6th Annual Global Health & Infectious Disease Conference

April 06, 2018
8:30 a.m. - 5 p.m.
Eric P. Newman Education Center, Medical Campus

“Science to Solutions: Antimicrobial Resistance”

Speakers include:

Scholars
Carey-Ann D. Burnham headshot
Associate Professor of Pathology & Immunology, and Pediatrics, School of Medicine
Gautam Dantas headshot
Professor of Pathology and Immunology, and Biomedical Engineering, School of Medicine
Associate Professor of Molecular Microbiology, School of Medicine
Instructor, Internal Medicine, School of Medicine
Assistant Professor, School of Medicine, Pediatrics Education Program Director, Washington University Institute of Clinical and Translational Sciences
Associate Professor, School of Engineering & Applied Sciences

  • Anucha Apisarnthanarak, MD, Thammasat University Hospital, Thailand
  • Cesar Arias, MD, MSc, PhD, FIDSA, The University of Texas Health Services Center at Houston
  • Carey-Ann Burnham, PhD, Washington University
  • Gautam Dantas, PhD, Washington University
  • Mario Feldman, PhD, Washington University
  • Sumanth Gandra, MD, MPH, Center for Disease Dynamics, Economics & Policy
  • Stephanie Fritz, MD, MSCI, Washington University
  • Caline Mattar, MD, Washington University
  • Srikanth Singamaneni, PhD, Washington University

Topics

  • Diagnostic challenges
  • Antibiotic resistome exchange
  • Community-associated Methicillin-resistant Staphylococcus aureus infections
  • Plasmonic biosensors
  • Acinetobacter baumannii
  • WHO recommendations
  • Antimicrobial stewardship
  • Emerging resistance
  • Low-resource settings
  • New drug development

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Related Event

Global Health & Infectious Disease Trainee Oral Symposium

These events are all free and open to the public. Please feel free to register for one or both events.

For questions, contact jvanrheenen@wustl.edu.

Agenda

8:00 AM Registration and Poster Session
8:30 AM Welcome
William Powderly, MD, Washington University
Victoria Fraser, MD, Washington University
8:35 AM Antimicrobial Resistance, What is at Stake and the Global Action Plan
Caline Mattar, MD, Washington University
8:50 AM Antimicrobial Resistance: Public Health Approach in Missouri
George Turabelidze, MD, Missouri Department of Health & Senior Services
9:00 AM Diagnostic Challenges with Multi-Drug Resistant Organisms: Update from the Clinical Laboratory
Carey-Ann Burnham, PhD, Washington University
9:35 AM Antibacterial Resistance in India
Sumanth Gandra, MD, MPH, Center for Disease Dynamics, Economics & Policy
10:10 AM Break
10:25 AM Understanding and Combatting Antibiotic Resistome Exchange Across Commensal, Environmental, and Pathogenic Microbes
Gautam Dantas, PhD, Washington University
11:00 AM Limiting Emerging Resistance in Resource-Limited Settings in Asia
Anucha Apisarnthanarak, MD, Thammasat University Hospital, Thailand
11:35 AM Plasmonic Biosensors for Resource-Limited Settings
Srikanth Singamaneni, PhD, Washington University
12:10 PM Lunch with Speakers (sign up at registration on the day of the event)
1:00 PM Poster Session
2:00 PM Treatment and Prevention of Community-Associated Methicillin-Resistant Staphylococcus Aureus Infections: Past, Present, and Future
Stephanie Fritz, MD, MSCI, Washington University
2:35 PM Acinetobacter Baumannii Virulence: From Obscurity to Celebrity
Mario Feldman, PhD, Washington University
3:10 PM Break
3:25 PM Rebirth of the Antibiotic Pipeline
Cesar Arias, MD, MSc, The University of Texas Health Services Center at Houston
4:00 PM Panel: Challenges of Ensuring that Developing Countries Are Included in Plans for Access to Address AMR Worldwide
Panelists: Cesar Arias, Anucha Apisarnthanarak, Sumanth Gandra
Moderator: Caline Mattar, MD,
Washington University
4:50 PM Award Ceremony & Concluding Remarks
William Powderly, MD, Washington University

