Infectious disease physicians from Vanderbilt University Medical Center will soon be applying their expertise overseas as part of the CDC’s new Global Action in Healthcare Network.
The team will be helping direct a network of hospitals in Greece through the process of enhancing laboratory capacity for detection and control of antibiotic-resistant bacteria.
The global collaborative was formed to ensure the rapid detection of and response to threats of infectious disease in the health care setting. So far, the Global Action in Healthcare Network has put $22 million toward that effort through grants to 28 organizations, with more than 50 countries participating.
“Greece has among the highest rates of drug-resistant bacteria in Europe; we applied for this grant with this in mind,” said Vanderbilt’s principal investigator on the project, Ritu Banerjee, M.D., a professor of pediatric infectious diseases. The medical center received nearly $2.5 million for the first two years of the five-year award.
Focus On Emerging Threats
Antibiotic resistance is nothing new, but it is a persistent threat with evolving players, Banerjee said. Today’s targets include carbapenem-resistant Enterobacterales (CRE) species, including Escherichia coli and Klebsiella pneumoniae, with some strains of these species resistant to all available antimicrobials.
“CRE are among the most urgent antimicrobial resistant threats,” Banerjee said. “What is unique about these strains is that they carry resistance genes that make our usual first-line antibiotics ineffective.”
Beyond being difficult to treat, patients who are asymptomatic carriers of CRE can spread these strains inside hospitals and further complicate identification and mitigation approaches. And, since detection via routine culture can take days, Banerjee has urged use of rapid diagnostics to prevent outbreaks.
“The focus of our work in this CDC network is rapid detection and containment of CRE so that they don’t further spread within these hospitals,” she said. “We will work with these facilities to enhance their lab testing to quickly detect resistance and to support infection prevention and control interventions.”
Building on Expertise
At Vanderbilt, Banerjee and others have pioneered efforts to identify those most at risk for emerging infections. The critical next step, she said, is clamping down on excessive use of the dwindling pipeline of effective antimicrobials.
“The indiscriminate use of antibiotics is a huge factor,” she said. “Many countries have over-the-counter antibiotics available without prescriptions. Even in countries like ours, which require prescriptions to obtain antibiotics, they are not always prescribed appropriately.”
Joining Banerjee on the project at Vanderbilt is Peter Lane, program manager at the Vanderbilt Institute for Global Health; Lynne Berry, Ph.D., vice chair of informatics and collaborative programs in the Department of Biostatistics; Thomas Talbot, M.D., professor of medicine and infectious diseases and chief hospital epidemiologist at Vanderbilt; and Amanda Mixon, M.D., an associate professor of medicine at Vanderbilt and the Veterans Affairs Tennessee Valley Healthcare System.
