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U-M Researchers to Study Role of Patients' Hands as Key Factors in the Spread of Superbugs

The Centers for Disease Control and Prevention (CDC) has announced that it will pour $14 million into urgently needed research on the issue of superbugs, and steps to prevent, test for and understand antibiotic-resistant bacteria.
  
Four University of Michigan Medical School teams will receive funding through this effort, for a total of nearly $1.6 million. That's on top of other funding the U-M researchers have previously won for their work, and a major investment by the Medical School over recent years to create a hub for research on the microbes that inhabit the human body, and how antibiotics and superbugs affect them.

The new funds relate to two major national initiatives created in recent years since the threat of "superbugs" became a national issue: the CDC Antibiotic Resistance Solutions Initiative and the National Action Plan for Combating Antibiotic-Resistant Bacteria.

With the new funding, U-M teams will:

• Focus on the role of patients' hands as key factors in the spread of superbugs in hospitals and nursing homes: Lona Mody, MD, MSc, will lead a team from U-M and other health systems to evaluate the role of patient hand contamination in the spread of antibiotic-resistant organisms both in hospitals and post-acute care facilities. They will build on their prior work showing that nearly 25 percent of patients discharged from a hospital to a nursing home carry antibiotic-resistant organisms on their hands. Using innovative laboratory methods, they will define the link between patient hand contamination with antibiotic-resistant organisms and an institutional environment; study predictors and consequences of patient hand and other body site contamination on the patients' health; and evaluate patients' and family members' preferences to develop hand hygiene programs and a toolkit that hospitals, outpatient clinics and nursing homes can use to help staff, patients and families prevent that spread. 

• Develop a fast, inexpensive test to predict infections by one of the most dangerous superbugs: A team led by Michael Bachman, MD, PhD, of the Department of Pathology will focus on an especially dangerous group of antibiotic-resistant bacteria known as Extended-Spectrum Beta-Lactamase (ESBL)-producing Enterobacteriaceae, which kill about 1,700 Americans each year and sicken many more. Using samples from real patients, Bachman will try to adapt state-of-the-art genetic techniques used in research labs so that hospital clinical testing labs can use them to identify patients most at risk of ESBL-related infections.

• Track the real-time effect of antibiotics on the balance of bacteria in the guts of surgery patients: Although surgery patients often get antibiotics to reduce their chance of an infection, no one knows how those drugs affect the ecosystem of bacteria that live inside the human digestive tract, also known as the gut microbiome. Krishna Rao, MD, MS, and his team in Infectious Diseases will create the first-ever real-time tracking effort to study how antibiotics alter the balance of gut bacteria, and how the population recovers – including how some bacteria start to evolve antibiotic-resistant traits. This could lead to future tests and tool for evaluating new treatments.

• Figure out how superbugs spread within and between nursing homes: Evan Snitkin, PhD, and his team in the Department of Microbiology & Immunology will use an approach called genomic epidemiology to study the bacteria found in patients in 18 nursing homes, and fill a critical gap in understanding of how antibiotic resistance emerges and spreads in these settings. The approach involves studying the entire genome, or set of DNA, of all the bacteria species found in these samples, to look for tiny differences that can trace how a specific superbug traveled from person to person.

"Antibiotics are life-saving medicines, but they also can disrupt a person's microbiome and increase the risk for drug-resistant infections. To protect people, their microbiomes, and the effectiveness of antibiotics, these projects are examples of applied research that has the potential to produce innovative public health approaches to better combat antibiotic resistance," says Clifford McDonald, associate director of science for CDC's Division of Healthcare Quality Promotion.

The four researchers who lead these teams are all part of a broader U-M effort to study the human microbiome, and the ways that diseases and treatments alter the balance of microscopic organisms in and on our bodies.

Through the U-M Host Microbiome Initiative, they have access to advanced equipment for rapidly spelling out bacterial DNA, assessing the biodiversity of microbe populations in a sample,  growing cultures under the same conditions found in the body, and processing and analyzing the massive amounts of data that microbiome research generates.

Source: University of Michigan Health System

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