Prevention of Infection in Indian Neonates

  • Panigrahi, Pinaki, (PI)

Project: Research project

Description

DESCRIPTION (Provided by applicant): India, with one of the world's largest
populations, continues to struggle with extremely high infant and neonatal
mortality rates. Sepsis now accounts for 50% of deaths among community-born
(and 20% of mortality among hospital-born) infants. Closely linked with this
is a burgeoning problem with antimicrobial resistance, which is increasingly
restricting the therapeutic options for medical care providers. To deal with
these critical issues, the investigators propose to establish a Research Unit
for the study of MCH in India, based on strong, existing collaborations
between investigators in the Department of Pediatrics and Epidemiology and
Preventive Medicine at the UMSM, Baltimore, and the AIIMS, New Delhi, and
hospitals and the Ministry of Health in the state of Orissa, India. The
applicant will initially develop an infrastructure to monitor occurrence of
neonatal sepsis in community- and hospital-born infants. This will include:
1) identification of all hospitalized children, and children brought to
hospital, with the diagnosis of sepsis; 2) obtaining blood cultures from these
children; 3) screening of all bacterial strains isolated from blood cultures
for antimicrobial resistance; 4) collecting basic demographic, risk factor,
and treatment data on each case; and 5) development of a computer-based system
and network for data management. In villages of Orissa State, the applicants
will set up a village-level surveillance system to identify women during their
pregnancy, monitor pregnancy outcomes, and establish a mechanism for referral
of all potentially septic infants to participating clinics or hospitals for
evaluation, including collection of blood cultures. Subsequent studies will
identify potential sources of bacterial isolates causing sepsis. To this end,
the applicants will screen skin, nares, and stool cultures from infants (and
skin, nares, and vaginal cultures from their mothers), and seek to match blood
isolates with these colonizing isolates, using molecular epidemiologic
techniques. In the latter years of the grant period, and with these data
collection systems in place, the applicants will initiate a series of
interventions, including implementation of a hospital- and community-based
system of "preferred" antimicrobials, use of probiotics to reduce the risk of
neonatal sepsis, and implement alcohol-based hand-washing products in hospital
and community-based healthcare settings to minimize pathogen transmission.
StatusFinished
Effective start/end date9/3/014/30/08

Funding

  • National Institutes of Health: $700,342.00
  • National Institutes of Health: $74,892.00
  • National Institutes of Health: $623,903.00
  • National Institutes of Health: $509,555.00
  • National Institutes of Health: $267,537.00
  • National Institutes of Health: $688,696.00
  • National Institutes of Health: $720,138.00

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Sepsis
Newborn Infant
India
Infection
Research Personnel
Community Health Services
Hand Disinfection
Baltimore
Hospitalized Child
Infectious Disease Transmission
Organized Financing
Community Hospital
Probiotics
Pregnancy Outcome
Hospital Mortality
Epidemiology
Alcohols
Mothers
Medicine
Demography

ASJC

  • Medicine(all)