Tulip A. Jhaveri, Zoe Freeman Weiss, Marisa L. Winkler, Alexander D. Pyden, Sankha S. Basu, Nicole D. Pecora

Tina H. Dao, Haley Echlin, Abigail McKnight, Enolia S. Marr, Julia Junker, Qidong Jia, Randall Hayden, Tim van Opijnen, Ralph R. Isberg, Vaughn S. Cooper, Jason W. Rosch

Alysse G. Wurcel, Rubeen Guardado, Emily D. Grussing, Peter J. Koutoujian, Kashif Siddiqi, Thomas Senst, Sabrina A. Assoumou, Karen M. Freund, Curt G. Beckwith

Shea K Roe, Brian Felter, Bo Zheng, Sanjay Ram, Lee M Wetzler, Eric Garges, Tianmou Zhu, Caroline A Genco, Paola Massari

Andrzej J Ogrodny, Rinosh Mani, Sarah M Schmid, Emily N Gould, Claire L Fellman, Ian DeStefano, Sarah Shropshire, Jillian M Haines, Timothy A Bolton, Sara A Jablonski, Nicole Jess, Harry Cridge

Majd Alsoubani, Jennifer K Chow, Angie Mae Rodday, David Kent, David R Snydman

Perry, Whitney A. MD, MS; Chow, Jennifer K. MD, MS; Nelson, Jason MPH; Kent, David M. MD, MS; Snydman, David R. MD

Antibiotic resistance is one of the greatest public health challenges of our time. International efforts to curb resistance have largely focused on drug development and limiting unnecessary antibiotic use. However, in areas where water, sanitation, and hygiene infrastructure is lacking, we propose that bacterial flow between humans and animals can exacerbate the emergence and spread of resistant pathogens. Here, we describe the consequences of poor environmental controls by comparing mobile resistance elements among Escherichia coli recovered from humans and meat in Cambodia, a middle-income country with substantial human-animal connectivity and unregulated antibiotic use. We identified identical mobile resistance elements and a conserved transposon region that were widely dispersed in both humans and animals, a phenomenon rarely observed in high-income settings. Our findings indicate that plugging leaks at human-animal interfaces should be a critical part of addressing antibiotic resistance in low- and especially middle-income countries.

Scott R Evans, Robin Patel, Toshimitsu Hamasaki, Jessica Howard-Anderson, Tori Kinamon, Heather A King, Deborah Collyar, Heather R Cross, Henry F Chambers, Vance G Fowler, Jr, Helen W Boucher

The Antibacterial Resistance Leadership Group (ARLG) has prioritized infections caused by gram-positive bacteria as one of its core areas of emphasis. The ARLG Gram-positive Committee has focused on studies responding to 3 main identified research priorities: (1) investigation of strategies or therapies for infections predominantly caused by gram-positive bacteria, (2) evaluation of the efficacy of novel agents for infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci, and (3) optimization of dosing and duration of antimicrobial agents for gram-positive infections. Herein, we summarize ARLG accomplishments in gram-positive bacterial infection research, including studies aiming to (1) inform optimal vancomycin dosing, (2) determine the role of dalbavancin in MRSA bloodstream infection, (3) characterize enterococcal bloodstream infections, (4) demonstrate the benefits of short-course therapy for pediatric community-acquired pneumonia, (5) develop quality of life measures for use in clinical trials, and (6) advance understanding of the microbiome. Future studies will incorporate innovative methodologies with a focus on interventional clinical trials that have the potential to change clinical practice for difficult-to-treat infections, such as MRSA bloodstream infections.

Heather L. Shearer, Paul E. Pace, Leah M. Smith, Peter C. Fineran, Allison J. Matthews, Andrew Camilli, Nina Dickerhof, Mark B. Hampton