# Pathogen and patient determinants of Candida gut colonization in critically ill patients

> **NIH NIH K23** · METHODIST HOSPITAL RESEARCH INSTITUTE · 2024 · $194,036

## Abstract

PROJECT SUMMARY/ABSTRACT
This K23 proposal outlines a five-year research and training plan that will accelerate Dr. Max Adelman's career
as an independent physician-scientist with expertise in Candida colonization and infection in critically ill
patients. Dr. Adelman is an infectious diseases and critical care clinician whose translational research focuses
on severe infections among patients in the intensive care unit (ICU), a population at high risk of infectionrelated
morbidity and mortality. These patients are particularly susceptible to infections with Candida spp.,
which are the second-leading cause of ICU-onset bloodstream infection and are associated with up to 60%
mortality. Before developing infection, patients are first "colonized" with Candida, and the primary site of
Candida colonization is the gut. Importantly, while gut colonization is a risk factor for Candida bloodstream
infection, there is little data on the host and Candida characteristics that predispose to gut colonization itself.
Additionally, Candida bloodstream infections are increasingly caused by multidrug-resistant species including
C. glabrata and C. auris, but whether these species consistently colonize the gastrointestinal tracts of ICU
patients has not been determined. In this proposal, Dr. Adelman will test the hypothesis that several host and
pathogen-specific factors facilitate gut colonization with Candida, which in tum affects important clinical
outcomes. In Specific Aim 1, he will (a) determine whether broad-spectrum antibiotics commonly used in the
ICU predispose to Candida colonization, (b) evaluate the impact of colonization on clinically important
outcomes using a desirability of outcomes ranking (DOOR) analysis, and (c) determine the genomic
epidemiology of gut colonizing antifungal-resistant Candida spp. In Specific Aim 2, he will examine the immune
pathology that facilitates Candida colonization in the ICU by expanding on his preliminary data linking defective
IFN-y production with colonization. To accomplish these goals, Dr. Adelman has designed a training plan that
builds on his strong clinical research background with advanced training in data science, Candida genomics,
and host-pathogen interactions. Dr. Adelman's research will be overseen by dedicated mentors from Houston
Methodist Hospital and surrounding institutions in the Texas Medical Center with complimentary expertise in
translational research, microbial genomics, Candida pathogenesis, and immune control of Candida.
Additionally, this project will leverage extensive data and sample collection from an NIH-funded P01 project of
gut bacterial colonization in ICU patients (Al152999) led by Dr. Adelman's primary mentor, Cesar A Arias, MD,
PhD. Overall, this integrated training and mentorship plan will support Dr. Adelman in his discovery of factors
that lead to Candida colonization in critically ill patients. Through the proposed award, Dr. Adelman will develop
into an independent physician-scient...

## Key facts

- **NIH application ID:** 10947181
- **Project number:** 1K23AI185174-01
- **Recipient organization:** METHODIST HOSPITAL RESEARCH INSTITUTE
- **Principal Investigator:** Max Wiener Adelman
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $194,036
- **Award type:** 1
- **Project period:** 2024-06-01 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10947181

## Citation

> US National Institutes of Health, RePORTER application 10947181, Pathogen and patient determinants of Candida gut colonization in critically ill patients (1K23AI185174-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10947181. Licensed CC0.

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