Antimicrobial Resistance

Antimicrobial resistance is one of the top global health threats. Antibiotic resistant organisms and new resistance mechanisms and are emerging and spreading across the globe, thereby threatening our ability to treat and prevent common infectious diseases. Estimates from the Centers for Disease Control (CDC) and Prevention indicate that antibiotic resistance causes more than two million illnesses and 23,000 deaths yearly in the United States. Without action, the problem of antibiotic resistance will likely get worse over time; projections indicate that deaths due to antibiotic resistance may reach 10 million per year globally and surpass cancer deaths by 2050. Reducing the overall risk of antibiotic resistance requires sustained research and public health prevention efforts that simultaneously addresses antimicrobial resistance from several different perspectives. Efforts include antimicrobial stewardship, surveillance for antibiotic resistant bacteria, development of diagnostics, and design of novel therapeutic and prevention approaches.

Through a combination of clinical epidemiologic studies, laboratory-based work, and mathematical modeling, YSPH faculty are working to address the global health threat of antimicrobial resistance.

Ted Cohen’s research focuses on how Mycobacterium tuberculosis drug-resistance and medical comorbidities impede efforts to control epidemics, with the ultimate goal of developing effective approaches to limit morbidity caused by this pathogen. He and his research team are also developing new modeling approaches that integrate data on pharmacokinetics and bacterial killing in vivo and in vitro to inform the development of new anti-tuberculosis regimens.

Melinda Pettigrew serves on the Steering Committee of the Antibiotic Resistance Leadership Group. The Antibiotic Resistance Leadership Group is a national network of scientists who develop and manage a clinical research agenda to combat antimicrobial resistance. Dr. Pettigrew’s research examines complex relationships between the microbiota, antibiotic exposure, and risk of respiratory and hospital-acquired infections.

Clostridium difficile is a leading cause of hospital-acquired infections and the incidence of community-acquired C. difficile infections is increasing. Students, faculty, and staff at the Connecticut Emerging Infections Program are conducting surveillance on C. difficile to increase understanding of the epidemiology of community- and healthcare-associated C. difficile infections and to generate hypotheses for future research.

While many projects in EMD focus on antibiotic resistance in bacterial pathogens, Sunil Parikh’s research focuses on the first-line therapies for malaria, the artemisinin-based combination therapies. His group conducts pharmacokinetic/pharmacodynamic studies in sub-Saharan Africa. Through a combination of observational and clinical trials, lab-based studies, and modeling, the group aims to understand how antimalarial PK/PD contribute to the development of resistance. The ultimate goal is to optimize treatment regimens to maximize the useful therapeutic life of current and future antimalarials.