Genomics of MDRO Transmission in Nursing Homes

疗养院 MDRO 传播的基因组学

• 批准号: 10549491
• 负责人: Ashlee Miriam Earl
• 金额: $ 35.56万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-11 至 2028-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10549491
• 关键词: Address; Admission activity; Candida auris; Caring; Circulation; Collection; Communities; Complement; County; Data; Disease Outbreaks; Economics; Ecosystem; Environmental Pollution; Epidemiologic Methods; Epidemiology; Extended-spectrum β-lactamase; Future; Genomics; Goals; Health care facility; Healthcare; Hospitals; Human; Individual; Infection; Infection Control; Infection prevention; Intervention; Logistics; Low Prevalence; Measures; Metagenomics; Modeling; Morbidity - disease rate; Multi-Drug Resistance; Nursing Homes; Organism; Pathway interactions; Pattern; Persons; Prevalence; Prevention; Prospective Studies; Recording of previous events; Resolution; Resources; Retrospective Studies; Risk Factors; Role; Sampling; Site; Source; Surface; Swab; Vancomycin resistant enterococcus; Vancomycin-resistant S. aureus; Vulnerable Populations; Work; carbapenem resistance; connected care; cost effective; epidemiologic data; genomic data; genomic epidemiology; high risk; insight; metagenomic sequencing; methicillin resistant Staphylococcus aureus; microbial; mortality; multi-drug resistant pathogen; multimodality; novel; pathogen; pathogen genomics; prospective; surveillance strategy; transmission process

Abstract Project 2: Evaluating MDRO Transmission Patterns in Nursing Homes Using Pathogen Genomic Data MDRO infections are a major cause of morbidity and mortality for residents in nursing homes (NHs), and these facilities are increasingly recognized as hubs for the rise and spread of MDROs into hospitals and the wider community. Thus, there is an urgent need to be able to sensitively detect, trace and control transmission of MDROs in NHs to limit their impact on residents and the healthcare ecosystem. Despite this need, MDRO dynamics are poorly characterized in this setting. Risk factors for MDRO carriage may not correspond to drivers of MDRO transmission. High pathogen prevalence may be fueled by (i) external importation with admission; (ii) environmental reservoirs; or (iii) inter-person transmission, each requiring distinct measures to reduce pathogen burden. It is also likely that transmission dynamics will differ considerably between organisms, and thus certain interventions may have a differential impact on distinct MDROs. Genomic surveillance of MDROs in NHs is thus urgently needed to complement studies of carriage and prevalence by providing insight into the major drivers of spread within facilities. To address this gap, we will assess the roles of human and environmental pathogen reservoirs contributing to MDRO transmission in nursing homes in order to optimize sampling for genomic surveillance. We will develop integrative models leveraging prospective genomic and epidemiological data from host and environmental sources collected within an optimized multi-modal sampling framework to assess the spread and persistence of MDROs in NHs. Furthermore, we will evaluate commensal organism sharing patterns in NHs using metagenomic sequence data to resolve further microbial transmission networks. As part of a highly integrated framework with the other P01 Projects and Cores, these studies will lead to a more comprehensive view of MDRO transmission patterns in NHs using pathogen genomic data, including a new analytical framework for genomic assessment of endemic pathogen transmission. This work will advance infection prevention and control strategies to detect, trace and eliminate high risk transmission pathways, thus reducing the burden of MDROs in NHs, connected healthcare facilities and the community.

抽象的 项目2：使用病原体基因组数据评估疗养院中的MDRO传播模式 MDRO感染是疗养院（NHS）居民发病率和死亡率的主要原因， 这些设施越来越被公认为是MDROS崛起和传播到医院的枢纽和 更广泛的社区。因此，迫切需要能够敏感地检测，跟踪和控制 MDRO在NHS中的传播以限制其对居民和医疗生态系统的影响。尽管如此 需求，在这种情况下，MDRO动力学的特征很差。 MDRO运输的风险因素可能不会 对应于MDRO传输的驱动因素。高病原体患病率可能会被（i）外部推动 入学进口； （ii）环境水库；或（iii）人际关系传输，每个传输需要 减轻病原体负担的不同措施。传输动态也可能会有所不同 在生物体之间相当大多，因此某些干预措施可能会对不同的不同影响 MDROS。因此，迫切需要对NHS中MDRO的基因组监测来补充运输的研究 并通过深入了解设施内传播的主要驱动力来流行。为了解决这个差距，我们 将评估有助于MDRO传播的人类和环境病原体库的作用 疗养院以优化基因组监测的采样。我们将开发综合模型 利用收集的宿主和环境来源的前瞻性基因组和流行病学数据 在优化的多模式采样框架中，以评估MDROS在NHS中的传播和持久性。 此外，我们将使用元基因组序列评估NHS中的共生生物共享模式 数据以解决进一步的微生物传输网络。作为与另一个高度集成框架的一部分 P01项目和核心，这些研究将导致对MDRO传输模式的更全面的看法 在使用病原体基因组数据的NHS中，包括用于基因组评估的新分析框架 流行病原体传播。这项工作将推动预防感染和控制策略，以检测， 追踪并消除高风险传输途径，从而减轻了NHS中MDRO的负担 医疗机构和社区。