Development of a point-of-care platform for differential diagnosisof emerging in

开发用于鉴别诊断的即时护理平台

• 批准号: 8230236
• 负责人: Christina Egan
• 金额: $ 13.11万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-01 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8230236
• 关键词: Acute; Africa; Animal Model; Antibiotics; Antiviral Agents; Appearance; Asia; Categories; Clinical Medicine; Clinical Microbiology; Communicable Diseases; Culture Techniques; Development; Diagnostic; Differential Diagnosis; Disease Outbreaks; Encephalitis; Engineering; Fever; HIV; Habitats; Hot Spot; Immunohistochemistry; Infection; Infectious Agent; Influenza; Investments; Malignant Neoplasms; Meningoencephalitis; Methods; Microbe; Molecular; New Agents; Nucleic Acids; Population Density; Poverty; Predisposition; Preparation; Prions; Protocols documentation; Public Health; Rhinovirus; Serologic tests; Signs and Symptoms; Source; South America; Speed; Staging; Syndrome; Therapeutic Monoclonal Antibodies; Transplantation; Travel; Vaccines; Viral Hemorrhagic Fevers; West Nile virus; aging population; biodefense; chikungunya; climate change; cost; immunosuppressed; improved; insight; methicillin resistant Staphylococcus aureus; novel; pandemic disease; pathogen; point of care; vector

Emerging and re-emerging pathogens such as HIV, prions, MRSA, XDR Tb, West Nile, hendra- and nipah, metapneumo-, calici-, hanta-, Ebola-, Marburg-, corona-, influenza-, chikungunya- and rhinoviruses, are sculpting a new landscape for public health and clinical medicine. This phenomenon has been ascribed to the destruction of natural habitats; political instability and poverty; climate change; the increased susceptibility to infection of an aging population or one immunosuppressed by HIV, cancer or transplantation; increasing population density; and inappropriate use of antibiotics. With globalization of travel and trade, microbes, vectors and reservoirs do not remain geographically discrete. Point source infections can rapidly become outbreaks or distribute even more broadly to become pandemics. Thus, clinicians and public health practitioners must be prepared for the appearance of new pathogens, new syndromes, as well as known syndromes due to known pathogens in new contexts. Classical culture techniques, immunohistochemistry, EM, and serology are vital in pathogen discovery as well as diagnostic clinical microbiology; nonetheless, molecular methods are increasingly employed due to speed, lower cost and the capacity to succeed in instances where fastidious requirements confound cultivation. We have established a staged strategy that enables rapid identification of emerging as well as known pathogens. This strategy will be used to investigate unexplained hemorrhagic fevers, unexplained encephalitis and meningoencephalitis, and unexplained febrile illness in "hot spots" in Asia, Africa and South America using materials collected from well characterized subjects under standardized network protocols. Specific Aims include: (1) Optimize preparation of nucleic acid template for GreeneChip and high throughput sequencing platforms; (2) Investigate unexplained hemorrhagic fevers; (3) Investigate unexplained encephalitis and meningoencephalitis; (4) Investigate unexplained febrile illness; and (5) Investigate potential reservoirs and vectors for the presence of agents implicated in Aims 2-4.

新出现和重新出现的病原体，如艾滋病毒、朊病毒、MRSA、XDR结核病、西尼罗河病毒、亨德拉病毒和尼帕病毒， 偏甲氧西林病毒、杯状病毒、汉他病毒、埃博拉病毒、马尔堡病毒、冠状病毒、流感病毒、基孔肯雅病毒和鼻病毒，正在塑造一个新的 公共卫生和临床医学景观。这种现象被归因于自然的破坏。 栖息地;政治不稳定和贫困;气候变化;老龄化人口更容易感染 或一个免疫抑制的艾滋病毒，癌症或移植;人口密度增加;和不适当的使用， 抗生素随着旅游和贸易的全球化，微生物、病媒和宿主不再局限于地理位置， 离散的点源感染可以迅速成为暴发或传播更广泛，成为流行病。 因此，临床医生和公共卫生从业人员必须为新病原体的出现做好准备， 综合征，以及已知的综合征由于已知的病原体在新的情况下。传统的培养技术， 免疫组化、EM和血清学在病原体发现以及诊断临床微生物学中是至关重要的; 尽管如此，由于速度快、成本低和成功的能力， 要求苛刻的地方混淆了种植。我们制定了一个阶段性战略， 快速识别新出现的以及已知的病原体。这一策略将用于调查无法解释的 出血热、原因不明的脑炎和脑膜脑炎，以及“热点”地区的原因不明的发热性疾病， 亚洲、非洲和南美洲，使用从标准化网络下的特征良好的主题收集的材料 协议.具体目的包括：（1）优化绿色芯片核酸模板的制备方法，提高芯片的高通量 测序平台;（2）调查不明原因的出血热;（3）调查不明原因的脑炎， 脑膜脑炎;（4）调查不明原因的发热性疾病;（5）调查潜在的水库和载体， 目标2-4中涉及的制剂的存在。