Presenters

Anucha Apisarnthanarak, MD, Thammasat University Hospital

Biography
Dr. Apisarnthanarak is currently an Associate Professor and Chief of Infectious Diseases Division at Thammasat University Hospital. He also serves as an Adjunct Visiting Professor at Division of Infectious Diseases, Washington University School of Medicine. Dr. Apisarnthanarak’s research focus included infection prevention in resource-limited setting, infection control to prevent multi-drug resistant microorganisms as well as outbreak investigations. He published more than 230 peer-review articles and more than 20 peer-review book chapters. He has been a key committee member of many national and international societies including Thai National Nosocomial Infection Group, Society of Healthcare Epidemiology of America, and Asia Pacific Society of Infection Control. Dr. Apisarnthanarak also serves as editorial board for key infectious diseases and infection control journals including Clinical Infectious Diseases, Infection Control and Hospital Epidemiology and American Journal of Infection Control.

Title: Limiting Emerging Resistance in Resource-Limited Settings in Asia

Abstract
Multi-drug resistant Gram-negative, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. The emergence and subsequent dissemination of carbapenem-resistant Gram-negative bacteria, especially plasmid-borne carbapenemases in Enterobacteriaceae, represent a global public health threat for which there is as yet no clear solution. This situation has potentially been exacerbated by the discovery of transmissible polymyxin resistance in the form of the mcr-1 gene.  The combination of transmissible mcr-1 and carbapenemases in Enterobacteriaceae, already seen in Enterobacteriaceae in a few countries, further narrows the therapeutic options for treating infections caused by such bacteria, raising the specter of untreatable infections in the near future. Gram-negative bacteria among countries inAsia, where the rates of resistance are some of the highest in the world, share one of the biggest burden for global MDR-Gram negative burden. These countries house more than a third of the world’s population, and several are also major medical tourism destinations.  In this session, with focus on Asian Pacific, I will discuss epidemiology of MDR-Gram negative, issues relevant to emerging of MDR-Gram negative, antimicrobial stewardship as well as how to adapt evidence-based practice to contain MDR-Gram-negative in resource-limited setting.

Cesar Arias, MD, MSc, PhD, The University of Texas Health Services Center at Houston

Biography
Dr. Arias is the Margaret and Herbert Dupont Chair in Infectious Diseases and holds the Laurel and Robert H. Graham Faculty Fellowship at McGovern Medical School. He is the director and founder of the Center of Antimicrobial Resistance and Microbial Genomics (CARMiG) at McGovern Medical School and the Center for Infectious Diseases at the UTHealth School of Public Health. Dr. Arias obtained his medical degree from Universidad El Bosque, Bogota, Colombia (first in class) and then spent 6 years in the United Kingdom where he obtained Masters in Clinical Microbiology at The University of London and a PhD in Microbial Biochemistry and Molecular Microbiology at University of Cambridge. He then was awarded a Wellcome Trust International Fellowship to develop antimicrobial resistance research in Colombia, where he founded (and still directs) the Molecular Genetics and Antimicrobial Resistance Unit and International Center for Microbial Genomics at Universidad El Bosque, Bogota. In 2002, he moved to Houston for training in Internal Medicine and Infectious Diseases at UTHealth McGovern Medical School and MD Anderson Cancer Center. He joined the UTHealth faculty as assistant professor in 2008 and became professor in 2016.

Dr. Arias is a nationally and internationally recognized expert conducting NIH-funded basic, translational and clinical research on mechanisms of antibiotic resistance with emphasis on Gram-positive organisms (in particular enterococci). His expertise also includes the clinical impact of resistance and the molecular epidemiology of antibiotic-resistant organisms, using state-of-the-art genomic analyses.

