Epidemiology of Gonoccoccal Subpopulations

淋球菌亚群的流行病学

• 批准号: 7363010
• 负责人: Jonathan M Zenilman
• 金额: $ 8.2万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-17 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7363010
• 关键词: Antimicrobial Resistance; Archives; Baltimore; Behavioral; Biological Assay; Characteristics; Cities; Clinic; Clinical; Clonality; Collection; Communities; Consensus; DNA; Data; Diagnosis; Diagnostic tests; Disease Outbreaks; Drug usage; Endemic Diseases; Environment; Epidemiologist; Epidemiology; Evaluation; Funding; Genotype; Geography; Gonorrhea; Healthy People 2010; Hereditary Disease; Incidence; Infection; Information Networks; Intervention; Interview; Link; Membrane Proteins; Methods; Minority; Molecular; Molecular Genetics; Molecular Profiling; Neisseria; Nucleic Acids; Patients; Persons; Pharmaceutical Preparations; Population; Process; Proxy; Public Health; Questionnaires; Relative (related person); Risk; Risk Factors; Sampling; Scheme; Screening procedure; Series; Sex Behavior; Social Network; Spatial Distribution; Specimen; Speed; Techniques; Technology; Testing; Time; Work; base; case-based; cost effective; epidemiologic data; genetic analysis; high risk; insight; member; prevent; research study; tool; transmission process

DESCRIPTION (provided by applicant): Gonorrhea (GC) rates remain stubbornly high. Hyperendemic core groups are believed essential for continued transmission. Core groups are defined geographically or through behavioral risk factors, such as repeated gonorrhea incidence. In previous work, we have developed and validated a typing scheme for GC isolates, based on the porB outer membrane proteins, that can be used on either culture isolates or DNA obtained from nucleic acid diagnostic testing. This scheme accurately differentiates GC from other Neisseriae, and has demonstrated clonality in outbreaks of antimicrobial resistance. We propose that porB typing may be a more efficient way to identify core groups using a molecular signature linked to epidemiological characteristics. In this R03, we propose a series of proof of concept experiments. The substrate is a collection of 667 samples of gonococcal isolates or gonococcal DNA material obtained from the Baltimore Repeaters Project, a longitudinal intervention in 2004 which involved re- screening patients with gonorrhea 3 months after their initial diagnosis. Initial samples, repeat samples, and linked epidemiological and behavioral data obtained from clinic abstraction and questionnaires are available. Initially we will perform porB typing on the isolates, and adapt the techniques for more rapid typing. Initial typing methods will be performed by previously validated checkerboard hybridization assays, and we will be adapting these methods to real-time PCR, which would be more rapid. By linking the typing results to the epidemiological data we will 1). Confirm spatial distribution of GC infection and linkage to specific genotypes, hypothesizing that within geographic confines, the isolates will be similar. 2). Determine if specific genotypes diagnosed at baseline predict repeat infection. 3). By linking behavioral data, determine whether GC genotypes are associated with behavioral risk factors and sexual network information, hypothesizing that typing can act as proxy data for behavioral variables. We propose that genotyping, performed in or close to real time, may be a useful tool to identify patients with GC who are members of high-risk sexual networks, and who are central to transmission within a community. This process would in turn trigger focused efforts for intensive public health interventions. would be much more rapid and cost effective than intensive interview techniques. This method would then provide the framework for implementing intervention and control approaches

描述（由申请人提供）：淋病（GC）率仍然居高不下。高流行核心群体被认为是持续传播的关键。核心群体是通过地理或行为风险因素，如反复淋病发病率来定义的。在以前的工作中，我们已经开发并验证了一个分型方案的GC分离株，基于porB外膜蛋白，可以用于培养分离株或从核酸诊断检测获得的DNA。该方案准确区分GC与其他奈瑟菌，并已证明在抗生素耐药性爆发的克隆性。我们建议，porB分型可能是一个更有效的方式来确定核心组使用的分子签名与流行病学特征。在R03中，我们提出了一系列概念验证实验。底物是从巴尔的摩重复者项目获得的667个淋球菌分离物或淋球菌DNA材料样品的集合，该项目是2004年的纵向干预，其涉及在淋病患者初次诊断后3个月重新筛查淋病患者。初始样本，重复样本，并从临床提取和问卷调查中获得的相关流行病学和行为数据。最初，我们将对分离株进行porB分型，并采用更快速的分型技术。最初的分型方法将通过先前验证的棋盘杂交试验进行，我们将使这些方法适应实时PCR，这将更快。通过将分型结果与流行病学数据联系起来，我们将1）。确认GC感染的空间分布和与特定基因型的联系，假设在地理范围内，分离株相似。2）。确定在基线诊断的特定基因型是否预测重复感染。3）。通过链接行为数据，确定GC基因型是否与行为风险因素和性网络信息相关，假设分型可以作为行为变量的代理数据。我们建议，基因分型，在或接近真实的时间进行，可能是一个有用的工具，以确定与GC患者谁是高风险的性网络的成员，谁是中央社区内的传播。这一进程反过来又会引发集中努力，采取密集的公共卫生干预措施。会比密集的面试技巧更迅速和更划算。这种方法将为实施干预和控制方法提供框架