UoN Receives USCDC funding for Global AR Lab & Response Network

The University of Nairobi is among 28 organizations that have received funding from the U.S. Centers for Disease Control and Prevention to combat antimicrobial resistance and other healthcare threats through the establishment of the Global Action in Healthcare Network (GAIHN) and the Global Antimicrobial Resistance Laboratory and Response Network (Global AR Lab & Response Network) that cover more than 50 countries worldwide.

The $22 million global grant will go towards building programs that focus on preventing infections in healthcare, building laboratory capacity and developing new and innovative ways to rapidly detect and respond to antimicrobial resistance  and COVID-19 threats.

Antimicrobial resistance is a major threat to the healthcare system and occurs when bacteria, viruses, fungi and parasites no longer respond to medicines. It is increasingly recognized in multiple settings particularly in hospitals as a threat that makes it difficult to treat hospital acquired infections, as antibiotics and other antimicrobial medicines become ineffective. Antimicrobial resistance leads to increased cost of care, severe illness and death. The COVID-19 pandemic has worsened antimicrobial resistance due to the rise in antibiotic prescriptions. Infection prevention and control teams have also been drawn away from antimicrobial resistance control to management of COVID-19 units.

The prevention and containment of antimicrobial resistance requires a multi-pronged approach including antimicrobial stewardship, enhanced infection prevention and control measures and improved capacity of healthcare workers and laboratories to collect appropriate microbiology samples, correctly identifying bacteria and fungi causing infections and appropriate interpretation of antibiotic and antifungal sensitivity tests to guide antimicrobial use and treatment.

At the University of Nairobi, the grant will be implemented under the Monitor and Prevent Antimicrobial Resistance in Kenya (MAP-AMR Kenya) project, which is led by Dr. Loice Achieng Ombajo. This project brings together a highly experienced team from the University of Nairobi, the Kenyatta National Hospital, The Nairobi Hospital, the National Spinal Injury Referral Hospital, the Ministry of Health and Washington State University-Global Health program in Kenya who are directly involved in patient care, laboratory work and epidemiology in Kenya. The target organisms for this project is Candida auris.

Candida auris is a highly resistant candida species that is difficult to eradicate from hospital settings and is associated with high mortality.  It has recently emerged as a global threat to health.

The expected outcomes of the project include increased capacity of clinical and reference laboratory staff to detect C. auris in Kenya, improved epidemiologic data collection to monitor C. auris in Kenya, increased identification of C. auris threat in Kenya, improved identification of risk factors driving C. auris threat in Kenya, increased understanding of C. auris in Kenya, improved containment of C. auris threat in Kenya, and reduced C. auris drivers in Kenya.

The overall goal of the project is to enhance the capacity to detect and respond to the threat of antimicrobial resistance in healthcare facilities in the country, identify the risk factors for antimicrobial resistance and nosocomial outbreaks in specialized and intensive care units, and determine the appropriate containment strategies to improve treatment outcomes of patients and protect the healthcare workforce. The project aims at identifying and monitoring emerging antimicrobial resistance threats in healthcare facilities and the environment not previously well characterized, and identify the most appropriate prevention and control strategies for the Kenyan context.

The project will also build local bioinformatics capacity for antimicrobial resistance and resistant fungal organisms in Kenya to provide a local evidence base for policy recommendations and actions for the control of antimicrobial resistance in Kenya.

The University of Nairobi Vice Chancellor Prof. Stephen Kiama acknowledged that the COVID-19 pandemic has enhanced consumption of over-the-counter medication including antibiotics which increase the risk of antimicrobial resistance.

“The university is honoured to implement a project that will be of great benefit to the country in controlling the threat of antimicrobial resistance across human and animal populations and the environment,” said Prof. Kiama.

On her part, Dr. Ombajo noted that there are many threats to health in the world that we are living in, many of which have become even more evident in the context of the current pandemic. She went on to add that antimicrobial resistance is one of such threats that is responsible for many healthcare associated infections. Candida auris in particular poses a significant challenge to health security.

“We look forward to implementing this project to equip laboratory and clinical personnel with the necessary resources and skills to identify, control and prevent C.auris in healthcare settings in Kenya,” Dr. Ombajo said.

Dr. Evelyn Wesangula who is the Head of the Patient and Health Workers Safety Division and the AMR Focal Point at the Ministry of Health mentioned that C. auris is a new and emerging pathogen, which needs further study to identify additional risk factors to support optimal patient outcomes.

“This project will support surveillance, in a critical and underfunded area, in the selected facilities to identify C. auris, monitor trends, estimate the incidence, identify possible sources of outbreaks and better respond to cases of C. auris. The data collected and disseminated  through surveillance and isolate submission will provide much needed evidence to drive targeted infection prevention and control measures to protect patients from Health Care Associated Infections,” Dr. Wesangula noted.