Emerging drug-resistant infections

描述（由申请人提供）：在医院和社区环境中发生的耐药细菌感染是中等收入发展中国家（如巴西）大城市中心的一个新出现的传染病问题。该培训计划将建立在Fogarty国际新兴传染病培训和研究（ITREID）支持的培训计划的最后5年，以在巴西建立可持续的研究培训基础设施，以解决医院和社区环境中发生的耐药细菌感染问题。这一基础设施将在里约热内卢联邦大学（FUR J）建立，涉及FUR J和美国的教师，他们在过去5年中一直在合作。具体而言，新计划将围绕三个研究领域建立一个培训计划：1）现场流行病学，2）分子流行病学，3）细菌耐药性的分子生物学。在美国的培训地点将包括加州大学伯克利分校（UCB）公共卫生学院的传染病和流行病学课程，加州大学弗朗西斯科分校（UCSF）的传染病课程，以及纽约市康奈尔大学威尔医学院的医学系。在FURJ的现场培训将提供医学博士，硕士和博士水平的学生，而一组选择的硕士，博士和博士后学生，以及初级教师将接受培训短期（3-6个月），中期-（6-12个月），或长期-（>12个月）在美国的网站。现场流行病学活动将包括研究设计、疫情调查、数据收集和分析、疾病监测和生物统计方面的在职培训。分子流行病学培训将侧重于新的分子菌株分型方法的开发、验证和应用，以及菌株亚型数据库的计算机分析，以解决特定的流行病学问题。耐药性机制的分子生物学培训将包括分析介导耐药性的遗传因素（整合子、盒、质粒）。通过这些培训活动，该计划希望创建一个研究人员的骨干，他们不仅将成为未来的培训师，而且可以生成和提供高质量的信息，以确保临床医生，医院感染控制服务，大城市公共卫生当局以及巴西州和国家政府决策者的循证决策。

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.