Novel Risk Factors For Vancomycin Resistant Enterococci In Persons With Cancer

癌症患者中万古霉素耐药肠球菌的新危险因素

• 批准号: 8260345
• 负责人: Mini Kamboj
• 金额: $ 13.04万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8260345
• 关键词: Address; Advisory Committees; Affect; Animals; Anti-Bacterial Agents; Antibiotics; Antimicrobial Effect; Antineoplastic Agents; Applications Grants; Biological Assay; Cancer Patient; Caring; Clinical; Clinical Investigator; Clinical Research; Communicable Diseases; Critical Illness; Diagnosis; Diagnostic; Disease; Environment; Failure; Feces; Fluorouracil; Foundations; Genome; Genomics; Goals; Growth; Healthcare; Hematologic Neoplasms; Human; Immunocompromised Host; Immunologic Receptors; In Vitro; Incidence; Individual; Infection; Infection Control; Institution; Laboratories; Malignant Neoplasms; Measures; Medicine; Memorial Sloan-Kettering Cancer Center; Methods; Methotrexate; Microbiological Techniques; Microbiology; Molecular; Morbidity - disease rate; Multi-Drug Resistance; Mus; Natural History; Nosocomial Infections; Organism; Outcome; Pathogenesis; Patients; Persons; Pharmaceutical Preparations; Polymerase Chain Reaction; Population; Predictive Value; Predisposition; Prevalence; Property; Publishing; Regimen; Reporting; Resistance; Resources; Risk; Risk Factors; Role; Series; Supervision; System; Techniques; Technology; Testing; Therapeutic; Time; United States; Vancomycin; Vancomycin resistant enterococcus; Work; antimicrobial; antimicrobial drug; attributable mortality; base; cancer care; cancer therapy; career; chemotherapeutic agent; commensal microbes; density; gastrointestinal; high risk; insight; instructor; methicillin resistant Staphylococcus aureus; microbial; mortality; novel; pathogen; patient oriented; patient population; pressure; professor; programs; transmission process

DESCRIPTION (provided by applicant): This proposal describes a five year program for a clinical research based career in Infectious Diseases. The candidate, Mini Kamboj MD, an Instructor in Medicine and Associate-Director of Hospital Infection Control will conduct the program under the supervision of Dr. Kent Sepkowitz, Professor of Medicine, and Director of the Infection Control Program at Memorial Sloan-Kettering Cancer Center (MSKCC), to study the role of novel risk factors for a multi-drug resistant organism (MDRO) Vancomycin resistant enterococcus (VRE).These infections are more common in persons with cancer and result in devastating outcomes and greater resource utilization. The study will be conducted at MSKCC, one of the largest programs of clinical research in the world. The candidate has enlisted an advisory committee of esteemed leaders in the field of microbial pathogenesis, infection control and genome based testing for guidance and advice during this program. The proposal is guided by the hypothesis that many anti-cancer drugs have anti microbial properties and therefore are likely to influence gastrointestinal flora including the microbial burden (density) of VRE. We also hypothesize that a change in density of VRE in turn has an effect on clinical outcome. To examine this hypothesis we propose to (1)Determine VRE density in stool in 50 cancer patients at MSKCC using a new quantitative PCR assay and standard microbiologic techniques (2) Determine the effect of commonly used chemotherapeutic agents with strong antimicrobial activity, (5-Fluorouracil and Methotrexate) upon density of VRE among colonized individuals. (3) Determine the predictive value of VRE density determined by standard techniques and quantitative PCR on clinical outcome, including mortality and resource utilization, among patients with cancer at highest risk for invasive VRE disease. The candidate's immediate goal is to develop into an independent clinical investigator in patient-oriented clinical research with a focus on hospital acquired infections in persons with cancer and long term goal is to implement studies on devising and testing therapeutic approaches including decolonizing and other control strategies for MDRO's that are common in the cancer population. Hospital-acquired infections are a major cause of morbidity and mortality in persons with cancer. In this population, colonization and infection with vancomycin-resistant enterococci are more common. The studies in this proposal will provide novel insight into common but previously unrecognized risk factors for VRE in persons with cancer and provide a basis for devising and testing control strategies against this multi-drug resistant organism.

描述（由申请人提供）：该提案描述了一项为基于临床研究的传染病职业的五年计划。候选人Mini Kamboj MD，医学教练和医院感染控制副导演将在肯特·塞普科维茨（Kent Sepkowitz）博士，医学教授兼纪念斯隆 - 凯特凯特林癌症中心（MSKCC）的感染控制计划主任的监督下进行该计划，以研究多种抗药性有机体（MSKCC）的新风险因素（MSKCC）（MSKCC）（MSKCC）的作用。 （VRE）。这些感染在癌症患者中更为常见，并导致毁灭性的结果和更多的资源利用。该研究将在世界上最大的临床研究计划之一MSKCC进行。该候选人已在该计划期间，在微生物发病机理，感染控制和基于基因组的指导和建议的测试中，邀请了受人尊敬的领导人的咨询委员会。该提案的指导是以下假设：许多抗癌药具有抗微生物特性，因此很可能会影响包括VRE的微生物负担（密度）的胃肠道菌群。我们还假设，VRE密度的变化反过来会影响临床结果。为了检查这一假设，我们建议（1）使用新的定量PCR测定法和标准微生物技术（2）确定50名癌症患者的粪便密度（2）确定具有强抗菌活性的常用化学治疗剂的影响（5-氟尿酸氨酸和甲基甲醇）对vre n n n e n e n necor的效果。 （3）确定通过标准技术确定的VRE密度的预测价值和对临床结果的定量PCR，包括死亡率和资源利用率，在患有侵入性VRE疾病风险最高的癌症患者中。候选人的近期目标是发展为以患者为导向的临床研究的独立临床研究者，重点是在患有癌症患者的医院获得的感染，长期目标是实施有关设计和测试治疗方法的研究，包括非殖民化和其他控制MDRO的控制策略在癌症中很常见。 医院可获得的感染是癌症患者发病和死亡率的主要原因。在这种人群中，抗性霉素肠球菌的定殖和感染更为常见。该提案中的研究将提供对癌症患者中VRE的常见但未认识到的风险因素的新颖见解，并为针对这种多药耐药的生物制定和测试控制策略提供了基础。