P01 Administrative Core

摘要(管理核心) 20世纪30年代至40年代抗生素的临床引入代表了一项重大的医学突破，使许多 现代医学、农业和工业实践的进步。不幸的是，抗生素耐药性的上升 全球微生物现在被认为是21世纪最具挑战性的公共卫生威胁之一。 呼吁采取行动应对抗生素耐药性威胁的呼声现在已经到达了政府的最高层 包括美国总统办公室(成立了总统打击问题咨询委员会 抗生素抗药性细菌)和联合国全球行动倡议等。 耐万古霉素肠球菌、携带超广谱β-内酰胺酶的肠杆菌科细菌和 碳青霉烯酶(ESBL-E/CRE)和艰难梭菌对于高危患者尤其令人担忧 免疫功能受损和/或住进重症监护病房(ICU)的患者。有可能导致生命- 有危险的感染，特别是那些已经接受过多种抗生素治疗的患者 方案中，这些微生物中的每一个都在肠道中定居，它们的存在会影响随后的定居。 由其他病原体进一步促进这些高危人群的严重疾病进展甚至死亡 病人。虽然这些病原体已经被孤立地研究过，但动态相互作用的阐明 病原体和共生肠道微生物区系之间的关系及其对预测结果的意义， 因此，治疗战略比以往任何时候都更加紧迫，需要战略性的协调努力。得克萨斯州 德克萨斯州休斯顿的医疗中心是几家抗菌素耐药性研究和研究的世界领先者的所在地 与患者接触的临床实践以及尖端基因组和表型方面的丰富专业知识 具有独特地位的技术，可执行协调和协同的系统层面的研究 必须理解的多个参与者才能应对这一挑战。这些专家已经认识到了这一点 非同寻常的机会和力量，通过形成 多机构合作研究项目多药定植和感染的动力学- 免疫功能低下和危重患者的耐药病原体(炸药)。这对美国的 这一多机构研究工作的有效性，是专门的集中行政监督和 支持。行政核心将作为项目监督、问责、 三个项目和功能基因组核心的沟通和项目/进程协调。至 为了实现这些目标，行政核心将通过以下方式提供综合问责和监督 行政领导小组和内部和外部咨询委员会，并为 所有项目负责人、研究人员、主要合作者和顾问以及机构行政联络人。

ABSTRACT (Administrative Core) The clinical introduction of antibiotics in 1930s-40s represented a major medical breakthrough enabling many advances in modern medicine, agriculture and industrial practice. Unfortunately, the rise of antibiotic-resistant microorganisms globally is now considered one of the most challenging public health threats of the 21st century. The call for action against the threat of antibiotic resistance has now reached the highest level of government including the Office of the US President (with the creation of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria) and the initiative for global action by the United Nations, among others. Vancomycin-resistant enterococci (VRE), Enterobacteriaceae carrying extended spectrum β-lactamases and carbapenemases (ESBL-E/CRE), and Clostridiodes difficile are particularly concerning for high-risk patients who are immunocompromised and/or admitted to intensive care units (ICUs). Having the potential to cause life- threatening infections, particularly in those patients who have already been subjected to multiple antibiotic regimens, each of these organisms colonize the intestines, and their presence impacts subsequent colonization by other pathogens further contributing to serious disease progression and even mortality in these high-risk patients. Although these pathogens have been studied in isolation, elucidation of the dynamic interactions between pathogens and commensal gut microbiota and their implication for predicting outcomes and, thus, treatment strategies is more urgent than ever and requires a strategic, coordinated effort. The Texas Medical Center in Houston, Texas is home to several world leaders in antimicrobial resistance research and clinical practice with patient access and tremendous expertise in the cutting-edge genomic and phenotypic techniques who are uniquely positioned to perform concerted and synergistic systems-level studies of the multiple players that must be understood to address this challenge. These experts have recognized this exceptional opportunity and the strength of addressing the critical and unmet challenge through the formation of a multi-institutional collaborative research program Dynamics of Colonization and Infection by Multidrug- Resistant Pathogens in Immunocompromised and Critically Ill Patients (DYNAMITE). Crucial for the effectiveness of this multi-institutional research effort, is dedicated centralized administrative oversight and support. The Administrative Core will serve as the central “hub” for program oversight, accountability, communication, and project/process coordination for the three Projects and the Functional Genomics Core. To achieve these goals, the Administrative Core will provide integrative accountability and oversight through the Executive Leadership Team and the Internal and External Advisory Committees, and administrative support for all project leaders, research personnel, key collaborators and advisors, and institutional administrative liaisons.