POR and Training Program on Multidrug-Resistant Organisms

ABSTRACT
Antimicrobial resistance (AMR) is one of the most pressing public health priorities. AMR is thought to be re-
sponsible for more than 35,000 deaths in the US with a projection of 300 million deaths worldwide by 2050. My
original K24 application sought to increase my ability to conduct patient oriented research (POR) on antibiotic
resistance and mentor a new generation of clinicians scientists on different aspects of this important public
health threat. With support from the K24 award, I was able to markedly increase my research portfolio, launch
a microbial genomics mission and increase my mentoring activities. Thus, the overarching goal of this com-
petitive K24 renewal is to fully transition to an established investigator by continuing and further strengthening
my POR portfolio and mentoring abilities. I also aim to fortify my leadership skills to expand an ambitious re-
search and training program, focused on AMR. Supported in part by my original K24 award, I founded the Cen-
ter for Antimicrobial Resistance and Microbial Genomics (CARMiG) at UTHealth. The vision of CARMiG was to
amalgamate the world-class expertise available in the Houston’s Texas Medical Center (TMC) to serve as a
major platform for cutting edge research programs and integrate a training mission to the highest level. I also
led the creation of the Gulf Coast Consortium on Antimicrobial Resistance (GCC-AMR), an inter-institutional
hub for AMR researchers across the TMC to interact and foster collaborations. We developed a robust training
program on AMR, recruiting and supporting the career of a diverse pool of trainees (MD, PhDs and PharmDs)
at different stages of their careers. My trainees have secured 4 NIH K developments awards (2 with perfect
scores), and equivalent independent grants. Furthermore, the number of trainee’s publications has markedly
expanded (94 publications as firs/corresponding author). Our NIH grant portfolio also grew with more than $ 20
million brought in as PI of NIH grants in the last 5 years, including a recent P01 program ($11m). We were also
able to secure the first post-doctoral inter-institutional T32 training program on AMR. Thus, the foundations of
my initial K24 program put me in an ideal position to sustain and further strengthen my research and training
objectives. In my original K24 program I focused on the clinical and genomic aspects of vancomycin-resistant
enterococci (VRE) one of the most challenging organisms in clinical settings. Using the expertise acquired in
VRE, my K24 renewal will support new areas of research, including the intersection of microbiome science and
AMR, genomics and molecular epidemiology of Gram-negative pathogens and use of machine learning to es-
tablish clinical/genomic correlates in patients infected with multidrug-resistant organisms (MDRO). The spe-
cific aims are: i) strengthen my portfolio of POR related to AMR as the foundation for trainees to develop their
careers, and ii) mentor talented young investigators in translational and POR focused on AMR. I plan to con-
tinue my robust mentoring program that integrates the understanding of the molecular and genomic bases of
resistance and their translation into clinical practice.

Grant Number: 5K24AI121296-10
NIH Institute/Center: NIH
Principal Investigator: Cesar Arias