Grant: CIHR Fellowship

Antibiotics are vital for treating bacterial infections. However, many of these disease-causing bacteria have developed drug resistance to counter antibiotic treatment. These bacteria are often referred to as multi-drug resistant organisms (MDROs). Infections caused by MDROs are harder to treat, and in worst case scenario, can lead to death. Among healthcare facilities, nursing homes (NHs) play a critical role in providing care for older and chronically sick people. Unfortunately, NHs are also major reservoirs of MDROs, putting their already frail residents at risk of MDRO colonization (carriage without being sick) and infection. When colonized or infected NH residents go home or transfer to another hospital, they bring the MDROs with them which then can spread to other healthcare facilities and the community. To begin to put a stop to this vicious chain of events, I will study how MDROs spread within the healthcare system with a focus on NHs, and how MDROs colonize NH residents. To understand how MDROs spread, I will collaborate with a NH researcher who has collected MDROs from 18 Michigan NHs during 2010-2015. By studying the DNA of these MDROs, I can determine how similar or different they are. Similar MDROs found in different NHs suggest that these MDROs have been moving between these NHs. I will then address whether residents from these NHs visit the same hospital or are associated with the same neighbourhood, which may be where MDROs from different NHs are exchanged. Next, as my preliminary data have shown that NH residents colonized with one type of MDRO are at a higher risk of acquiring a second type of MDRO, I will examine the biological mechanism underlying these relationships, an important step for understanding the clinical implications of MDRO colonization. My proposed work will provide the first glimpse into MDRO ecology and epidemiology in NH settings, identifying the most effective points of intervention to control MDRO colonization and infection.