that promote or protect against neonatal colonization with sepsis-causing pathogens by examining the following exposures: (1) maternal rectovaginal colonization with sepsis-causing pathogens, (2) kangaroo care (day of onset and duration), and (3) proximity to an environmental reservoir of sepsis-causing pathogens. Dr. McGann's K23 proposal addresses a critical gap in knowledge about the mechanisms of neonatal colonization with sepsis-causing pathogens in LMIC. Her findings will provide preliminary data for future R01 proposals aimed at decreasing the risk of neonatal sepsis. Her career development plan outlines a clear path to gain the knowledge, skills and experience needed to gain independence as a global health research scientist and to become a leader in global health neonatology.
