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The Vanderbilt Urologic Infection Repository, a Resource for Personalized Clinical Discovery

范德比尔特泌尿感染存储库，个性化临床发现的资源

基本信息

批准号：
9913350
负责人：
Douglass Brooks Clayton
金额：
$ 34万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-17 至 2021-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9913350
关键词：
Acinetobacter baumannii Advisory Committees Antimicrobial susceptibility Area Bacteriuria Benign Caring Child Clinical Clinical Data Communities Community Outreach Data Databases Diagnosis Diagnostic Disease Education and Outreach Educational Activities Educational workshop Electronic Health Record Environment Escherichia coli Fostering Foundations Functional disorder Funding Genetic Genetic Polymorphism Genitourinary System Infection Genitourinary system Genomics Genotype Genus staphylococcus Goals Health Heterogeneity Human Individual Infection Informatics Infrastructure Institution Knowledge Laboratories Light Link Location Logistics Machine Learning Maps Medical Medical Informatics Medical Records Microbe Microbiology Molecular Organism Outcome Pathogenesis Pathology Patients Phenotype Physiology Pilot Projects Population Published Comment Records Reporting Resources Risk Factors Role Science Scientist Services Source Specimen Sum Symptoms Taxonomy Technology Urinary tract infection Urine Urologic Diseases Urology Uropathogen Virulence Factors Woman base biobank biomedical resource career development clinical database clinical infrastructure clinical sequencing combat data mining data space data warehouse demographics functional genomics genome sequencing genome wide association study health data improved individual patient innovation interest member men microbial microbial genome microbiome multidisciplinary novel operation organizational structure outcome forecast pathogen pathogenic microbe personalized care personalized medicine precision medicine prevent programs repository symptomatology tool translational impact urinary urologic whole genome young woman

项目摘要

SUMMARY - OVERALL In personalized medicine, the care of each patient is guided by his/her unique clinical circumstances. At its foundation, however, this paradigm holds a concurrent need for personalized science, in which technologies are developed and hypothesis explored in light of individual diversity. Critically, this diversity also includes unique microbial populations, which can augment the onset, progression, and treatment of disease. Within the field of benign urology, one of the most common pathologies—urinary tract infections (UTIs)—is also one of the most heterogenous, as the risk factors, symptomatology, and outcomes can vary significantly from patient to patient. Not surprisingly, the complexity of UTIs extends beyond the host, with tremendous genotypic and phenotypic diversity among the species/strains of microbes that elicit these infections. To better align the management of UTIs with the goals of precision care, our understanding of pathophysiology must become more nuanced, as we network in tandem the inherent diversity of host and microbe. To these ends, we propose a resource that provides an interconnected picture of both components, the Vanderbilt Urologic Infection Repository (VUIR). With our institution's unique foundation in medical informatics, we will create a searchable database of clinical parameters from bacteriuric patients (many thousands of cases annually), together with microbiologic data on the organisms. In parallel, the paired microbial strains will be stored permanently as a biobank for analysis and experimentation, together with linkage to anonymized versions of patient records within Vanderbilt's Synthetic Derivative (a filtered version of our electronic health data). The logistical infrastructure for clinical biobanking is also already in place at Vanderbilt via the institutionally-supported microVU initiative, in which microbial isolates from the diagnostic laboratory are repurposed as academic resources. As a basic expansion of these efforts, the VUIR will represent a first-in-kind tool for developing technologies to combat UTIs, while also investigating their underlying pathogenesis. In particular, it could facilitate functional genomic studies that bridge host and pathogen. Demonstrating the resource's value, we will conduct whole-genome sequencing of clinically underrepresented bacterial species, together with genome-wide association studies that focus on the infection phenotypes of the source-patients. In addition to novel virulence factors, we seek to identify elusive genomic determinants that distinguish cases of asymptomatic bacteriuria (ASB) and symptomatic UTI. The molecular basis of UTI-versus-ASB epitomizes a clinical challenge that requires integration of host and pathogen, as provided by the VUIR. Finally, to support the program and its discoveries, we propose an organizational structure of multidisciplinary content-area experts and dedicated support staff. Along with coordinating daily activities and assuring seamless dissemination of data/specimens, this Administrative Core (AdCore) will champion educational activities and additional pilot projects that build upon the resource. In sum, the VUIR stands to generate actionable discoveries from the human and microbial diversity of UTIs—not in spite of it.

摘要-整体