Development of a point-of-care platform for differential diagnosisof emerging in

新出现和再次出现的病原体，如艾滋病毒、普恩病毒、耐甲氧西林金黄色葡萄球菌、广泛耐药结核病、西尼罗河、亨德拉和尼帕， 偏肺炎、卡里氏、韩流、埃博拉、马尔堡、冠状、流感、基孔肯雅和鼻病毒，正在塑造一种新的 公共卫生和临床医学的景观。这一现象被归因于自然资源的破坏 栖息地；政治不稳定和贫困；气候变化；老龄化人口更容易受到感染 或因艾滋病毒、癌症或移植而受到免疫抑制；人口密度增加；以及不适当地使用 抗生素。随着旅行和贸易的全球化，微生物、病媒和水库在地理上不再存在 离散的。点源感染可迅速暴发，或在更广泛的范围内分布成为流行病。 因此，临床医生和公共卫生从业者必须为新病原体、新病原体的出现做好准备 症状，以及已知病原体在新的背景下引起的已知症状。经典的栽培技术， 免疫组织化学、EM和血清学在病原体发现和临床微生物学诊断中至关重要； 尽管如此，分子方法由于速度快、成本低和成功的能力而被越来越多地使用。 挑剔的要求混淆了修养的例子。我们已经制定了阶段性战略，以实现 快速识别新出现的和已知的病原体。这一策略将被用来调查原因不明的 出血热、不明原因脑炎和脑膜脑炎、不明原因发热等 亚洲、非洲和南美洲使用从标准化网络下的有特色的对象收集的材料 协议。具体目标包括：(1)优化绿色芯片核酸模板的制备，实现高通量 测序平台；(2)调查不明原因的出血热；(3)调查不明原因的脑炎和 脑膜脑炎；(4)调查不明原因的发烧疾病；以及(5)调查潜在的宿主和病媒 AIMS 2-4中涉及的特工的存在。

Emerging and re-emerging pathogens such as HIV, prions, MRSA, XDR Tb, West Nile, hendra- and nipah, metapneumo-, calici-, hanta-, Ebola-, Marburg-, corona-, influenza-, chikungunya- and rhinoviruses, are sculpting a new landscape for public health and clinical medicine. This phenomenon has been ascribed to the destruction of natural habitats; political instability and poverty; climate change; the increased susceptibility to infection of an aging population or one immunosuppressed by HIV, cancer or transplantation; increasing population density; and inappropriate use of antibiotics. With globalization of travel and trade, microbes, vectors and reservoirs do not remain geographically discrete. Point source infections can rapidly become outbreaks or distribute even more broadly to become pandemics. Thus, clinicians and public health practitioners must be prepared for the appearance of new pathogens, new syndromes, as well as known syndromes due to known pathogens in new contexts. Classical culture techniques, immunohistochemistry, EM, and serology are vital in pathogen discovery as well as diagnostic clinical microbiology; nonetheless, molecular methods are increasingly employed due to speed, lower cost and the capacity to succeed in instances where fastidious requirements confound cultivation. We have established a staged strategy that enables rapid identification of emerging as well as known pathogens. This strategy will be used to investigate unexplained hemorrhagic fevers, unexplained encephalitis and meningoencephalitis, and unexplained febrile illness in "hot spots" in Asia, Africa and South America using materials collected from well characterized subjects under standardized network protocols. Specific Aims include: (1) Optimize preparation of nucleic acid template for GreeneChip and high throughput sequencing platforms; (2) Investigate unexplained hemorrhagic fevers; (3) Investigate unexplained encephalitis and meningoencephalitis; (4) Investigate unexplained febrile illness; and (5) Investigate potential reservoirs and vectors for the presence of agents implicated in Aims 2-4.