Prevention of Infection in Indian Neonates

印度新生儿感染的预防

• 批准号: 6908162
• 负责人: PINAKI PANIGRAHI
• 金额: $ 26.75万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-03 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6908162
• 关键词: India; Klebsiella; Staphylococcus aureus; antibiotics; bacterial disease; bacterial pneumonia; blood; blood toxicology; chemoprevention; clinical research; community; computer data analysis; cooperative study; data collection methodology /evaluation; disease /disorder prevention /control; disease /disorder proneness /risk; disinfectants; drug resistance; epidemiology; hospitals; human subject; infant mortality; newborn human (0-6 weeks); rural area; skin; tissue /cell culture

DESCRIPTION (Provided by applicant): India, with one of the world's largest populations, continues to struggle with extremely high infant and neonatal mortality rates. Sepsis now accounts for 50% of deaths among community-born (and 20% of mortality among hospital-born) infants. Closely linked with this is a burgeoning problem with antimicrobial resistance, which is increasingly restricting the therapeutic options for medical care providers. To deal with these critical issues, the investigators propose to establish a Research Unit for the study of MCH in India, based on strong, existing collaborations between investigators in the Department of Pediatrics and Epidemiology and Preventive Medicine at the UMSM, Baltimore, and the AIIMS, New Delhi, and hospitals and the Ministry of Health in the state of Orissa, India. The applicant will initially develop an infrastructure to monitor occurrence of neonatal sepsis in community- and hospital-born infants. This will include: 1) identification of all hospitalized children, and children brought to hospital, with the diagnosis of sepsis; 2) obtaining blood cultures from these children; 3) screening of all bacterial strains isolated from blood cultures for antimicrobial resistance; 4) collecting basic demographic, risk factor, and treatment data on each case; and 5) development of a computer-based system and network for data management. In villages of Orissa State, the applicants will set up a village-level surveillance system to identify women during their pregnancy, monitor pregnancy outcomes, and establish a mechanism for referral of all potentially septic infants to participating clinics or hospitals for evaluation, including collection of blood cultures. Subsequent studies will identify potential sources of bacterial isolates causing sepsis. To this end, the applicants will screen skin, nares, and stool cultures from infants (and skin, nares, and vaginal cultures from their mothers), and seek to match blood isolates with these colonizing isolates, using molecular epidemiologic techniques. In the latter years of the grant period, and with these data collection systems in place, the applicants will initiate a series of interventions, including implementation of a hospital- and community-based system of "preferred" antimicrobials, use of probiotics to reduce the risk of neonatal sepsis, and implement alcohol-based hand-washing products in hospital and community-based healthcare settings to minimize pathogen transmission.

描述（由申请人提供）：印度，是世界上最大的 人口，继续与极高的婴儿和新生儿斗争 死亡率。败血症现在占社区出生死亡的50％ （在医院出生中死亡的20％）婴儿。与此密切相关 是抗菌素耐药性的新兴问题，这越来越多 限制医疗服务提供者的治疗选择。处理 这些关键问题，调查人员建议建立一个研究部门 对于印度MCH的研究，基于强大的现有合作 儿科和流行病学系的调查人员与 UMSM，巴尔的摩和AIIMS，新德里和 医院和印度奥里萨邦的卫生部。这 申请人最初将开发一个基础架构，以监视 在社区和医院出生的婴儿中新生儿败血症。这将包括： 1）确定所有住院儿童，并带到 医院，并诊断为败血症； 2）从中获得血液培养 孩子们; 3）筛选从血液培养物中分离出的所有细菌菌株 用于抗菌耐药性； 4）收集基本人口统计学，风险因素， 和每种情况上的治疗数据； 5）开发基于计算机的系统 和数据管理网络。在奥里萨邦的村庄，申请人 将建立一个乡村级的监视系统，以识别女性 怀孕，监测怀孕结果，并建立转诊的机制 在所有潜在的化粪池婴儿中，参与诊所或医院 评估，包括血液培养物的收集。随后的研究将 确定引起败血症的细菌分离株的潜在来源。为此， 申请人将筛查婴儿的皮肤，鼻孔和粪便培养物（以及 皮肤，鼻腔和阴道培养的母亲），并寻求匹配血液 使用分子流行病学的分离株与这些定植分离株 技术。在赠款期的后期以及这些数据 收集系统到位，申请人将启动一系列 干预措施，包括实施医院和社区 “首选”抗菌剂的系统，使用益生菌来降低 新生儿败血症，并在医院实施基于酒精的洗手产品 和基于社区的医疗机构，以最大程度地减少病原体的传播。