National surveillance of emerging MDR in pediatric Enterobacteriaceae infections

儿童肠杆菌科感染中新出现的多重耐药性国家监测

基本信息

  • 批准号:
    7845852
  • 负责人:
  • 金额:
    $ 37.8万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2009
  • 资助国家:
    美国
  • 起止时间:
    2009-08-11 至 2010-05-31
  • 项目状态:
    已结题

项目摘要

PROJECT SUMMARY/ABSTRACT The growing problem of antimicrobial resistance is well recognized. Infections with multi-drug resistant organisms are challenging to treat, and are associated with increased morbidity, mortality, and expenditure of healthcare resources. While much attention has been directed at understanding the epidemiology of resistance in Gram-positive organisms, especially methicillin-resistant Staphylococcus aureus, much less is known about the epidemiology of multi-drug resistance in Gram-negative organisms, particularly in pediatrics. Our preliminary data demonstrate statistically significant and very worrisome increases in plasmid-borne, broad-spectrum ¿-lactam resistance (PBLR) in Enterobacteriaceae at our pediatric center. This type of resistance includes plasmid-borne AmpC-, ESBL-, and carbapenemase-type determinants, and is concerning both because it limits the antimicrobials available to treat infections and because plasmids are readily transferable between organisms, creating a threat for rapid spread of resistance. We propose a multicenter pilot project to describe national molecular and epidemiological trends in pediatric PBLR in Enterobacteriaceae. Aims 1. To estimate the prevalence of plasmid-borne, broad-spectrum ¿-lactam resistance (PBLR), and to describe frequency distributions of the respective molecular determinants and plasmid types, among clinical pediatric Enterobacteriaceae isolates from 4 medical centers across the U.S. over time. 2. To define the clonal background and virulence properties of E. coli isolates demonstrating PBLR versus control E. coli isolates without PBLR. 3. To define the demographic, clinical, and bacterial factors associated with PBLR in Enterobacteriaceae infections in pediatric patients. Methods. A consortium of 4 pediatric hospitals is involved in this project. Each site, through routine clinical care, will identify Enterobacteriaceae with resistance patterns potentially indicative of PBLR. These isolates (along with non-PBLR control isolates) and demographic and clinical data from the infected patients will be sent to Seattle Children's, where further characterization of the organisms and data analyses will take place. Expected Outcomes of the Project. This project will define the scope of PBLR resistance in pediatrics on a national scale. This information has the potential to inform treatment, especially empiric treatment, of serious bacterial infections in children. It will also provide novel information from integrated analyses of clinical data from the human host, strain background and virulence of the bacterial host, and the molecular determinants of resistance. This will provide needed information for the design of future interventional studies aimed at preventing PBLR resistance.
项目概要/摘要 日益严重的抗菌素耐药性问题已得到广泛认可。多重耐药感染 有机体的治疗具有挑战性,并且与发病率、死亡率和支出增加有关 医疗保健资源。虽然很多注意力都集中在了解流行病学上 革兰氏阳性菌的耐药性,尤其是耐甲氧西林金黄色葡萄球菌,更不用说 已知革兰氏阴性生物体(特别是儿科)多重耐药性的流行病学。 我们的初步数据表明,质粒携带的、 我们儿科中心肠杆菌科细菌的广谱 β-内酰胺耐药性 (PBLR)。这类 耐药性包括质粒携带的 AmpC-、ESBL- 和碳青霉烯酶型决定簇,并且与 既因为它限制了可用于治疗感染的抗菌药物,也因为质粒很容易 可在生物体之间转移,对耐药性的快速传播造成威胁。我们建议多中心 描述国家儿童 PBLR 分子和流行病学趋势的试点项目 肠杆菌科。 目标 1. 估计质粒传播的广谱 β-内酰胺耐药性 (PBLR) 的流行率,并 描述各自分子决定因素和质粒类型的频率分布,其中 随着时间的推移,临床儿科肠杆菌从美国 4 个医疗中心分离出来。 2. 定义展示 PBLR 的大肠杆菌分离株的克隆背景和毒力特性 与不含 PBLR 的对照大肠杆菌分离株相比。 3. 定义与 PBLR 相关的人口统计学、临床和细菌因素 儿科患者的肠杆菌科感染。 方法。由 4 家儿科医院组成的联合体参与了该项目。每个站点,通过常规临床 护理,将识别具有潜在指示 PBLR 耐药模式的肠杆菌科细菌。这些分离株 (以及非 PBLR 对照分离株)以及受感染患者的人口统计和临床数据将被 被送往西雅图儿童医院,在那里将进行进一步的生物体表征和数据分析。 项目的预期成果。该项目将定义儿科 PBLR 耐药的范围 全国规模。这些信息有可能为严重疾病的治疗,尤其是经验性治疗提供信息。 儿童细菌感染。它还将从临床数据的综合分析中提供新的信息 来自人类宿主、细菌宿主的菌株背景和毒力,以及细菌宿主的分子决定因素 反抗。这将为未来干预研究的设计提供所需的信息 防止 PBLR 耐药。

