Impact of Pandemic Mitigation Efforts on Colonization and Transmission of Respiratory Pathogens and Antibiotic Resistance Genes

流行病缓解措施对呼吸道病原体和抗生素抗性基因定植和传播的影响

• 批准号: 10510137
• 负责人: CARLOS G GRIJALVA
• 金额: $ 25.95万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-08 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10510137
• 关键词: 2019-nCoV; Acute; Address; Adenoviruses; Adult; Antibiotic Resistance; Antibiotic Therapy; Bacteria; COVID-19 pandemic; Calendar; Child; Clinical; Detection; Development; Disease; Dwarfism; Effectiveness; Exhibits; Face; Gene Exchanges; Home; Household; Human; Infection; Influenza; Interruption; Measurement; Measures; Mobile Genetic Elements; Modeling; Monitor; Nasopharynx; Nature; Organism; Pathogenesis; Pathogenicity; Pattern; Peru; Pneumococcal Colonization; Pneumonia; Prevention strategy; Process; Recommendation; Respiratory Signs and Symptoms; Respiratory Tract Infections; Respiratory syncytial virus; Rhinovirus; Risk; SARS-CoV-2 transmission; Sampling; Schools; Staphylococcus aureus; Streptococcus pneumoniae; Symptoms; Testing; Time; Vaccination; Vaccines; Viral Respiratory Tract Infection; Virus Diseases; Visit; base; clinically relevant; community transmission; human coronavirus; member; pandemic disease; pathogen; prospective; resistance gene; respiratory; respiratory colonization; respiratory pathogen; respiratory virus; success; surveillance data; transmission process; vaccine development

ABSTRACT Nasopharyngeal (NP) colonization with commensal and pathogenic organisms is common and a dynamic process. While these dynamics typically occur in the healthy state, many respiratory viruses and colonizing bacteria are important causes of acute respiratory illness (ARI) and invasive disease. Respiratory viruses and bacteria also exhibit interactions that are important in ARI pathogenesis. The initial period shortly after acquisition of respiratory bacteria or infection with respiratory viruses is particularly critical, imparting an increase in ARI risk. S. pneumoniae, S. aureus, and other colonizing bacteria also commonly express antibiotic resistance genes that may be transferred or exchanged between co-colonizing organisms. Broad mitigation strategies were implemented for SARS-CoV-2 pandemic control in many settings, including use of face coverings, stay-at-home orders, and school closures. Collectively, these efforts were associated with reduced community transmission of SARS-CoV-2. In addition, ecologic studies during these periods also demonstrated interruptions in influenza, respiratory syncytial virus, and S. pneumoniae disease activity that were very substantial, dwarfing the success of existing preventive strategies, including vaccines, which are available against only few respiratory pathogens and limited in their scope and effectiveness. Understanding the impact of mitigation strategies on the activity of colonizing respiratory pathogens beyond SARS-CoV-2 would inform efforts to understand infection dynamics and reduce the burden of these common yet currently unpreventable infections. We conducted intensive household-based ARI surveillance in Lima, Peru during the same period in two consecutive years: 2019, just prior to the COVID-19 pandemic, and 2020, during peak SARS-CoV-2 activity. We aim to leverage this unique platform to characterize patterns of household acquisition and infection with respiratory pathogens during periods with and without mitigation strategies through the conduct of two Specific Aims: 1) To test the hypothesis that mitigation strategies are associated with a) fewer acquisitions of colonizing respiratory bacteria, b) fewer infections with respiratory viruses, shorter durations of colonization/detections, and reduced transmission of these pathogens among children and adults in households in semi-urban Peru, and 2) To test the hypothesis that mitigation strategies are associated with fewer acquisitions, shorter duration of detection, and reduced household transmission of nasopharyngeal antibiotic resistance genes among children and adults in households in semi-urban Peru. A detailed understanding of the impact of these mitigation strategies on the dynamics of colonization with clinically relevant respiratory pathogens may inform targeted applications to reduce the global impact of ARI and pneumonia, particularly for infections that are not yet vaccine-preventable.

抽象的 共生生物和病原生物在鼻咽 (NP) 定植很常见，并且 动态过程。虽然这些动态通常发生在健康状态下，但许多呼吸道病毒和 定植细菌是急性呼吸道疾病 (ARI) 和侵袭性疾病的重要原因。呼吸系统 病毒和细菌也表现出在 ARI 发病机制中很重要的相互作用。初期不久 在获得呼吸道细菌或感染呼吸道病毒后尤为重要， ARI 风险增加。肺炎链球菌、金黄色葡萄球菌和其他定植细菌也通常表达抗生素 抗性基因可以在共定殖生物体之间转移或交换。 在许多情况下，为控制 SARS-CoV-2 大流行实施了广泛的缓解策略， 包括使用面罩、居家令和学校停课。总的来说，这些努力是 与 SARS-CoV-2 社区传播减少有关。此外，这些时期的生态学研究 期间还表现出流感、呼吸道合胞病毒和肺炎链球菌疾病的中断 活动规模非常大，使包括疫苗在内的现有预防战略的成功相形见绌， 这些药物只能针对少数呼吸道病原体，并且其范围和有效性有限。 了解缓解策略对呼吸道病原体定植活动的影响 SARS-CoV-2 将为了解感染动态并减轻这些常见疾病的负担提供信息 但目前无法预防的感染。 我们在两个时期的同一时期在秘鲁利马进行了密集的家庭 ARI 监测 连续几年：2019 年，即 COVID-19 大流行之前，以及 2020 年，在 SARS-CoV-2 活动高峰期。 我们的目标是利用这个独特的平台来描述家庭感染和感染的模式 在有或没有缓解策略期间，通过进行两种特定的措施来控制呼吸道病原体 目标： 1) 检验缓解策略与以下因素相关的假设：a) 减少殖民获取 呼吸道细菌，b) 呼吸道病毒感染较少，定植/检测持续时间较短， 并减少了这些病原体在秘鲁半城市家庭中儿童和成人之间的传播， 2) 检验缓解策略与更少的收购、更短的持续时间相关的假设 检测，并减少鼻咽部抗生素抗性基因的家庭传播 秘鲁半城市家庭中的儿童和成人。详细了解这些影响 临床相关呼吸道病原体定植动态的缓解策略可能会提供信息 有针对性的应用程序，以减少急性呼吸道感染和肺炎的全球影响，特别是非传染性疾病 但可以通过疫苗预防。