Epideiology of Shigellosis in the Peruvian Amazon

描述(申请人提供)：志贺氏菌病是 临床痢疾是儿童发病和死亡的常见原因 生活在贫困地区。由于繁殖病毒的迅速出现和蔓延 抗生素耐药菌株和缺乏可用的疫苗 如果不采取措施，志贺氏菌病的发病率和死亡率可能会增加 改进疾病控制措施。拟议的研究将由L)确定 志贺氏菌病社区发病率及发病危险因素分析 秘鲁亚马逊地区6岁以下儿童的志贺氏菌病发病率；2) 通过以下方式描述不同传播途径的相对重要性 来自患者、家庭成员和家庭的分离株的基因分型 环境来源；以及3)确定获得的菌株的多样性 志贺氏菌病患儿家庭和基因组对照家庭 分析、血清型和抗生素敏感性图谱。这些数据将 有助于增进对志贺氏菌病流行病学的了解 地方病流行地区，因此可作为定义 最有效的干预措施。关于血清型的信息 整体人口和有子女的家庭的多样性 痢疾将提供重要的数据，对疫苗开发和 将其作为未来疫苗试验的候选地点。最新进展 以及对一种快速、高度区分性的分子分型系统的评价 更容易适用于欠发达地区，将促进未来 对疫区进行调查。带来的协作团队 共同进行拟议的研究是一个既定的国际小组 微生物学家、分子遗传学家、流行病学家和内科医生 具有在国际上培训初级科学家的丰富经验 布景。该项目将进一步加强这些国际联系。 在培养初级临床医生-科学家的过程中。

DESCRIPTION (provided by applicant): Shigellosis is the principal cause of clinical dysentery and a frequent cause of morbidity and mortality in children living in impoverished areas. Due to rapid appearance and spread of multiply antibiotic resistant strains and the lack of an available vaccine the morbidity and mortality from shigellosis is likely to increase without improved disease control measures. The proposed study will l) determine the community incidence rates of shigellosis and risk factors for the development of shigellosis in children under six years of age in the Peruvian Amazon; 2) characterize the relative importance of different routes of transmission by the genotyping of isolates from patients, family members, and household environmental sources; and 3) determine the diversity of isolates obtained in households of children with shigellosis and control households by genomic analysis, serotype, and antibiotic sensitivity profile. These data will contribute to an improved understanding of the epidemiology of shigellosis in an endemic area and therefore serve as the basis for the definition of the most highly effective interventions. The information on the serotypic diversity in the population as a whole and in households with children with dysentery will provide important data useful in vaccine development and establish this as a candidate site for future vaccine trials. The development and evaluation of a rapid highly discriminatory molecular typing system that is more readily applicable in less developed regions will facilitate future investigation in endemic areas. The collaborative team that is brought together to conduct the proposed study is an established international group of microbiologists, molecular geneticists, epidemiologists, and physicians with extensive experience training junior scientists in an international setting. This project will further strengthen these international connections in the process of the training of a junior clinician-scientist.