Title: Rebirth of the Antibiotic Pipeline

Abstract
The development of antimicrobial resistance in bacterial and fungal pathogens constitutes one of the most important threats to modern medicine. Antibiotics are life-saving drugs and emergence of resistance jeopardizes the care of the most vulnerable patients. The rapid pace by which bacteria can develop resistance through natural selection has been an important factor to make some of the most common antibiotics almost obsolete. Development of antibiotics (as for any drug) is a long and expensive process. However, unlike other drugs, the process has inherent risks: i) the return of investments is lower compared to drugs used for chronic conditions, ii) the definition of the condition is much more difficult than with specific diseases, iii) prescribers avoid using new compounds for the fear of losing the effectiveness of the antibiotic due to resistance and, iv) the regulatory environment makes it less likely for the manufacturers to invest in the development process. Nonetheless, in the last 5-7 years, important changes in the regulatory and financial process for development antibiotics have occurred. As an example, the creation of the Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) has created new possibilities to decrease the financial risks on developing antibiotics. In fact, CARB-X has become one of the world’s largest public-private partnerships focused on preclinical discovery and development of new antibacterial products. With this and other initiatives, a new and increasingly robust antibiotic pipeline is now in its ascendency. The new drugs with potential to be used in clinical practice can be classified in five broad categories, i) new molecules of existing antibiotic classes (e.g., delafloxacin, plazomicin), ii) specific inhibitors of mechanisms of resistance (e.g., inhibitors of carbapenemase inihibitors), iii) drugs bypassing permeability barriers (e.g., siderofore β-lactams), iv) new mechanisms of action (e.g., inhibitors of fatty acid biosynthesis pathway), and v) non-traditional approaches for bacterial infections. The increase in the pipeline has resulted in a much promising outlook for the treatment of patients infected with multidrug-resistant organisms that may mitigate the dire consequences of antibiotic resistance in clinical practice. Worldwide access to these new drugs should be considered a priority.

Carey-Ann Burnham, PhD, D(ABMM), F(IDSA), F(AAM), Washington University

Biography
Dr. Burnham, is an Associate Professor of Pathology & Immunology, Molecular Microbiology, and Pediatrics at Washington University School of Medicine in St. Louis. She is also the Medical Director of Clinical Microbiology for Barnes-Jewish Hospital. Dr. Burnham has a keen interest in education and is the Program Director for the Medical and Public Health Microbiology Fellowship at Washington University, the Co-Editor of “Medical Microbiology Question of the Day,” and the Section Editor for “The Brief Case” for the Journal of Clinical Microbiology. Dr. Burnham’s research program is focused on novel diagnostics and antimicrobial resistance, with a focus on Staphylococcus aureus, Clostridium difficile, and multi-drug resistant Gram-negative bacteria. Dr. Burnham has authored or co-authored more than 130 articles, six book chapters, and two books. She is a Fellow of the Infectious Diseases Society of American and the American Academy of Microbiology.

Title: Diagnostic Challenges with Multi-Drug Resistant Organisms:  Update from the Clinical Laboratory

Abstract
Antibiotics have transformed the practice of medicine; many infections that were once lethal are now readily treatable. These advances have made other medical advancements, such as organ transplantation and cancer chemotherapy, possible. However, antimicrobial resistance (AMR) is on the rise world-wide. If the trend continues, we may be facing a post-antibiotic era. Currently, it is estimated that up to half of antibiotics prescribed in U.S. acute care hospitals are either unnecessary or inappropriate.  One of the key factors that contributing to excess use of broad spectrum antimicrobials is the relatively long interval between when a clinical specimen is collected and when antimicrobial susceptibility results are available. Rapid diagnostic methods for pathogen detection and susceptibility testing are essential to support clinical trials for new anti-infective agents and can facilitate antimicrobial stewardship, epidemiologic surveillance, and epidemiologic efforts. This session will describe emerging methods in the clinical microbiology laboratory, including methods for pathogen detection, antimicrobial resistance characterization, and total laboratory automation systems.

