The role of enteric pathogens and antimicrobial resistance in driving clinical and nutritional deterioration, and azithromycin's potential effect, among children discharged from hospital in Kenya
肠道病原体和抗菌药物耐药性在导致肯尼亚出院儿童临床和营养恶化中的作用以及阿奇霉素的潜在影响
基本信息
- 批准号:10341184
- 负责人:
- 金额:$ 67.77万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-03-15 至 2025-02-28
- 项目状态:未结题
- 来源:
- 关键词:AffectAfrica South of the SaharaAntibiotic ResistanceAntibioticsAntimicrobial ResistanceAutomobile DrivingAzithromycinBacteriaCampylobacterCessation of lifeChildChild MortalityChildhoodClinicalClinical TrialsCommunitiesCotrimoxazoleDataDetectionDeteriorationDevelopmentDiseaseDoseDouble-Blind MethodEnteralEnterobacteriaceaeEnvironmentEscherichia coliExposure toFailureFunctional disorderGenesGenotypeGrowthHIVHospitalizationHospitalsInterventionKenyaLeadLinkMacrolide-resistanceMacrolidesMediatingMolecularMorbidity - disease rateNational Institute of Child Health and Human DevelopmentNosocomial InfectionsNutritionalOutcomePathogen detectionPathway interactionsPharmaceutical PreparationsPhenotypePopulationPrevalenceRandomizedRandomized Clinical TrialsRandomized Controlled TrialsRecoveryReportingResistanceResource-limited settingRiskRoleSamplingShigellaTestingUnited States National Institutes of HealthVaccinesVital Statusantimicrobialazithromycin resistancebeta-Lactam Resistanceclinical efficacyclinically relevantcohortdiagnostic toolenteric pathogenenterotoxigenic Escherichia colihigh riskhospital readmissionimprovedmicrobialmolecular diagnosticsmortalitymortality riskpathogenpathogenic bacteriapredictive markerpreventrandomized placebo-controlled clinical trialrecurrent infectionrepositoryresistance gene
项目摘要
PROJECT SUMMARY/ABSTRACT
More than 2 million children under 5 die each year in sub-Saharan Africa (SSA). Children recently discharged
from hospital suffer a particularly high risk of death and no interventions target this period. Recent clinical trials
found 13%-49% mortality reductions associated with community-wide singe-dose azithromycin in SSA, and
mechanisms of this effect are poorly understood. The Toto Bora trial (NIH/NICHD-HD079695) is a double-blind
placebo-controlled randomized clinical trial (RCT) testing the effect of a 5-day course of azithromycin
administered at hospital discharge to Kenyan children under 5 years on mortality and re-hospitalization in the
subsequent 6-months. Utilizing samples from this trial, we have the unprecedented opportunity to elucidate
mechanisms of post-discharge morbidity, mortality, and growth faltering AND determine mechanisms of
azithromycin’s effect. We will test for enteropathogens and resistance genes in fecal samples and Escherichia
coli collected from children at hospital discharge and 3-months thereafter using qPCR and link this molecular
data to re-hospitalization, vital status, and anthropometric data collected throughout the 6-month post-discharge
period. Results from this highly efficient nested study will inform targets for vaccines and pathogen-directed
medications that could reduce post-discharge morbidity and mortality. Specific molecularly-determined pathogen
or resistance markers that predict azithromycin’s effects on mortality, morbidity, and growth will elucidate
mechanisms by which empiric azithromycin reduces child mortality and may identify specific populations who
can be treated with azithromycin to maximize benefit while minimizing resistance.
项目总结/文摘
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Patricia Pavlinac其他文献
Patricia Pavlinac的其他文献
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{{ truncateString('Patricia Pavlinac', 18)}}的其他基金
Lactoferrin and lysozyme to promote nutritional, clinical, and enteric recovery: A factorial placebo-controlled randomized trial among children with diarrhea and malnutrition
乳铁蛋白和溶菌酶促进营养、临床和肠道恢复:针对腹泻和营养不良儿童的阶乘安慰剂对照随机试验
- 批准号:
10533817 - 财政年份:2021
- 资助金额:
$ 67.77万 - 项目类别:
Lactoferrin and lysozyme to promote nutritional, clinical, and enteric recovery: A factorial placebo-controlled randomized trial among children with diarrhea and malnutrition
乳铁蛋白和溶菌酶促进营养、临床和肠道恢复:针对腹泻和营养不良儿童的阶乘安慰剂对照随机试验
- 批准号:
10095310 - 财政年份:2021
- 资助金额:
$ 67.77万 - 项目类别:
Lactoferrin and lysozyme to promote nutritional, clinical, and enteric recovery: A factorial placebo-controlled randomized trial among children with diarrhea and malnutrition
乳铁蛋白和溶菌酶促进营养、临床和肠道恢复:针对腹泻和营养不良儿童的阶乘安慰剂对照随机试验
- 批准号:
10322136 - 财政年份:2021
- 资助金额:
$ 67.77万 - 项目类别:
The role of enteric pathogens and antimicrobial resistance in driving clinical and nutritional deterioration, and azithromycin's potential effect, among children discharged from hospital in Kenya
肠道病原体和抗菌药物耐药性在导致肯尼亚出院儿童临床和营养恶化中的作用以及阿奇霉素的潜在影响
- 批准号:
10875843 - 财政年份:2020
- 资助金额:
$ 67.77万 - 项目类别:
The role of enteric pathogens and antimicrobial resistance in driving clinical and nutritional deterioration, and azithromycin's potential effect, among children discharged from hospital in Kenya
肠道病原体和抗菌药物耐药性在导致肯尼亚出院儿童临床和营养恶化中的作用以及阿奇霉素的潜在影响
- 批准号:
10569512 - 财政年份:2020
- 资助金额:
$ 67.77万 - 项目类别:
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