Combatting AntiMicrobial Resistance in Africa Using Data Science (CAMRA)

利用数据科学对抗非洲的抗菌素耐药性 (CAMRA)

• 批准号: 10490849
• 负责人: Derrick E Fouts
• 金额: $ 119.88万
• 依托单位: REDEEMER'S UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10490849
• 关键词: Acute; Address; Africa; African; Aminoglycosides; Ampicillin Resistance; Antibiotics; Antimicrobial Resistance; Archives; Area; Awareness; Bacteria; Bacterial Infections; Bacterial Proteins; Bioinformatics; Biomedical Engineering; Blood; Blood Circulation; Caring; Case Fatality Rates; Cause of Death; Child; Chloramphenicol; Clinical; Collection; Communities; Comparative Study; Complex; Country; Dangerousness; Data; Data Science; Demographic and Health Surveys; Diagnostic; Diagnostic Services; Diarrhea; Disease Outbreaks; Enrollment; Enterobacteriaceae; Etiology; Evaluation; Extended-spectrum β-lactamase; Genomics; Genotype; Geography; Goals; Growth; Healthcare; High Prevalence; Human; Human Development; Human Resources; Incubators; Individual; Infection; Knowledge; Laboratories; Live Birth; Maternal Mortality; Microbe; Microbiology; Molecular; Molecular Epidemiology; Morbidity - disease rate; Multi-Drug Resistance; Multiple Bacterial Drug Resistance; Newborn Infant; Nigeria; Nigerian; Pathway interactions; Periodicity; Pharmacy facility; Phenotype; Pneumonia; Population; Prevalence; Prevention strategy; Program Development; Research Proposals; Resource-limited setting; Rwanda; Salmonella typhi; Scientist; Screening procedure; Sentinel; Sepsis; Site; Sputum; Stream; Syndrome; Tobramycin; Training; Treatment Efficacy; Trimethoprim-Sulfamethoxazole; United Nations; Urine; Veterinarians; War; Woman; age group; aged; antimicrobial; antimicrobial peptide; bacterial resistance; bactericide; carbapenem resistance; clinical care; clinical epidemiology; comparative; health care service; indexing; inflammatory marker; mortality; multidisciplinary; novel; pathogenic bacteria; portability; programs; resistance gene; resistant Klebsiella pneumoniae; transmission process; trend

Bacterial infections are highly prevalent and contribute significantly to morbidity and mortality across all age-groups but because appropriate microbiologic diagnostic services are non- existent or very limited, ascertaining the specific etiologic agents and the true prevalence of antimicrobial resistance (AMR) is a major challenge in Africa, where objective data is limited. Preliminary observations from Nigeria, the most populous country in Africa include the following; a) High prevalence of Salmonella enterica serovar Typhi (S. Typhi) with 45% prevalence of multidrug resistance, b) High prevalence of Extended Spectrum β-Lactamase- producing Enterobacteriaceae (ESBL-E) blood stream infections, c) Maternal colonization by ESBL-E in women at delivery is associated with high all-cause morbidity and mortality in their newborn babies compared to ESBL-unexposed babies and d) Periodic outbreaks of carbapenem-resistant Klebsiella pneumoniae sepsis in newborn units with case fatality rates as high as 45%. We have preliminary molecular characterization of about 500 of the 2,750 diverse bloodstream bacterial isolates in our collection. In addition, we have access to a collection of over 2,500 clinical isolates of blood, sputum and urine from our sentinel laboratories in Nigeria and Rwanda that are partially characterized. Our unique observations related to AMR genes that we have identified in our archived isolates form the basis for this research proposal. Our overall strategy in this application focuses on three thematic areas: 1). Comparative phenotypic and genotypic studies of archived and contemporary clinical isolates to inform trends in AMR and dynamics of transmission. 2) Incorporation of acute inflammatory markers of serious bacterial infection and gene products from resistant bacteria into a portable screening tool for clinical care and 3). Explore the potential benefit of an aminoglycoside (Tobramycin) conjugated to an antimicrobial peptide for enhanced bactericidal activity against multi-drug resistant enterobacteriales. We have assembled a multidisciplinary team of clinical and molecular microbiologists, clinicians, biomedical engineers, environmental microbiologists, veterinarians, and industrialists to implement this project in Nigeria, West Africa and also Rwanda, East Africa to provide data with geographic representation for Africa. Upon successful completion of this program, we would have utilized the data science platform for bacteria genomics and antimicrobial resistance to raise awareness on the scope of AMR in Africa, provide novel pathways for optimizing empiric use of antibiotics and trained a handful of young African scientists in bacterial genomics and bioinformatics.

细菌感染高度流行，并显着促进发病率和死亡率 在所有年龄组中，但由于适当的微生物诊断服务是非 存在或非常有限，确定特定的病因学和真正的流行率 抗菌耐药性（AMR）是非洲的主要挑战，在非洲，客观数据受到限制。 来自尼日利亚的初步观察，非洲人口最多的国家包括 下列的; a）肠沙门氏菌血清鼠伤寒的高患病率（typhi）为45％ 多药电阻的患病率，b）扩展频谱β-内酰胺酶的高流行率 产生肠杆菌科（ESBL-E）血流感染，c）通过 交付时女性的ESBL-E与她们的全因发病率和死亡率高有关 与ESBL无暴露的婴儿相比，新生婴儿和D）定期暴发 新生单元中抗碳青霉烯氏菌肺炎肺炎败血症，病例死亡率为 高达45％。我们的初步分子表征约为2,750潜水员中的500个 我们收藏中的血液细菌分离株。此外，我们还可以访问 来自我们尼日利亚的前哨实验室的血液，痰液和尿液的临床分离株超过2500个 和部分特征的卢旺达。我们与AMR基因有关的独特观察 我们在存档的分离株中确定的是该研究建议的基础。我们的 该应用程序中的总体策略侧重于三个主题领域：1）。比较 存档和现代临床分离株的表型和基因型研究，以告知趋势 在AMR和传输动力学中。 2）掺入急性炎症标记 严重的细菌感染和从抗性细菌到便携式筛查的基因产物 临床护理工具和3）。探索氨基糖苷（毒素）的潜在益处 与抗菌胡椒相结合，以增强对多药的细菌活性 抗性肠杆菌。我们已经组建了一个临床的多学科团队 分子微生物学家，临床医生，生物医学工程师，环境微生物学家， 兽医和工业家在尼日利亚，西非以及 东非卢旺达为非洲提供地理代表的数据。成功 完成该计划的完成，我们将利用细菌的数据科学平台 基因组学和抗菌素抵抗，以提高对非洲AMR范围的认识， 提供新的途径来优化抗生素的经验使用并训练了少数年轻人 细菌基因组学和生物信息学的非洲科学家。