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Ashley Styczynski, MPH, MD

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GHES U.S. Fellow 2019-2020

FELLOWSHIP SITE: International Centre for Diarrhoeal Disease Research, Bangladesh
U.S. INSTITUTION: Stanford UNIVERSITY

Project Title: Use of Chromogenic Agar for Detection of Patient Colonization and Environmental Contamination with Antimicrobial Resistant Organisms in a Bangladeshi Hospital

Antimicrobial resistance (AMR) is a growing global health threat that is projected to be a leading cause of mortality worldwide by 2050 if the current epidemic remains unchecked. The greatest burden, including neonatal mortality, is in low- and middle-income countries. Though numerous causes have contributed to the rise of AMR, the strongest predictors of AMR are socioeconomic factors. Low-resource hospitals are particularly prone to suffering the consequences of AMR because of overcrowding of susceptible hosts, intensive use of antibiotics, and inadequate sanitation and hygiene. The maternal and neonatal wards are no exception. This has given rise to an increase in cases of neonatal sepsis for which available antibiotics are ineffective.

Substantial gains have been made in under-5 mortality over the past decade. However, reduction in newborn deaths has experienced the least progress among this demographic. Bangladesh is one of 10 countries that make up half of the world’s newborn mortality burden, and up to half of these deaths are attributed to infections. While an increase in hospital-based deliveries has helped to reduce newborn deaths by ensuring timely access to supportive services, this may also be contributing to increased transmission of resistant organisms to babies at the time of delivery.

Dr. Styczynski will be working with a research team at icddr,b and Faridpur Medical College Hospital in Bangladesh to better understand transmission dynamics of AMR in the hospital setting. Specifically, she will be evaluating mother-baby pairs and the hospital environment to understand drivers of AMR transmission. She will also be determining the relative contributions of community versus hospital exposures to colonization with AMR bacteria and how this predicts subsequent infections. The ultimate goal of this project is that it will lead to the development of an intervention that can interrupt the spread of AMR in the perinatal period.