Emerging drug-resistance infections

描述(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的大城市中心出现的一个新的传染病问题，如巴西。该培训计划将建立在Fogarty国际新兴传染病培训和研究(ITREID)支持的过去5年培训计划的基础上，在巴西建立一个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。这个基础设施将在里约热内卢联邦大学(FURJ)建立，涉及FURJ和美国的教职员工，他们已经在过去5年中进行了合作。具体地说，新计划将围绕三个研究领域建立培训计划：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。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、加州大学旧金山分校(UCSF)的传染病课程和纽约市康奈尔大学威尔医学院的医学系。FURJ将为MD、硕士和博士级别的学生提供现场培训，而一批精选的硕士、博士和博士后以及初级教员将在美国地点接受短期(3-6个月)、中期(6-12个月)或长期(&>12个月)的培训。实地流行病学活动将包括研究研究设计、暴发调查、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，以及基于计算机的菌株亚型数据库分析，以解决特定的流行病学问题。耐药机制的分子生物学培训将包括分析介导耐药的遗传因素(整合子、盒、质粒)。通过这些培训活动，该项目希望培养一支研究人员队伍，他们不仅自己将成为未来的培训者，而且能够生成和提供高质量的信息，确保临床医生、医院感染控制服务、大都市公共卫生当局以及巴西州和国家政府政策制定者做出基于证据的决策。

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.