Gautam Dantas, PhD, Washington University

Biography
Dr. Dantas is a professor in the Department of Pathology & Immunology, the Department of Biomedical Engineering, the Department of Molecular Microbiology, and the Center for Genome Sciences & Systems Biology, at Washington University School of Medicine in St. Louis. He received his PhD in biochemistry from the University of Washington under the guidance of Dr. David Baker, and post-doctoral training in microbial genomics from Harvard Medical School under the guidance of Dr. George Church. Dr. Dantas’s research interests and training lie at the interface of microbial genomics, synthetic biology, systems biology, and computational biology. His current research focuses on understanding the evolution and exchange of antibiotic resistance amongst diverse microbial communities, on engineering improved probiotics to treat gastrointestinal disorders, and on engineering microbial catalysts to produce value chemicals such as biofuels. He is a recipient of the AAAS Newcomb Cleveland Prize, the Harvard University Certificate for Distinction in Teaching, the NIH Director’s New Innovator Award, the Kenneth Rainin Foundation Breakthrough Award, the Edward Mallinckrodt Jr. Foundation Scholar Award, and the Academy of Science – St. Louis Innovator Award.

Title: Understanding and Combatting Antibiotic Resistome Exchange Across Commensal, Environmental, and Pathogenic Microbes

Abstract
Antibiotic resistant infections claim over 700,000 lives globally. If current trends in resistance continue unchecked, this toll is projected to bloom to 10 million annual deaths by 2050, encoding a cumulative loss of $150 trillion to the global economy. Antibiotic use and abuse over the past century in food animals, humans, and the environment has selectively enriched resistance genotypes in each of their associated microbiomes. An over-reliance on culture-based methods, the standard in the study of clinical resistance, has vastly underestimated these reservoirs of resistance genes (or ‘resistomes’). To address this issue, we have recently developed high-throughput metagenomic functional selections, aided by next-generation sequencing, to characterize resistomes encoded by the microbiota of humans, animals, soils, and built-environments. By combining these analyses with 16S amplicon sequencing and deep shotgun sequencing, we model the impact of various anthropogenic perturbations on the transmission and evolutionary dynamics of microbial communities and their resistomes across time and habitats. Hundreds of resistance genes we identify from specific taxa in these different microbial communities are identical to resistance genes found in major human pathogens, indicating recent genetic exchange between these microbes. We also find thousands of functionally validated resistance genes which are genetically novel, but flanked by genes involved in horizontal gene transfer, including transposases and integrases. Together, these findings highlight the substantial antibiotic resistome encoded by microbes from diverse environments, which is available for exchange with pathogens, with the potential to severely exacerbate the problems with clinical resistance.

Mario Feldman, PhD, Washington University

Biography
Dr. Feldman is originally from Argentina, where he obtained his PhD. After he finished his post-doctoral training in Belgium and Switzerland in 2006, Dr. Feldman established his group at the University of Alberta, Canada. Since 2015, he has been an Associate Professor in the Department of Molecular Microbiology at Washington University School of Medicine in St. Louis. His group has published more than 60 articles in top-ranked scientific journals, and he is recognized as a world-leader in the field of microbial glycobiology. In more recent years, he has become an expert in the pathogenesis of the multi-drug resistant bacterium Acinetobacter baumannii. He is an author of several patents, and co-founded two biotechnology companies developing therapies against microbial infections.

