Innovative Interdisciplinary Approaches to Sustainable Airborne Infection Control

可持续空气传播感染控制的创新跨学科方法

• 批准号: 9125675
• 负责人: Edward A. Nardell
• 金额: $ 35.33万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-18 至 2019-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9125675
• 关键词: Address; Adult; Air; Architecture; Boston; Centers for Disease Control and Prevention (U.S.); Clinical Research; Clinics and Hospitals; Coughing; Discipline; Disinfection; Drug resistance; Drug resistance in tuberculosis; Engineering; Epidemic; Epidemiology; General Hospitals; Grant; HIV; Health; Health Personnel; Hospitals; Industrial Respirators; Infection; Infection Control; Institutes; Institution; International; Intervention; Jail; Medical Research; Medicine; Mentorship; Molecular; Monitor; Patients; Peru; Physicians; Predisposition; Prisons; Public Health; Rana; Refugee Camp; Research; Research Project Grants; Research Training; Site; South Africa; South African; Stimulus; Technology; Testing; Tuberculosis; United States National Institutes of Health; Universities; Woman; Work; arm; case finding; clinical research site; design; drug testing; effective therapy; innovation; interdisciplinary approach; low and middle-income countries; multidisciplinary; novel; pandemic influenza; research facility; resistant strain; training project; transmission process

DESCRIPTION (provided by applicant): After HIV, tuberculosis is the single largest infectious killer of adults in the world today. Among the most important aspects of TB control in most low and middle-income countries is the airborne spread of drug resistant (DR) tuberculosis, substantially in institutions such as hospitals, clinics, jails, prisons, and refugee camps. Institutional airborne infection control is a public health problem that intersects with several oter disciplines: architecture, engineering, and medicine. However, there have been no real innovations in airborne infection control in many decades, perhaps since the adaptation of industrial respirators for health care worker use in the 1990s. This proposal seeks to build international research capacity to address the issue of airborne spread of infections in buildings. Of greatest concern is the DR TB epidemic, but most of the interventions that result from this research will be equally relevant to other infections with airborne potential, such as pandemic influenza. This proposal continues the air disinfection engineering research training conducted under a 1-year Stimulus Fogarty Innovations Framework grant in Boston and in South Africa. It expands that work to include research training for architects as well as engineers in Boston and South Africa, using as a Partners In Health (PIH) clinical sites around the world, as well as research sites accessible through our South African partners, the Council for Scientific and Industrial Research (CSIR) and the University of Pretoria (UP). Course work will be available through UP. Under expert multidisciplinary mentorship, our trainees will develop and test novel indicators of successful building designs and, with another partner, the Medical Research Council (MRC) of South Africa, quantitatively test novel air disinfection technology developed in Boston and Pretoria. Our trainees will perform testing at the Airborne Infections Research (AIR) Facility (Witbank, SA), an established collaborative project between the MRC, the US CDC, UP, and Brigham & Women's (BWH) Hospital. If these innovations show promise, we will work with our local partners and two transitional research partners (the National Institute of Design of Indi and Frog Design, Inc) to optimize and commercialize products for local manufacture so that implementation is sustainable. Our own research at the AIR facility has demonstrated the rapid and powerful effect of effective treatment on TB transmission, even for drug resistant strains. Therefore, another complementary approach to the airborne spread of DR TB will be to test the impact on TB transmission of active case finding through cough surveillance followed by rapid molecular testing and drug susceptibility testing that will allow patients to be rapidly placed on effective treatment. Our physician trainees will test this approach at a large general hospital in Lima, Peru that has carefully monitored TB cases among its workers over the years. Our partners in this clinical research and training project will be the National Institute of Health of Peru (INS) and Socios En Salud (SES), the Peru arm of PIH, with course work in epidemiology available through San Marcos University.

描述（由申请人提供）：在艾滋病毒之后，结核病是当今世界上最大的传染病杀手。在大多数低收入和中等收入国家中，结核病控制的最重要方面是耐药性（DR）结核病的空气传播，这在医院，诊所，监狱，监狱，监狱和难民营等机构中基本上是基本的。机构空中感染控制是一个公共卫生问题，与多个OTER学科相交：建筑，工程和医学。但是，几十年来，自1990年代适应用于卫生保健工人的工业呼吸器以来，空中感染控制却没有真正的创新。该提案旨在建立国际研究能力，以解决建筑物中感染的空中传播问题。 最引人注目的是TB博士的流行病，但是这项研究产生的大多数干预措施将与其他具有空气潜能的感染（例如大流行性流感）同样相关。该提案继续以1年的刺激性Fogarty Innovations框架在波士顿和南非进行了空气消毒工程研究培训。它扩展了这项工作，包括用于建筑师的研究培训以及波士顿和南非的工程师，并将其作为世界各地的卫生（PIH）临床地点，以及通过我们的南非合作伙伴，科学与工业研究委员会（CSIR）和Petoria University（UP）（UP）访问的研究地点。课程工作将通过UP提供。在专业的跨学科指导下，我们的学员将开发和测试成功建筑设计的新颖指标，并与另一位合作伙伴（MRC）南非的医学研究委员会（MRC）定量测试在波士顿和比勒陀利亚开发的新型空气消毒技术。我们的学员将在MRC，美国CDC，UP和Brigham＆Women's（BWH）医院之间建立的合作项目（AIR）感染研究（Witbank，SA）进行测试。如果这些创新表现出承诺，我们将与当地合作伙伴和两个过渡性研究合作伙伴（美国国家设计研究所，Indi and frog Design，Inc）合作，以优化和商业化本地制造产品，以使实施是可持续的。我们自己在空中设施的研究表明，即使是耐药菌株，有效治疗对结核病传播的迅速而有力的影响也是如此。因此，TB博士的空气传播传播的另一种补充方法是通过咳嗽监测测试对活性病例发现的影响，然后进行快速分子测试和药物敏感性测试，这将使患者能够迅速置于有效治疗中。我们的医师学员将在秘鲁利马的一家大型综合医院测试这种方法，多年来，该医院对工人的结核病病例仔细监测。我们在这个临床研究和培训项目中的合作伙伴将是美国国家健康研究所 秘鲁（INS）和Socios En Salud（SES），PIH的秘鲁部门，并在圣马科斯大学（San Marcos University）提供流行病学课程。

项目成果

Preventing Transmission of Mycobacterium Tuberculosis-A Refocused Approach.

预防结核分枝杆菌的传播——重新聚焦的方法。

• DOI: 10.1016/j.ccm.2019.07.010
• 发表时间: 2019
• 期刊: Clinics in chest medicine
• 影响因子: 5.7
• 作者: Nardell,EdwardA

Predicting Airborne Infection Risk: Association Between Personal Ambient Carbon Dioxide Level Monitoring and Incidence of Tuberculosis Infection in South African Health Workers.

• DOI: 10.1093/cid/ciac183
• 发表时间: 2022-10-12
• 期刊: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America