Antimicrobial resistance in Neisseria gonorrhoeae among men on PrEP in Vietnam

项目总结/摘要 抗生素耐药性（AMR）是一个全球性的卫生紧急事件。淋病奈瑟菌是一种高度优先的病原体 对于AMR，因为全世界每年有8700万例感染，并且细菌已表现出对 每一种抗生素都被推荐用于治疗已报告治疗失败，通常涉及 口咽感染，是可怕的警告，无法治愈的淋病时代即将到来。西部 太平洋地区，其中包括越南，耐药头孢曲松和阿奇霉素，最常见的 推荐的淋病抗生素治疗正在增加。男男性行为者（MSM） 不成比例地受到N.淋病感染，但在低- 中等收入国家（LMIC）。这项研究旨在更好地了解N.淋病 通过将新的研究嵌入到越南现有的男男性接触者艾滋病毒暴露前预防（PrEP）计划中。 本研究的目的是：1）确定N。男男性接触者淋病 在越南的PrEP计划中; 2）测量咽部N.淋病治疗失败 以及咽部感染与AMR之间的关联;以及3）使用全基因组测序（WGS） 进行N.淋病嵌套在我们的研究人群的男男性接触者在一个 越南的PrEP计划。该研究将利用N.淋病和后续发生 通过PrEP计划，为N.淋病在这一关键人群中。 Fogarty国际研究科学家发展奖（K 01）旨在支持 保罗·亚当森博士，一位传染病医生，他的目标是成为一个独立的全球健康 AMR和性传播感染（STI）交叉点的研究者。K 01将支持博士。 亚当森将在1）临床微生物学和AMR测试，2）WGS，生物信息学和基因组学方面发展专业知识 流行病学，以及3）临床试验研究的高级培训，重点是LMIC。为了实现拟议的 研究和培训的目标，亚当森博士已经组建了一个导师团队与成熟的经验指导 早期职业调查人员，并具有STI，流行病学，AMR，生物统计学和基因组学方面的专业知识。Drs. Pamina Gorbach（加州大学洛杉矶分校）和Le Minh Giang（河内医科大学，HMU）将担任初级导师 并在开展大规模性传播感染预防研究和临床试验方面拥有丰富的经验 艾滋病在MSM中此外，他的共同导师团队还包括杰弗里·克劳斯纳博士，一位美国的全球 卫生研究人员和国际性传播感染和耐甲氧西林耐药性专家。淋病和阮武忠医生 他是一位在越南的研究人员，在N. 淋病拟议的研究和培训目标利用了强大的研究合作和 UCLA和HMU之间存在强大的研究基础设施。IRSDA将推动亚当森博士的事业 作为性传播感染和抗生素耐药性的专家，并使他成为独立的全球健康调查员。

PROJECT SUMMARY/ABSTRACT Antimicrobial resistance (AMR) is a global health emergency. Neisseria gonorrhoeae is a high-priority pathogen for AMR, as there are 87 million infections per year worldwide and the bacteria has demonstrated resistance to every class of antibiotics recommended for its treatment. Treatment failures have been reported, typically involve oropharyngeal infections, and are dire warnings that the era of untreatable gonorrhea is near. In the Western Pacific Region, which includes Vietnam, resistance to ceftriaxone and azithromycin, the most commonly recommended antibiotic therapy for gonorrhea, are increasing. Men who have sex with men (MSM) are disproportionately affected by AMR in N. gonorrhoeae infections, but remain under-represented in data from low- and middle-income countries (LMICs). The proposed study seeks to better understand AMR in N. gonorrhoeae by embedding new research into an existing HIV pre-exposure prophylaxis (PrEP) program for MSM in Vietnam. The study aims are 1) to determine the prevalence of and risk factors for AMR in N. gonorrhoeae among MSM in a PrEP program in Vietnam; 2) to measure the frequency of pharyngeal N. gonorrhoeae treatment failures and the association between pharyngeal infections and AMR; and 3) to use whole-genome sequencing (WGS) to conduct a genomic epidemiology study of N. gonorrhoeae nested within our study population of MSM in a PrEP program in Vietnam. The study will leverage regular testing for N. gonorrhoeae and follow-up that occur through the PrEP program to shed new light on the issue of AMR in N. gonorrhoeae within this key population. This Fogarty International Research Scientist Development Award (K01) is to support the career development of Dr. Paul Adamson, an infectious diseases physician whose goal is to become an independent global health investigator at the intersection of AMR and sexually transmitted infections (STIs). The K01 will support Dr. Adamson to develop expertise in 1) clinical microbiology and AMR testing, 2) WGS, bioinformatics, and genomic epidemiology, and 3) advanced training in clinical trials research with a focus in LMICs. To achieve the proposed research and training aims, Dr. Adamson has assembled a mentorship team with proven experience mentoring early-career investigators and with expertise in STIs, epidemiology, AMR, biostatistics, and genomics. Drs. Pamina Gorbach (UCLA) and Le Minh Giang (Hanoi Medical University, HMU) will serve as Primary Mentors and have extensive experience in conducting large-scale prevention research studies and clinical trials on STIs and HIV among MSM. In addition, his Co-Mentorship team includes Dr. Jeffrey Klausner, a US-based global health researcher and an international expert on STIs and AMR in N. gonorrhoeae, and Dr. Nguyen Vu Trung, a Vietnam-based researcher with expertise in clinical microbiology and antibiotic susceptibility testing in N. gonorrhoeae. The proposed research and training aims leverage the strong research collaborations and the robust research infrastructure that exist between UCLA and HMU. The IRSDA will advance Dr. Adamson's career as an expert in STIs and AMR and establish him as an independent global health investigator.