(Administrative Core) The clinical introduction of antibiotics in 1930s-40s represented a major medical breakthrough enabling many advances in modern medicine, agriculture and industrial practice. Unfortunately, the rise of antibiotic-resistant microorganisms globally is now considered one of the most challenging public health threats of the 21st century. The call for action against the threat of antibiotic resistance has now reached the highest level of government including the Office of the US President (with the creation of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria) and the initiative for global action by the United Nations, among others. Vancomycin-resistant enterococci (VRE), Enterobacteriaceae carrying extended spectrum ?-lactamases and carbapenemases (ESBL-E/CRE), and Clostridiodes difficile are particularly concerning for high-risk patients who are immunocompromised and/or admitted to intensive care units (ICUs). Having the potential to cause life- threatening infections, particularly in those patients who have already been subjected to multiple antibiotic regimens, each of these organisms colonize the intestines, and their presence impacts subsequent colonization by other pathogens further contributing to serious disease progression and even mortality in these high-risk patients. Although these pathogens have been studied in isolation, elucidation of the dynamic interactions between pathogens and commensal gut microbiota and their implication for predicting outcomes and, thus, treatment strategies is more urgent than ever and requires a strategic, coordinated effort. The Texas Medical Center in Houston, Texas is home to several world leaders in antimicrobial resistance research and clinical practice with patient access and tremendous expertise in the cutting-edge genomic and phenotypic techniques who are uniquely positioned to perform concerted and synergistic systems-level studies of the multiple players that must be understood to address this challenge. These experts have recognized this exceptional opportunity and the strength of addressing the critical and unmet challenge through the formation of a multi-institutional collaborative research program Dynamics of Colonization and Infection by Multidrug- Resistant Pathogens in Immunocompromised and Critically Ill Patients (DYNAMITE). Crucial for the effectiveness of this multi-institutional research effort, is dedicated centralized administrative oversight and support. The Administrative Core will serve as the central ?hub? for program oversight, accountability, communication, and project/process coordination for the three Projects and the Functional Genomics Core. To achieve these goals, the Administrative Core will provide integrative accountability and oversight through the Executive Leadership Team and the Internal and External Advisory Committees, and administrative support for all project leaders, research personnel, key collaborators and advisors, and institutional administrative liaisons.
