Enhancing surveillance systems to slow the spread of antimicrobial-resistant gonorrhea in the United States

加强监测系统以减缓抗菌药物耐药性淋病在美国的传播

• 批准号: 10200650
• 负责人: Reza YAESOUBI
• 金额: $ 41.67万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-23 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10200650
• 关键词: Address; Anatomy; Antibiotic Resistance; Antibiotic Therapy; Antibiotics; Antimicrobial Resistance; Area; Behavior; Case Study; Centers for Disease Control and Prevention (U.S.); Cities; Clinic; Clinical; Computer Simulation; Data; Diagnosis; Disease; Ensure; Evolution; Geographic Locations; Goals; Gonorrhea; Guidelines; HIV; High Prevalence; Incidence; Individual; Infection; Investigation; Lead; Longevity; Mathematics; Measures; Methods; Modeling; Monitor; Names; Neisseria gonorrhoeae; Outcome; Performance; Pharmaceutical Preparations; Pharyngeal structure; Policy Maker; Population; Predisposition; Prevalence; Public Health; Quality-Adjusted Life Years; Recommendation; Rectum; Research; Resistance; Resistance development; Resources; Risk; Sampling; Science; Sentinel Surveillance; Sexually Transmitted Diseases; Site; Specimen; Surveys; System; Testing; Time; United States; Urethra; Woman; World Health Organization; base; combat; cost; cost effective; cost effectiveness; cost estimate; cost-effectiveness evaluation; drug testing; drug-resistant gonorrhea; economic evaluation; health economics; men; men who have sex with men; metropolitan; models and simulation; premature; sex; success; surveillance network; surveillance strategy; tool; transmission process; trend

PROJECT SUMMARY/ABSTRACT Gonorrhea is the second most common notifiable disease in the United States with 555,608 cases reported in 2017. In recognition of the high prevalence of gonorrhea and increasing antibiotic resistance, in 2013, the U.S. Centers for Disease Control and Prevention named antimicrobial-resistant (AMR) gonorrhea among the three most urgent infection threats in the United States. The continued evolution of AMR gonorrhea highlights the importance of surveillance systems that provide timely and accurate data to inform public health strategies to combat the spread of AMR gonorrhea. In this context, important questions remain on how best to configure a surveillance system: Where should the surveillance sites be located? How many isolates should be tested for drug susceptibility among risk groups, such as men who have sex with men, men who have sex with women, and women? How should sampling be distributed among the anatomical sites of infection (urethra, rectum, and/or pharynx)? This proposal describes a rigorous, simulation model-based investigation to evaluate strategies for the surveillance of AMR gonorrhea in the United States. Toward this goal, we will develop a simulation model of gonorrhea transmission in the 50 most populous metropolitan areas in the United States. The model will allow us to enumerate several performance measures including: 1) the clinically-effective lifespan of antibiotics, 2) the incidence of drug-susceptible and AMR gonorrhea, and 3) the overall cost of surveillance, diagnosis, and treatment of gonorrhea. We will use this model to project the impact of various strategies for the surveillance of AMR gonorrhea on these performance measures. This study will provide essential information to help policy makers identify strategies for the surveillance of AMR gonorrhea that are both cost-effective and expected to extend the clinically-effective lifespan of antibiotics. To ensure the successful completion of these aims, we have assembled a team of experts in gonococcal antimicrobial resistance, mathematical and computer simulation modeling, decision science, and health economics who are committed to working together to slow the spread of AMR gonorrhea in the United States by identifying strategies to optimize the surveillance of AMR gonorrhea.

项目概要/摘要 淋病是美国第二大常见的法定传染病，2017 年报告了 555,608 例病例。 2017 年。由于认识到淋病的高患病率和抗生素耐药性的增加，2013 年，美国 疾病控制和预防中心将抗菌素耐药性 (AMR) 淋病列为三类疾病之一 美国最紧迫的感染威胁。 AMR 淋病的持续演变凸显了 监测系统提供及时、准确的数据以告知公共卫生战略的重要性 对抗 AMR 淋病的传播。在这种情况下，重要的问题仍然是如何最好地配置 监控系统：监控点应该位于哪里？应测试多少分离株 危险人群中的药物敏感性，例如男男性行为者、男同性恋者、 和女人？应如何在感染的解剖部位（尿道、直肠、 和/或咽）？该提案描述了一项严格的、基于模拟模型的调查来评估 美国 AMR 淋病监测策略。为了这个目标，我们将开发一个 美国 50 个人口最多的大都市区的淋病传播模拟模型。 该模型将使我们能够列举几个性能指标，包括：1）临床有效的 抗生素的使用寿命，2) 药物敏感和 AMR 淋病的发病率，以及 3) 抗生素的总体成本 淋病的监测、诊断和治疗。我们将使用这个模型来预测各种影响 根据这些绩效指标制定 AMR 淋病监测策略。这项研究将提供 帮助政策制定者确定 AMR 淋病监测策略的重要信息 既具有成本效益，又有望延长抗生素的临床有效寿命。为确保 为了成功实现这些目标，我们组建了淋菌抗菌药物专家团队 阻力、数学和计算机模拟建模、决策科学和健康经济学 致力于共同努力，通过识别来减缓 AMR 淋病在美国的传播 优化 AMR 淋病监测的策略。