Multidrug-resistant
organisms are an increasing challenge for healthcare institutions worldwide.
Drug resistance spreading at an alarming rate among a variety of bacterial and
parasitic species, causing both community-acquired and nosocomial infections. These
infections are particularly dangerous for combat wounds, sometimes resulting in
the loss of life and limb; furthermore, as Service Members are evacuated to
higher levels of care, these infections can travel with them, spreading
throughout the world. To effectively overcome this threat, new care must be
given to detecting, preventing and controlling MDROs at all levels, ranging
from small community focal efforts to the entire international community.
Highly
problematic antibiotic resistant bacteria that we study include the ESKAPE-E pathogens (Enterococcus, Staphylococcus,
Klebsiella, Acinetobacter, Pseudomonas, Enterobacter
and E. coli) and Neisseria gonorrhoeae. Current efforts are
diversified into in vitro screening
for new drugs and new drug combinations as well as in vivo testing of compounds, antimicrobial peptides and
bacteriophages. Surveillance effort include phenotypic and genotypic
characterization and identification of existing and novel antibiotic resistance
genes from MDROs in Thailand, Cambodia and Nepal.
Surveillance
conducted in collaboration with the Royal Thai Army also improves the joint
medical intelligence picture of MDRO circulating in Thailand. These data are
requisite components of effective force health protection measures and
treatment guidelines for U.S. military personnel deploying to Southeast Asia.