Emerging drug-resistance infections

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DESCRIPTION (provided by applicant): Drug-resistant bacterial infections that occur in both hospital and community settings are an emerging infectious disease problem in large urban centers of middle-income developing countries, such as Brazil. This training program will build on the last 5 years of a training program supported under the Fogarty International Training and Research in Emerging Infectious Diseases (ITREID) to create a sustainable research training infrastructure in Brazil to address the problem of drug-resistant bacterial infections that occur in both hospital and community settings. This infrastructure will be established at the Federal University of Rio de Janeiro (FUR J), involving faculty members at FURJ and in the US who have already been collaborating over the last 5 years. Specifically, the new program will build a training program structured around three areas of research: 1) field epidemiology, 2) molecular epidemiology, and 3) molecular biology of bacterial drug resistance. The training sites in the US will include the Infectious Disease and Epidemiology programs of the School of Public Health at University of California at Berkeley (UCB), the Infectious Disease program at the University of California at San Francisco (UCSF), and Department of Medicine at Weill Medical College of Cornell University in New York City. On-site training at FURJ will be provided for MD, master's and PhD-level students, while a select set of master's, PhD, and postdoctoral students, as well as junior faculty members will be trained short- (3-6 months), intermediate-(6-12 months), or long- (>12 months) term at the US sites. The field epidemiology activities will include on-the-job training in research study design, outbreak investigations, data collection and analyses, disease surveillance, and biostatistics. The molecular epidemiology training will focus on the development, validation, and application of new molecular strain typing methods and computer-based analysis of strain subtyping database to address specific epidemiologic questions. Training in molecular biology of drug-resistance mechanisms will include the analysis of genetic elements (integrons, cassettes, plasmids) that mediate drug resistance. Through these training activities, the program hopes to create a cadre of researchers who will not only become future trainers themselves, but who can generate and provide quality information that will assure evidence-based decision-making by clinicians, nosocomial infection control services, metropolitan public health authorities, and state and national government policy makers in Brazil.