The Centers for Disease Control and Prevention (CDC) has awarded more than $14 million to fund new approaches to combat antibiotic resistance, including research on how microorganisms naturally present in the human body (referred to as a person’s microbiome) can be used to predict and prevent infections caused by drug-resistant organisms. The awards, made through CDC’s Broad Agency Announcement (BAA), support activities in the CDC Antibiotic Resistance Solutions Initiative. The initiative, which also provides funding for state health departments and other partners, implements the tracking, prevention, and antibiotic stewardship activities outlined in the National Action Plan for Combating Antibiotic-Resistant Bacteria.
“Understanding the role the microbiome plays in antibiotic-resistant infections is necessary to protect the public’s health,” said CDC director Tom Frieden, MD, MPH. “We think it is key to innovative approaches to combat antibiotic resistance, protect patients, and improve antibiotic use.”
The majority of the projects are being conducted through universities across the country and one by a commercial company and two by a nonprofit. Awardees include: Brown University, Columbia University, Cornell University, Emory University, Georgia Institute of Technology, The Joint Commission, Ohio State University, OpenBiome, Pennsylvania State University, Rutgers University, Synthetic Biologics, Inc., University of Georgia, University of California Berkley, University of California Davis, University of Cincinnati, University of Colorado, University of Maryland, University of Michigan, University of Pennsylvania, University of Virginia, University of Oregon, University of Utah, Virginia Commonwealth University, Washington University and Yale University. Some awardees are conducting multiple projects.
The role of the microbiome
The body’s microbiome is a community of naturally occurring microbes in and on our bodies. Bacteria and other microbes live on our skin and in our gut, mouth, and respiratory and urinary tract.
Antibiotics are life-saving medicines, but they also can disrupt the microbiome by changing the balance of good and bad bacteria. With a disrupted microbiome, resistant bacteria can take over (or colonize) and the body is less able to defend against infection, putting people at risk for potentially untreatable illnesses.
Patients with microbiomes disrupted by antibiotics are vulnerable to infections by tough-to-kill germs such as Methicillin-resistant Staphylococcus aureus (MRSA), Carbapenem-resistant Enterobacteriaceae (CRE) and Clostridium difficile (C. difficile). These patients can then carry drug-resistant bacteria, which can easily spread to other people, especially those who also have a disrupted microbiome.
The awards will fund research exploring the link between antibiotics, the microbiome and the downstream consequences of widespread antibiotic use. Research projects will study:
How antibiotics disrupt a healthy microbiome
• Determine how exposure to antibiotics early in life affects microbiome development.
• Determine novel strategies that protect and restore the microbiome.
How a disrupted microbiome puts people at risk
• Develop indices to predict risks for patients who take specific antibiotics. Determine if these indices predict risk for spreading an infection or becoming infected with drug-resistant bacteria.
• Develop and test microbiome measurements to monitor a patient’s risk, and assess enhanced infection control effectiveness in protecting a person’s microbiome.
How antibiotic stewardship can be improved to better protect the microbiome
• Tailor antibiotic stewardship strategies to a patient’s individual microbiome.
• Tailor antibiotic stewardship to address needs in different healthcare settings (e.g., hospital unit, nursing home, doctor’s office).
The BAA also funds research in the areas of advanced molecular detection, medication safety and infection prevention in healthcare. For more information on the BAA and the list of antibiotic resistance funded projects, visit the Antibiotic Resistance Solutions Initiative webpage.