Clinical Research and Mentoring in Epidemiology of Bacterial Diseases

描述（由申请人提供）：这是一份为匹兹堡大学Lee H. Harrison医学博士申请患者导向研究（K24）中期研究者奖的提案。主要目的是：1)在以患者为导向的研究中提供指导；2)为匹兹堡大学传染病流行病学研究单位（IDERU）和公共卫生传染病实验室（PHIDL）提供领导和指导；3)支持哈里森博士对严重细菌病原体的临床和流行病学研究。与该奖项的前五年一样，未来五年的主要重点将是为传染病研究员、在皮特公共卫生研究生院获得学位的临床医生和医学系的初级教员提供指导。为实现这一目标，将专门安排时间进行指导，并向受训者提供大量资源，包括：具有广泛研究组合的细菌疾病临床、流行病学和分子流行病学研究的细菌疾病研究所和匹兹堡大学前沿分子流行病学实验室PHIDL的资源；两项国立卫生研究院福格蒂国际中心研究培训补助金，一项是关于严重细菌性疾病的流行病学和分子流行病学，另一项是关于艾滋病毒/艾滋病；以及cdc资助的马里兰州活性细菌核心监测（abc）项目的资源，该项目位于约翰霍普金斯大学，由哈里森博士领导。在奖励期间将进行的众多面向患者的研究之一是题为“实时PCR诊断巴西培养阴性细菌性脑膜炎”的项目。这将是一项前瞻性研究，在巴西圣保罗和坎皮纳斯的13家医院寻求治疗的培养阴性脑膜炎患者，超过一半的化脓性脑膜炎患者为培养阴性。具体目的是：1)利用RT-PCR检测流感嗜血杆菌、肺炎链球菌和脑膜炎奈瑟菌，确定巴西细菌性脑膜炎培养阴性患者的比例；2)确定培养阴性/RT-PCR阳性的危险因素；3)确定将RT-PCR纳入常规公共卫生监测时的性能特征。这项研究有可能改善巴西细菌性脑膜炎患者的临床护理，并为决策者提供关于将新的结合疫苗纳入巴西免疫计划的知情决策信息。

DESCRIPTION (provided by applicant): This is a proposal for continuation of the Midcareer Investigator Award in Patient-Oriented Research (K24) for Lee H. Harrison, MD, at the University of Pittsburgh. The principal aims are to 1) provide mentorship in patient-oriented research, 2) provide leadership and direction to the Infectious Diseases Epidemiology Research Unit (IDERU) and Public Health Infectious Diseases Laboratory (PHIDL) at the University of Pittsburgh, and 3) support Dr. Harrison's clinical and epidemiologic research on serious bacterial pathogens. As with the first five years of the award, a major focus of the next five years will be to provide mentorship to infectious diseases fellows, clinicians obtaining degrees at the Pitt Graduate School of Public Health, and junior faculty members in the Department of Medicine. This will be accomplished by having dedicated time for mentorship and by making available substantial resources to trainees, including: the resources of the IDERU, which has a broad research portfolio of clinical, epidemiologic and molecular epidemiologic studies of bacterial diseases, and PHIDL, a cutting-edge molecular epidemiology laboratory, at the University of Pittsburgh; two NIH Fogarty International Center research training grants, one on the epidemiology and molecular epidemiology of serious bacterial diseases and another on HIV/AIDS; and the resources of the CDC-funded Maryland Active Bacterial Core Surveillance (ABCs) project, which is based at Johns Hopkins University and led by Dr. Harrison. One of the many patient-oriented studies that will be conducted during the award period is a project entitled, "Real-Time PCR for Diagnosis of Culture Negative Bacterial Meningitis in Brazil". This will be a prospective study of culture-negative meningitis patients seeking care at 13 hospitals in Sao Paulo and Campinas, Brazil, were over half of pyogenic meningitis patients are culture negative. The specific aims are to 1) characterize the proportion of Brazilian patients with culture-negative bacterial meningitis using RT-PCR for H. influenzae, S. pneumoniae, and N. meningitidis, 2) identify risk factors for being culture negative/RT-PCR positive, and 3) determine the performance characteristics of RT-PCR when incorporated into routine public health surveillance. This study has the potential to improve clinical care of bacterial meningitis patients in Brazil and provide policy makers with information for informed decisions about incorporation of new conjugate vaccines into the Brazilian immunization schedule.