Title: Acinetobacter baumannii virulence: from obscurity to celebrity

Abstract
Acinetobacter baumannii is a nosocomial pathogen that causes ventilator-associated, as well as urinary tract and bloodstream infections in immunocompromised patient. Multidrug resistant (MDR) infections caused by A. baumannii are increasing at alarming rates. Today, the MDR rates for A. baumannii clinical isolates are several folds higher than any other Gram-negative bacterium. Because of this, the World Health Organization has categorized A. baumannii as a top priority for the research and development of new antimicrobial therapies. Much of the success of A. baumannii can be directly attributed to its plastic genome, which rapidly mutates when faced with adversity and stress. However, fundamental virulence mechanisms beyond canonical drug resistance were recently uncovered that enable A. baumannii and, to a limited extent, other medically relevant Acinetobacter species to successfully thrive in the health-care environment. In this presentation, I will discuss the recent advances in our understanding of Acinetobacter pathobiology.

Acinetobacter baumannii is a nosocomial pathogen that causes ventilator-associated, as well as urinary tract and bloodstream infections in immunocompromised patient. Multidrug resistant (MDR) infections caused by A. baumannii are increasing at alarming rates. Today, the MDR rates for A. baumannii clinical isolates are several folds higher than any other Gram-negative bacterium. Because of this, the World Health Organization has categorized A. baumannii as a top priority for the research and development of new antimicrobial therapies. Much of the success of A. baumannii can be directly attributed to its plastic genome, which rapidly mutates when faced with adversity and stress. However, fundamental virulence mechanisms beyond canonical drug resistance were recently uncovered that enable A. baumannii and, to a limited extent, other medically relevant Acinetobacter species to successfully thrive in the health-care environment. In this presentation, I will discuss the recent advances in our understanding of Acinetobacter pathobiology.

Victoria Fraser, MD, Washington University

Biography
Dr. Victoria Fraser is the Adolphus Busch Professor of Medicine, chair of the Department of Medicine at Washington University School of Medicine, and physician-in-chief for Barnes-Jewish Hospital. She is also the director of the Clinical Research Training Center at Washington University and co-principal investigator of the university’s Institute of Clinical and Translational Science.

Dr. Fraser received her doctorate in medicine from the University of Missouri and was an internal medicine resident and chief resident at the University of Colorado. She completed a fellowship in Infectious Diseases at Washington University School of Medicine and Barnes-Jewish Hospital.

An expert in infectious disease and antibiotic resistance, Dr. Fraser currently focuses her research on preventing and controlling hospital-acquired infections, adverse events and medical errors. By analyzing administrative data and electronic health records in an integrated health care system, Dr. Fraser has identified risk factors for these infections, determined their morbidity, mortality and costs, and applied interventions in real-world settings to successfully reduce their occurrence.

Stephanie Fritz, MD, MSCI, Washington University

Biography
Dr. Fritz is an Associate Professor of Pediatrics in the Division of Infectious Diseases at Washington University School of Medicine in St. Louis and attending physician at St. Louis Children’s Hospital. Dr. Fritz leads a multidisciplinary, translational research team focusing on community-associated methicillin-resistant Staphylococcus aureus (MRSA).  Dr. Fritz has orchestrated studies to define the clinical and molecular epidemiology of MRSA colonization and infection in community children, determine the effectiveness of strategies for treating and preventing MRSA infections, and specify mechanisms of S. aureus virulence and host immune responses.

Dr. Fritz’s work has been funded by the Infectious Diseases Society of America/National Foundation for Infectious Diseases, National Institutes of Health, and Agency for Healthcare Research and Quality (AHRQ). She is currently the PI of several AHRQ-funded investigations to discern MRSA household transmission dynamics and evaluate the effectiveness of personal and household hygiene measures to interrupt MRSA household transmission and prevent infections.

Dr. Fritz is a member of the NIH/NIAID Antibiotic Resistance Leadership Group Pediatric Special Emphasis Panel. In 2012, her research accomplishments were recognized with the Pediatric Infectious Diseases Society Young Investigator Award.

