Acinetobacter baumannii has emerged from an organism of questionable pathogenicity to an infectious agent of importance to hospitals worldwide causing increased patient morbidity and mortality. The reasons for the emergence of A. baumannii are unknown and no interventions have been successful at curbing this emergence. For these reasons, A. baumannii is a significant public health problem. To our knowledge, no cohort similar to the one described in this application has been created to investigate the epidemiology of A. baumannii. This knowledge is essential in order to develop and implement new, cost-effective infection control strategies aimed at reducing nosocomial infection and the worldwide spread of A. baumannii. The long-term objective of this renewal application is to continue to understand the epidemiology of emergent Gram- negative bacteria and antibiotic-resistant bacteria with a focus in this application on A. baumannii.
The aims of this renewal are:
Aim 1) Construct a prospective cohort of intensive care unit (ICU) patients to quantify the proportion of A. baumannii acquisition that is attributable to patient-to-patient transmission.
Aim 2) Culture several environmental sites in the hospital rooms of patients colonized and infected with A. baumannii to determine sites of frequent contamination and determine whether terminal cleaning between patients is effective.
Aim 3) Identify potential genetic factors that contribute to high transmissibility of A. baumannii using genomic sequencing and comparative genomic techniques. This application is a competitive renewal of an ongoing ICU cohort. The cohort consists of patients admitted to the ICU who have peri-rectal surveillance cultures obtained. The peri-rectal cultures can be used to analyze in a retrospective fashion many bacterial species. The peri-rectal cultures are linked to demographic, comorbidity, laboratory, and medication data that are contained in a relational database. Thus the cohort serves as a rich mechanism of understanding the epidemiology of a number of different emerging bacteria and hospital pathogens.

Public Health Relevance

Acinetobacter baumannii has emerged from an organism of questionable pathogenicity to an infectious agent of importance to hospitals worldwide causing increased patient morbidity and mortality. The reasons for the emergence of A. baumannii are unknown and no interventions have been successful at curbing this emergence. For these reasons, A. baumannii is a significant public health problem.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI060859-07
Application #
8274769
Study Section
Infectious Diseases, Reproductive Health, Asthma and Pulmonary Conditions Study Section (IRAP)
Program Officer
Korpela, Jukka K
Project Start
2004-07-01
Project End
2014-05-31
Budget Start
2012-06-01
Budget End
2013-05-31
Support Year
7
Fiscal Year
2012
Total Cost
$181,306
Indirect Cost
$57,556
Name
University of Maryland Baltimore
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
188435911
City
Baltimore
State
MD
Country
United States
Zip Code
21201
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Thom, Kerri A; Hsiao, William W L; Harris, Anthony D et al. (2010) Patients with Acinetobacter baumannii bloodstream infections are colonized in the gastrointestinal tract with identical strains. Am J Infect Control 38:751-3
Johnson, J Kristie; Smith, Gwen; Lee, Mary S et al. (2009) The role of patient-to-patient transmission in the acquisition of imipenem-resistant Pseudomonas aeruginosa colonization in the intensive care unit. J Infect Dis 200:900-5

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