Theproposedprojectisaninvestigationofthesynergisticactivityofantimicrobialcombinations against carbapenem-resistant Enterobacteriaceae (CRE). The principal investigator, Dr. Thea Brennan-Krohn, recently completed fellowships in Pediatric Infectious Diseases and in Medical Microbiology and is now an Instructor at Harvard Medical School and a post-doctoral fellow at BethIsraelDeaconessMedicalCenter.Sheisinterestedinimprovingmethodsfordetectionand characterizationofantimicrobialsynergyinordertoguidethetreatmentofpatientsinfectedwith highly resistant pathogens. Her career goal is to become a leading investigator in the development, implementation and interpretation of tests for detection of antimicrobial synergy. During the award period, she will obtain a Master of Science in Pharmacology and will pursue courseworkinclinicalandtranslationalresearch.Theproposedresearchwillbecarriedoutunder the mentorship of James Kirby, MD, D(ABMM), an NIH-funded investigator at Beth Israel DeaconessMedicalCenterwhoselaboratoryinvestigatestopicshighlyrelevanttotheproposed project, including the development of novel antimicrobial susceptibility testing methods and the investigationofnewtherapeuticsforCRE.Dr.Brennan-Krohnwillbesupportedduringtheaward periodbyanadvisorycommitteethatincludesDr.GeorgeEliopoulos,aworld-renownedexpert onantimicrobialsynergy.Intheproposedproject,Dr.Brennan-Krohnwillinitiallytestantimicrobial combinations against a comprehensive collection of clinical CRE isolates in order to establish combinatorial spectra of activity. For this part of the project, she will use an automated checkerboard array microdilution method that makes use of the HP D300 inkjet printer-based dispensingsystem.Shewillnextdevelopanovel,fluorescenttime-killsynergyassayinorderto investigatethebactericidalkineticsofsynergisticcombinations.Finally,shewillinvestigatethein vivo efficacy and PK/PD parameters of the most effective combinations using an immunocompromisedmousemodelofCREinfection.Ultimately,theenhancedunderstandingof synergy as well as the technology developed and validated during the proposed study are expectedtoinformthedesignofprospectiveclinicaltrialsofcombinationantibiotictherapyand toestablishsimple,rapidsynergytestingplatformsthatwillforthefirsttimeprovidesynergydata thatcanbeusedinaclinicallyactionabletimeframetoguidepatientcare.

Public Health Relevance

Carbapenem-resistant Enterobacteriacae (CRE) are among the most drug-resistant bacteria known and are increasing in frequency worldwide. Treatment options for these pathogens are highlylimitedatpresent,butcombinationantibiotictherapyhasshownevidenceofefficacy.The proposed research project will investigate in vitro and in vivo synergistic activity of a range of antibiotic combinations in order to guide the development of new diagnostic and treatment modalitiesforCRE.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08AI132716-02
Application #
9643997
Study Section
Microbiology and Infectious Diseases B Subcommittee (MID)
Program Officer
Xu, Zuoyu
Project Start
2018-02-20
Project End
2023-01-31
Budget Start
2019-02-01
Budget End
2020-01-31
Support Year
2
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Beth Israel Deaconess Medical Center
Department
Type
DUNS #
071723621
City
Boston
State
MA
Country
United States
Zip Code
02215
Brennan-Krohn, Thea; Pironti, Alejandro; Kirby, James E (2018) Synergistic Activity of Colistin-Containing Combinations against Colistin-Resistant Enterobacteriaceae. Antimicrob Agents Chemother 62:
Truelson, Katherine A; Brennan-Krohn, Thea; Smith, Kenneth P et al. (2018) Evaluation of apramycin activity against methicillin-resistant, methicillin-sensitive, and vancomycin-intermediate Staphylococcus aureus clinical isolates. Diagn Microbiol Infect Dis 92:168-171