Title: Treatment and Prevention of Community-Associated Methicillin-Resistant Staphylococcus aureus Infections: Past, Present, and Future

Abstract
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as a significant public health burden over the past two decades. Skin and soft tissue infections are the most frequent entity caused by CA-MRSA. More than 50% of patients with skin infections will develop a recurrent infection over one year, engendering frustration for both patients and health care providers. Recent trials have demonstrated that prescribing systemic antibiotics for purulent skin infections, in conjunction with incision and drainage, results in a higher likelihood of clinical cure of the acute infection, as well as reduced incidence of recurrent infection. In addition, CA-MRSA infections cluster within households, likely resulting from person-to-person transmission as well as household environmental reservoirs.  Topical antimicrobials, traditionally used in healthcare settings to eradicate MRSA carriage with the goal of preventing subsequent infection, are now employed often to prevent recurrent CA-MRSA infections as well. A household approach to decolonization with topical antimicrobials results in a decreased incidence of recurrent skin infections compared to decolonization of individual patients alone, though challenges (e.g., waning effectiveness and antimicrobial resistance) surround CA-MRSA eradication and infection prevention.  Future directions for CA-MRSA treatment and prevention may include manipulation of the endogenous microbiota of the skin to interfere with CA-MRSA colonization and infection.

Sumanth Gandra, MD, MPH, Center for Disease Dynamics, Economics & Policy

Biography
Dr. Gandra received his medical degree from Osmania Medical College, Hyderabad, India in 2004, and MPH in community health from Eastern Kentucky University, Richmond, Kentucky in 2007. He completed his internal medicine residency at St. Francis Hospital, University of Illinois, College of Medicine at Peoria, Illinois in 2010 and infectious diseases fellowship at University of Massachusetts Medical School in 2013. He is currently a resident scholar at Center for Disease Dynamics, Economics & Policy, Washington, DC and medical microbiology fellow at University of Chicago.

Title: Antibacterial Resistance in India

Abstract
India has become the epicenter for emergence and spread of extremely drug resistant bacteria. India is the largest consumer of antibiotics in the world, however the per-capita consumption of antibiotics is lower than several high-income countries. So, why does India has high antibiotic resistance prevalence? This talk discusses the drivers of antibiotic resistance in India including unique patterns of antibiotic consumption in humans; high and increasing antibiotic consumption in food animals; pharmaceutical industrial effluents contaminating environment; poor environmental sanitation; rapid urbanization; poor infection control practices in healthcare settings; and unique cultural practices encouraging the spread of antibiotic resistance.

Caline Mattar, MD, Washington University

Biography
Dr. Mattar is an instructor in medicine in the division of Infectious Diseases Washington University School of Medicine in St. Louis. She is interested in antimicrobial resistance and the prevention of hospital-acquired infections in resource-limited settings. She has collaborated with the World Health Organization on the implementation of the Global Action Plan on Antimicrobial Resistance, specifically in the field of education of the health-care workforce on appropriate antibiotic prescribing. She also has a specific interest in global health policy and governance. She has previously served in many leadership positions in international organizations such as the International Federation for Medical Students Associations and more recently, the World Medical Association for which she chairs the Junior Doctors Network. She is involved in teaching global health at the undergraduate level as well as with residents and fellows.

Title: Antimicrobial Resistance, What is at Stake and the Global Action Plan

Abstract
TBA

William Powderly, MD, Washington University

Biography
Dr. Powderly is the Dr. J. William Campbell Professor of Medicine and the Larry J. Shapiro Director of the Institute for Public Health at Washington University in St. Louis. He is also Co-Director of the Division of Infectious Diseases at the Washington University School of Medicine. From 2005 to 2012, he was Dean of Medicine and Head of the School of Medicine and Medical Sciences at University College Dublin in Ireland. Dr. Powderly has been actively involved in HIV-related clinical research for almost 30 years.

