Mitigate the Global Impact of Sepsis Through ACESO (CARB) (Navy)
Abstract
This project seeks to demonstrate that the impact of sepsis from resistant and other high risk organisms in Egypt can be mitigated through the ACESO approach of discovering common, host-based pathogenic pathways for improved recognition and management of sepsis. This project will improve understanding of pathogenesis and antimicrobial resistance mechanisms through network and biomarker analysis to offer unique opportunities for improving sepsis diagnosis and management. Most specifically, ACESO will execute biomarker discovery identifying diagnostic and prognostic biomarker panels which may improve sepsis management in all environments including resourced and austere. FY 2017 Accomplishments: FY17 efforts supported continued enrollment of severely ill patients in an observational study in Cambodia at Takeo Provincial Hospital and in Ghana at Komfo Anoyke Teaching Hospital (KATH). The goals of this study are to 1) identify diagnostic and prognostic markers, 2) investigate common pathogenic pathways, 3) describe the spectrum of pathogens causing sepsis, 4) describe the treatment strategies currently in use, and 5) assess the long-term sequelae. Adult patients with suspected infection and evidence of systemic inflammation were considered for enrollment. Laboratory testing augmented the testing routinely performed at the hospital microbiology laboratory, and included diagnostic tests (e.g. blood cultures, malaria smears, HIV tests, and serology), molecular diagnostics, and assays measuring the host-response (RNA sequencing, proteomics, and metabolomics). Sophisticated analytic and statistical approaches are being applied to the complex data set to identify diagnostic and prognostic markers for sepsis and to investigate common pathogenic pathways. The Vietnam-Australia-US military study of drug resistance patterns in Central Vietnam was closed in Jan 2017 due to a lower than expected malaria burden. Preliminary data supports previous findings, reported in FY16, that there is no resistance for 1st choice malaria drug treatments. Additionally, a review of Vietnam malaria burden, control measures and environmental factors was initiated; the preliminary findings suggest increased average daily temperature was a primary factor of decreased malaria rates. Recruitment for the cross-sectional study in Gai Lia Province (on the border with Cambodia) started in Dec 2016 and was completed in Feb 2017. Sample and data analysis are ongoing, however, preliminary results from the >3,000 participants indicate the rate of patients without symptoms, but still carrying malaria parasite, was >1.25% in this study population, representing a silent malaria transmission risk in this forested, border region on the Cambodia-Vietnam border. The study of Vietnamese workers returning from Africa was initiated in Q2 FY17 with concurrent records review was stated for malaria patients recently returned from Africa presenting for care at two referral medical facilities in Ha Noi in 2014-2016. Preliminary results were accepted for presentation at the Joint International Tropical Medicine Meeting in Bangkok, Thailand from 06-08 Dec 2017. These data suggest delayed malaria clearance in patients returning from Africa was likely due to delayed medical treatment and not from malaria drug resistance.
Document Details
- Document Type
- Accomplishment
- Publication Date
- Oct 01, 2019
- Source ID
- 3b7311c4e0f299ad722947a4bd81f2b8