Bangladesh – UC Berkeley
Dhaka and Matlab, Bangladesh
International Center for Diarrheal Diseases Research, Bangladesh (icddr,b)
UC Berkeley, School of Public Health
Research Focus: Transmission dynamics of multi-drug resistant uropathogenic E. coli in Bangladesh
Site and Background
This is a collaborative project between Dr. Mohammad Aminul Islam (GHES Fellow 2012-2013) at International Center for Diarrheal Diseases Research, Bangladesh (icddr,b) and Dr. Lee Riley at UC, Berkeley, to study transmission dynamics of drug-resistant extraintestinal pathogenic Escherichia coli (ExPEC) that cause community-acquired urinary tract infections. A large proportion of community-acquired UTI in most regions of the world are caused by a limited set of multi-drug resistant E. coli strains belonging to related lineages, orE. coli strains that harbor drug-resistance genes shared by pathogenic and environmental Gram negative bacteria. Some MDR uropathogenic E. coli (UPEC) strains share the same genetic lineages with those isolated from food sources, indicating potential foodborne transmissions of antibiotic resistant UPEC. This project will examine the transmission dynamics of MDR UPEC in slum and non-slum communities of Dhaka, Bangladesh as a paradigm of how UPEC clonal lineages and their drug-resistance determinants disseminate in community as opposed to healthcare settings. Bangladesh and India appear to be an important reservoir of many multidrug-resistant Enterobacteriaceae organisms and lineages that are observed globally. This study will have 3 main aims: 1) determine the trend in prevalence of MDR E. coli in patients with UTI and identify risk factors associated with MDR UTI; 2) study the retail food and poultry sources for MDR UPEC; and 3) compare the antibiotic resistance profiles and genotypic characteristics of isolates from UTI and food sources to track mode of transmission of UPEC associated with community acquired UTI. Whole genome sequencing of isolates sharing their genetic lineages (based on PFGE and MLST data) will be used to assess direction of transmission. This project is designed to quantitatively determine the impact, if any, of food and food-producing animals as reservoirs for UPEC on a common community-acquired infection—UTI. Demonstration of such a mode of transmission will contribute to devising more focused public health interventions to prevent them.
GHES fellowships conducted at these sites: