Thursday, April 25, 2024
4/25/2024
Abstract: Component 1 Strategy 2 Background: Carbapenem-resistant organisms (CRO) may pose the greatest antimicrobial resistance (AMR) threat as they result in high mortality rates (>60%) and are easily transmitted between patients in healthcare settings. CRO colonization increases the risk of infection and nosocomial spread. The prevalence of CRO in India (~36-46%) far exceeds the US (2%). Empowering microbiology laboratories and infection control teams to identify, detect, and contain CRO in healthcare settings is critical to reduce the spread of CRO. Purpose: The project seeks to introduce in 5 hospitals active and passive surveillance for CRO, including those with rare resistance mechanisms or limited treatment options paired with enhanced infection prevention and control (IPC) to reduce CRO burden. Outcomes: Outcomes include determining the prevalence and mechanism of CRO infection and colonization, building bacteriology capacity to characterize CRO, determining the acquisition rate of CRO colonization, investigating CRO with rare mechanisms of resistance, identifying CRO nosocomial transmission, and implementing enhanced IPC practices. Strategies and Activities: Each hospital will implement passive and active surveillance, case investigation, and enhanced IPC. Passive surveillance will identify carbapenemase production. Active surveillance will collect rectal samples in select wards with selective culture for CRO. Case investigation will be pursued for CRO with rare resistance mechanisms and CROs present in suspected clusters of infection. Enhanced IPC will draw from a toolbox of activities aimed to prevent and contain CRO. Collaborations/Organizational Capacity: The network will support surveillance and IPC at 5 hospitals in India including 1 designated as a reference lab and a network coordination center. The reference lab will be located at Hinduja Hospital in Mumbai, which already serves as one of the leading bacteriology labs in India. Network sites participate in surveillance networks run by Government of India programs. Abstract: Component 2, Strategy 1 Background: Neonatal bloodstream infection (BSI) with Gram-negative (GN) organisms are a leading cause of early childhood mortality. Common Extended-Spectrum Cephalosporin resistance (ESCr) complicates GN BSI treatment in India. Our prior CDC-supported cohort study enrolled >1000 pregnant women and collected maternal, neonatal, and environmental samples to ascertain the role of maternal and environmental colonization in neonatal GN BSI. The maternal and infant microbiome also contribute to enteric colonization and subsequent invasive infection. Purpose: Using a biorepository of maternal and neonatal samples, we propose a case-control study to explore the association between maternal neonatal colonization and ESCr GN BSI as well as the role of the maternal and neonatal microbiome in colonization and BSI risk. Outcomes: We will assess the impact of maternal, neonatal, and environmental ESCr GN colonization on neonatal BSI risk. We will determine the association of maternal gut, maternal vaginal, and neonatal gut microbiome composition with neonatal colonization with ESCr GN organisms and neonatal BSI. Strategies and Activities: We will conduct a matched case-control study to test the association of ESCr GN organisms in previously collected maternal rectal, maternal vaginal, neonatal rectal, and sink trap samples with subsequent BSI. We will also assess microbiome composition, function, and presence of genes conveying drug resistance using metagenomic next-generation sequencing. Collaborations/Organizational Capacity: Pursuit of this project will expand bacteriology capacity at Byramjee Jeejeebhoy Government Medical College in Pune, India. Engagement with other clinician and government stakeholders will seek to maximize the impact of the findings generated by this project.
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).
