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CDC initiative to combat antimicrobial resistance, infectious diseases

School of Medicine projects focus on superbugs commonly found in hospitalized patients in India, Pakistan

December 7, 2021

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The Centers for Disease Control and Prevention (CDC) has awarded $22 million to nearly 30 organizations in 50 countries for efforts to combat antimicrobial resistance and other infection-related threats to health. Part of that funding will support 11 short-term research projects aimed at identifying new solutions to help prevent antimicrobial-resistant infections and their spread, including two such projects led by Washington University School of Medicine in St. Louis.

One project, co-led by infectious diseases specialists David Warren, MD, professor of medicine, and Sumanth Gandra, MD, associate professor of medicine, involves conducting surveillance for superbugs – carbapenem-resistant Enterobacterales (CRE) – in two hospital intensive care units in India.

According to the CDC, such bacteria are resistant to nearly all existing antibiotics, and about half of patients in intensive care units who contract bloodstream infections from CRE die. Enterobacterales is a large family of bacteria that includes E. coli, Klebsiella and Enterobacter.

In India, CRE is commonly found in health-care facilities, but it is resource intensive for health-care facilities to monitor this threat. The researchers aim to find an effective and sustainable way to implement screening for CRE in hospital systems in low- and middle-income countries where resources are limited. This research is important because creating a robust way to screen for CRE in low- and middle-income countries will provide data needed to inform infection prevention efforts and help health-care facilities reduce death rates caused by these infections.

A second project, co-led by Gautam Dantas, PhD, and Carey-Ann Burnham, PhD, both professors of pathology & immunology, involves studying multidrug-resistant organisms in hospitalized patients in Pakistan.

The researchers will collect fecal samples and nostril and armpit swabs from seriously ill patients in hospitals in Pakistan. They also will collect samples from nonhospitalized people who live in the patients’ homes. Researchers will compare multidrug-resistant organisms — including CRE, extended-spectrum β-lactamase (ESBL)-producing Enterobacterales, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE) — to determine if there is a connection between the germs in patients and the germs found in household members. Knowing the genetic relatedness between the organisms in the hospital and those in the community will inform efforts to improve infection-prevention strategies in the region.

Washington University School of Medicine’s 1,700 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is a leader in medical research, teaching and patient care, consistently ranking among the top medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.