# Microbial Community Disruption Following Topical Antimicrobial Application in Staphylococcus aureus-Affected Households

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2022 · $781,932

## Abstract

PROJECT SUMMARY
 The National Action Plan for Combating Antibiotic-Resistant Bacteria identified critical research needs to
confront the advancing threat of antimicrobial resistance. These include understanding the nature of microbial
communities, determining the effects of antibiotics on these communities, and harnessing these communities to
develop strategies for disease prevention. Staphylococcus aureus causes significant morbidity and mortality in
healthcare and community settings. S. aureus carriage confers risk for endogenous infection. Previous studies
investigated clinical and epidemiological factors associated with S. aureus colonization and infection, although
the influence of the skin and nasal microbiota on S. aureus acquisition is unclear. We hypothesize that features
of the commensal microbiota may confer susceptibility to, or provide protection against, S. aureus acquisition
and development of subsequent infection. Further, in an effort to prevent S. aureus acquisition and infection,
decolonization with topical antimicrobials is frequently employed in healthcare and community settings. However,
broad-spectrum topical antimicrobial application may disrupt commensal microbiota, thereby promoting the
acquisition or enrichment of multidrug-resistant and/or potentially pathogenic microorganisms. The impact of this
potential adverse effect remains understudied.
 In this proposed project, we will analyze a vast and unmatched biorepository of >13,000 skin and nasal swab
samples that were longitudinally collected over 24 months from a well-characterized cohort of 476 participants,
including 99 pediatric patients with methicillin-resistant S. aureus skin infections and their household contacts,
all of whom are at high risk for S. aureus acquisition and infection. The samples were collected during 12 months
of longitudinal samplings (the natural history phase) followed by a randomized, 5-day decolonization intervention
with topical antimicrobial application, and subsequent longitudinal sampling for 12 months (post-decolonization
phase). We will perform metagenomic shotgun sequencing (enabling classification at the species and strain
levels), to longitudinally characterize skin and nasal microbial communities in the context of S. aureus
colonization and disease. We will compare microbial community features associated with susceptibility or
resistance to S. aureus acquisition between household contacts with different phenotypic outcomes (e.g.,
colonization and infection), and integrate these data with detailed epidemiological data to predict individuals at
risk for acquiring S. aureus colonization and/or developing symptomatic infection. We will quantify changes in
microbial community structures following topical antimicrobial application, and correlate this disruption with
subsequent acquisition and persistence of S. aureus and other pathogens. Finally, we will employ innovative
targeted sequence capture to quantify genetic determinants of ant...

## Key facts

- **NIH application ID:** 10407645
- **Project number:** 5R01AI163161-02
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Stephanie Ann Fritz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $781,932
- **Award type:** 5
- **Project period:** 2021-05-19 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10407645

## Citation

> US National Institutes of Health, RePORTER application 10407645, Microbial Community Disruption Following Topical Antimicrobial Application in Staphylococcus aureus-Affected Households (5R01AI163161-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10407645. Licensed CC0.

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