Srikanth Singamaneni, PhD, Washington University

Biography
Dr. Singamaneni is an Associate Professor in the Department of Mechanical Engineering and Materials Science at Washington University in St. Louis. He obtained his PhD in Polymer Materials Science and Engineering from Georgia Institute of Technology in 2009. His research group is involved in the design, synthesis and self-assembly of plasmonic nanostructures and organic-inorganic hybrid nanomaterials for various biomedical applications. He has co-authored nearly 130 refereed articles (including nine invited reviews) in archival journals, six book chapters, and a book (Scanning Probe Microscopy of Soft Matter: Fundamentals and Practices). He is a recipient of the NSF CAREER award (2013), Dean’s Faculty Award for Innovation in Research (2013), Translational New Investigator Award, DOD-Army (2011) and Materials Research Society Graduate Student GOLD Award (Fall 2008).

Title: Plasmonic Biosensors for Resource-limited Settings

Abstract
Plasmonics is expected to make a tremendous impact in the field of life sciences, with applications in bioimaging, biosensing, targeted delivery and externally-triggered locoregional therapy. Plasmonic biosensors are considered to be highly promising for the development of simple, portable, sensitive, on-chip biodiagnostics for resource-limited settings such as at-home care, rural clinics, developing countries with low and moderate incomes and battle-field. While there has been a tremendous progress in the rational design of nanotransducers with high sensitivity and the development of hand-held read-out devices, the translation of these biosensors to resource-limited settings is hindered by the poor thermal, chemical, and environmental stability of the biorecogntion elements. “Cold-chain,” which is employed in the affluent parts of the world for reagent transport, storage, and handling, is expensive (capital cost of freezers, recurring cost of liquid nitrogen), environmentally unfriendly, and simply not feasible in resource-limited settings where electricity and refrigeration are not reliable or even available. Degradation of the sensitive reagents and biodiagnostic chips outside the cold-chain, compromises analytical validity, preventing accurate and timely diagnosis. We will present a novel class of plasmonic biosensors that rely artificial antibodies or peptide recognition elements with excellent thermal and chemical stability. In addition, we have recently introduced silk and metal-organic frameworks as protective coatings to stabilize natural antibodies bound to nanotransducers against thermal denaturation and loss of biorecognition. This multi-pronged approach overcomes the poor stability of existing plasmonic biosensors and takes them closer to real-world applications in resource-limited settings.

George Turabelidze, MD, Missouri Department of Health and Senior Services

Biography
Dr. Turabelidze is a Missouri State Epidemiologist. He is also a Board Certified pediatrician and hospitalist physician. Dr. Turabelidze joined the Missouri Department of Health and Senior Services in 2003 as a Medical Epidemiologist, and became the Missouri State Epidemiologist in 2011. His primary interests are communicable disease epidemiology, disease surveillance, and emergency preparedness. Dr. Turabelidze’s published work addresses epidemiology of various infectious diseases, including influenza, parechovirus, salmonellosis, shigellosis, coccidioidomycosis, infectious mononucleosis, mucormycosis, yersiniosis, cryptosporidiosis, tularemia, Q-fever, STEC, norovirus, MRSA, healthcare associated infections, as well as chronic disease epidemiology and the vital statistics. He is a co-developer of the novel analytical surveillance system, the Disease Electronic Surveillance with Trigonometric Models (DESTEM), which was awarded an Association of State and Territorial Health Officials (ASTHO) Vision Award in 2015.

Dr. Turabelidze served as an Adjunct Associate Professor of Epidemiology at Saint Louis University, and he is an Adjunct Assistant Professor of Clinical Pediatrics at Washington University School of Medicine.

Abstract
Update on the efforts undertaken in Missouri to combat the issue of rising antibacterial resistance from the public health perspective. Also, the latest on the Carbapenem-resistant Enterobacteriaceae (CRE) infections in Missouri and the antibiotic stewardship programs across the state.

Event Sponsors: The Center for Global Health and Infectious Disease at the Institute for Public Health, and the Departments of Medicine, Molecular Microbiology, and Pediatrics in the School of Medicine

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