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 (NH) 居民发病和死亡的主要原因， 这些设施越来越被认为是多重耐药菌在医院和医院中兴起和传播的中心。 更广泛的社区。因此，迫切需要能够灵敏地检测、追踪和控制 防止多重耐药菌在新罕布什尔州传播，以限制其对居民和医疗生态系统的影响。尽管如此 需要，MDRO 动态在这种情况下的特征很差。 MDRO携带的风险因素可能不会 对应MDRO传输的驱动程序。病原体高流行可能是由于 (i) 外部因素 进口与入场； (二) 环境水库； (iii) 人际传播，每项都要求 减少病原体负担的独特措施。传输动态也可能会有所不同 生物体之间差异很大，因此某些干预措施可能对不同的生物体产生不同的影响 MDRO。因此，迫切需要对 NH 中的 MDRO 进行基因组监测，以补充携带研究 通过深入了解设施内传播的主要驱动因素来了解流行情况。为了解决这一差距，我们 将评估人类和环境病原体储存库在MDRO传播中的作用 疗养院，以优化基因组监测采样。我们将开发综合模型 利用从宿主和环境来源收集的前瞻性基因组和流行病学数据 在优化的多模式抽样框架内评估多重耐药菌在新罕布什尔州的传播和持久性。 此外，我们将使用宏基因组序列评估 NH 中的共生生物共享模式 数据来解决进一步的微生物传播网络。作为与其他框架高度集成的一部分 P01 项目和核心，这些研究将带来对 MDRO 传播模式的更全面的了解 在NHs中使用病原体基因组数据，包括用于基因组评估的新分析框架 地方性病原体传播。这项工作将推进感染预防和控制策略，以检测、 追踪并消除高风险传播途径，从而减轻国家医疗机构中多重耐药菌的负担， 医疗机构和社区。