# Advancing Public Health Research in Central America - An Integrated Surveillance Platform for Infectious Diseases and Their Burden on Antibiotic Resistance

> **NIH ALLCDC U01** · WASHINGTON STATE UNIVERSITY · 2022 · $594,060

## Abstract

PROJECT SUMMARY
The growing prevalence of antibiotic resistance is a threat to human health globally. More than
80% of the world’s population lives in low- and middle-income countries that are particularly
challenged by antibiotic resistance. This situation arises because of greater disease burdens,
greater antibiotic demand, greater unsupervised antibiotic availability, and more opportunities
for transmission of pathogens and antibiotic-resistant bacteria that, in turn, increases disease
incidence and demand for antibiotics. We hypothesize that the transmission component of this
process is even more important than antibiotic use, and consequently interventions that limit
transmission would be most efficacious in resource-limited settings. The proposed project will
directly assess the connection between burden of disease (defined as syndromic illness
including acute febrile illness, diarrhea, and respiratory infections) and subsequent demand for
antibiotics on the prevalence of antibiotic-resistant bacteria (commensal and pathogenic). We
will establish a surveillance platform in a rural and an urban community located in the
Quetzaltenango Department of Guatemala. A cross-sectional, randomly-selected sample of
households (n=600) will be enrolled during the initial phase of the study, and both stool and
throat samples will be collected to detect the presence (colonization) of extended-spectrum
cephalosporin-resistant Enterobacteriaceae (ESCrE), carbapenem-resistant Enterobacteriaceae
(CRE) and Group A Streptococcus. The baseline data will be compared with subsequent
longitudinal samples while cases of syndromic illness will be investigated at the enrolled
households. Pathogen isolation and tracking of patients at local hospital will be used to examine
the healthcare contribution to the prevalence of antibiotic resistance in the community. If funding
is available, the surveillance platform will continue to collect baseline prevalence data on
antibiotic resistance and investigate syndromic illness for three years. Additional work will
include molecular characterization of bacterial isolates and inclusion of a separate cross-
sectional study to examine the prevalence of antibiotic-resistant bacteria in a community that
has a higher incidence of acute febrile illness. Data from years 1-3 will be used to identify and
test interventions during years 4-5.

## Key facts

- **NIH application ID:** 10464872
- **Project number:** 5U01GH002241-05
- **Recipient organization:** WASHINGTON STATE UNIVERSITY
- **Principal Investigator:** DOUGLAS R. CALL
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2022
- **Award amount:** $594,060
- **Award type:** 5
- **Project period:** 2018-09-15 → 2023-09-14

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10464872

## Citation

> US National Institutes of Health, RePORTER application 10464872, Advancing Public Health Research in Central America - An Integrated Surveillance Platform for Infectious Diseases and Their Burden on Antibiotic Resistance (5U01GH002241-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10464872. Licensed CC0.

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