POR and Training Program on Multidrug-Resistant Organisms

摘要 抗生素耐药性（AMR）是最紧迫的公共卫生优先事项之一。AMR被认为是重新- 美国有超过35，000人死亡，预计到2050年全球将有3亿人死亡。我 最初的K24申请旨在提高我进行抗生素患者导向研究（POR）的能力 阻力和指导新一代的临床医生科学家对这一重要的公众 健康威胁。在K24奖的支持下，我能够显着增加我的研究组合，推出 微生物基因组学的使命，并增加我的指导活动。因此，本次会议的总体目标是-- 申请K24延期的目的是通过继续和进一步加强 我的POR档案和指导能力我还打算加强我的领导能力，以扩大一个雄心勃勃的重新- 搜索和培训计划，重点是AMR。在我最初的K24奖的部分支持下，我创立了Cen- 抗菌素耐药性和微生物基因组学（CARMiG）在UTHealth。卡米格的愿景是 将休斯顿德克萨斯医疗中心（TMC）的世界级专业知识融合在一起， 尖端研究项目的主要平台，并将培训使命整合到最高水平。我也 领导创建了墨西哥湾沿岸抗菌素耐药性联盟（GCC-AMR），这是一个跨机构的 为TMC的AMR研究人员提供交流和促进合作的中心。我们开发了一个强大的训练 AMR计划，招募和支持各种学员（MD，PhD和PharmDs）的职业生涯 在他们职业生涯的不同阶段。我的学员获得了4个NIH K发展奖（2个完美 #21453;，以及同等的独立补贴。此外，学员的出版物数量明显增加， 扩大（作为第一作者/通讯作者发表了94篇文章）。我们国家卫生研究院的拨款组合也增加了20多美元 在过去的5年里，作为NIH资助的PI，包括最近的P01项目（1100万美元）。我们也 能够确保第一个博士后跨机构T32培训计划的AMR。因此， 我最初的K24计划使我处于一个理想的位置，以维持和进一步加强我的研究和培训 目标.在我最初的K24项目中，我专注于万古霉素耐药的临床和基因组方面。 肠球菌（VRE）是临床环境中最具挑战性的微生物之一。利用在以下方面获得的专门知识， VRE，我的K24更新将支持新的研究领域，包括微生物组科学的交叉， 革兰氏阴性病原体的AMR、基因组学和分子流行病学以及机器学习的使用， 在感染多药耐药微生物（MDRO）的患者中建立临床/基因组相关性。特别- cific目标是：i）加强我与AMR相关的POR组合，作为学员发展其 职业生涯，和ii）指导有才华的年轻研究人员在翻译和POR专注于AMR。我打算骗- 继续我的强大的指导计划，整合了分子和基因组基础的理解， 并将其转化为临床实践。

ABSTRACT Antimicrobial resistance (AMR) is one of the most pressing public health priorities. AMR is thought to be re- sponsible for more than 35,000 deaths in the US with a projection of 300 million deaths worldwide by 2050. My original K24 application sought to increase my ability to conduct patient oriented research (POR) on antibiotic resistance and mentor a new generation of clinicians scientists on different aspects of this important public health threat. With support from the K24 award, I was able to markedly increase my research portfolio, launch a microbial genomics mission and increase my mentoring activities. Thus, the overarching goal of this com- petitive K24 renewal is to fully transition to an established investigator by continuing and further strengthening my POR portfolio and mentoring abilities. I also aim to fortify my leadership skills to expand an ambitious re- search and training program, focused on AMR. Supported in part by my original K24 award, I founded the Cen- ter for Antimicrobial Resistance and Microbial Genomics (CARMiG) at UTHealth. The vision of CARMiG was to amalgamate the world-class expertise available in the Houston’s Texas Medical Center (TMC) to serve as a major platform for cutting edge research programs and integrate a training mission to the highest level. I also led the creation of the Gulf Coast Consortium on Antimicrobial Resistance (GCC-AMR), an inter-institutional hub for AMR researchers across the TMC to interact and foster collaborations. We developed a robust training program on AMR, recruiting and supporting the career of a diverse pool of trainees (MD, PhDs and PharmDs) at different stages of their careers. My trainees have secured 4 NIH K developments awards (2 with perfect scores), and equivalent independent grants. Furthermore, the number of trainee’s publications has markedly expanded (94 publications as firs/corresponding author). Our NIH grant portfolio also grew with more than $ 20 million brought in as PI of NIH grants in the last 5 years, including a recent P01 program ($11m). We were also able to secure the first post-doctoral inter-institutional T32 training program on AMR. Thus, the foundations of my initial K24 program put me in an ideal position to sustain and further strengthen my research and training objectives. In my original K24 program I focused on the clinical and genomic aspects of vancomycin-resistant enterococci (VRE) one of the most challenging organisms in clinical settings. Using the expertise acquired in VRE, my K24 renewal will support new areas of research, including the intersection of microbiome science and AMR, genomics and molecular epidemiology of Gram-negative pathogens and use of machine learning to es- tablish clinical/genomic correlates in patients infected with multidrug-resistant organisms (MDRO). The spe- cific aims are: i) strengthen my portfolio of POR related to AMR as the foundation for trainees to develop their careers, and ii) mentor talented young investigators in translational and POR focused on AMR. I plan to con- tinue my robust mentoring program that integrates the understanding of the molecular and genomic bases of resistance and their translation into clinical practice.