项目成果

期刊论文数量(1)
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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DANIELLE M ZERR其他文献

DANIELLE M ZERR的其他文献

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{{ truncateString('DANIELLE M ZERR', 18)}}的其他基金

Impact of chlorhexidine bathing on reducing infections in children with cancer
洗必泰沐浴对减少癌症儿童感染的影响
  • 批准号:
    9133317
  • 财政年份:
    2012
  • 资助金额:
    $ 37.8万
  • 项目类别:
Impact of chlorhexidine bathing on reducing infections in children with cancer
洗必泰沐浴对减少癌症儿童感染的影响
  • 批准号:
    8516476
  • 财政年份:
    2012
  • 资助金额:
    $ 37.8万
  • 项目类别:
Impact of chlorhexidine bathing on reducing infections in children with cancer
洗必泰沐浴对减少癌症儿童感染的影响
  • 批准号:
    8371626
  • 财政年份:
    2012
  • 资助金额:
    $ 37.8万
  • 项目类别:
HHV-6 and CNS disease following stem cell transplant
干细胞移植后的 HHV-6 和 CNS 疾病
  • 批准号:
    7899703
  • 财政年份:
    2009
  • 资助金额:
    $ 37.8万
  • 项目类别:
VIRAL PATHOGENS AND FIRST TIME SEIZURES IN THE SETTING OF ILLNESS
患病时的病毒病原体和首次癫痫发作
  • 批准号:
    7603544
  • 财政年份:
    2007
  • 资助金额:
    $ 37.8万
  • 项目类别:
VIRAL PATHOGENS AND FIRST TIME SEIZURES IN THE SETTING OF ILLNESS
患病时的病毒病原体和首次癫痫发作
  • 批准号:
    7379427
  • 财政年份:
    2006
  • 资助金额:
    $ 37.8万
  • 项目类别:
VIRAL PATHOGENS AND FIRST TIME SEIZURES IN THE SETTING OF ILLNESS
患病时的病毒病原体和首次癫痫发作
  • 批准号:
    7198929
  • 财政年份:
    2005
  • 资助金额:
    $ 37.8万
  • 项目类别:
HHV-6 and CNS disease following stem cell transplant
干细胞移植后的 HHV-6 和 CNS 疾病
  • 批准号:
    7099589
  • 财政年份:
    2004
  • 资助金额:
    $ 37.8万
  • 项目类别:
HHV-6 and CNS disease following stem cell transplant
干细胞移植后的 HHV-6 和 CNS 疾病
  • 批准号:
    7264557
  • 财政年份:
    2004
  • 资助金额:
    $ 37.8万
  • 项目类别:
HHV-6 and CNS disease following stem cell transplant
干细胞移植后的 HHV-6 和 CNS 疾病
  • 批准号:
    7480236
  • 财政年份:
    2004
  • 资助金额:
    $ 37.8万
  • 项目类别:

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抗生素对抗生素抗性基因转移频率和高水平抗性进化的影响。
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