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: 10641008
• 负责人: CARLOS G GRIJALVA
• 金额: $ 21.63万
• 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/10641008
• 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; Licensing; 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; Social Distance; Staphylococcus aureus; Streptococcus pneumoniae; Symptoms; Testing; Time; Vaccination; Vaccines; Viral Respiratory Tract Infection; Virus Diseases; Visit; clinically relevant; community transmission; human coronavirus; member; pandemic impact; pandemic response; pathogen; prospective; resistance gene; respiratory; respiratory pathogen; respiratory virus; school closure; stay-at-home order; 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 具有共生和致病生物的鼻咽（NP）定植是常见的，A 动态过程。尽管这些动态通常发生在健康状态，但许多呼吸道病毒和 定植细菌是急性呼吸系统疾病（ARI）和侵入性疾病的重要原因。呼吸道 病毒和细菌还表现出在ARI发病机理中很重要的相互作用。最初的时间很快 在获取呼吸道细菌或用呼吸道病毒感染后，特别关键 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 可以在共殖化生物之间转移或交换的抗性基因。 在许多情况下，针对SARS-COV-2大流行控制实施了广泛的缓解策略， 包括使用面部覆盖物，全职订单和学校关闭。总的来说，这些努力是 与SARS-COV-2的社区传播减少有关。此外，在这些过程中 时期还表明流感，呼吸道合胞病毒和肺炎链球菌的中断 活动非常实质，使​​现有预防策略的成功相形见var，包括疫苗， 仅与少数呼吸道病原体可用，并且其范围和有效性有限。 了解缓解策略对殖民呼吸道病原体活动的影响 SARS-COV-2将为理解感染动态的努力提供信息，并减轻这些常见的负担 目前目前无法预防的感染。 我们在同一时期在秘鲁利马进行了密集的家庭ARI监视 连续几年：2019年，在COVID-19-19大流行之前和2020年，在SARS-COV-2活性期间。 我们旨在利用这个独特的平台来表征家庭获取和感染模式 通过进行两种特定的特定时期，在有或没有缓解策略的期间呼吸道病原体 目的：1）检验缓解策略与a）殖民殖民较少相关的假设 呼吸道细菌，b）呼吸道病毒感染较少，定殖/检测持续时间较短， 并减少了这些病原体在秘鲁半城市的家庭中的儿童和成人中的传播， 2）测试缓解策略与较少的获取相关的假设，持续时间较短 检测和鼻咽抗生素抗性基因的家庭传播减少 秘鲁半城市家庭的儿童和成人。对这些影响的详细理解 与临床相关的呼吸道病原体有关殖民动力学动态的缓解策略可能会告知 有针对性的应用程序来减少ARI和肺炎的全球影响，特别是对于不是 但可预防疫苗。