Grant Awarded to Study High-Risk Transplants

The Duke University School of Medicine has awarded Drs. Mihai Podgoreanu and Quintin Quinones a $10,000 grant for their project titled, “Sequencing Technology for Rapid Detection of Fastidious and Resistant Infectious Agents in the Critically Ill.”

Infectious disease is a major contributor to mortality in critically ill patients, particularly those who are immunosuppressed. The immediate post-transplant population is acutely at risk for infection given the heavy doses of induction immunosuppression needed to prevent allograft rejection. Of all solid organ transplants, lung transplant patients are particularly at risk for infection, as the recipient is frequently colonized with resistant pathogens pre-transplant; after transplant, the graft is continuously exposed to pathogens from the environment.

Drs. Podgoreanu and Quinones’ central hypothesis is that they can rapidly detect and identify infectious microorganisms, and in some cases, determine their antibiotic resistance patterns using nucleic acid amplification and sequencing technology. With this information, they believe they can more rapidly tailor care plans and antimicrobial therapy for our critically ill lung-transplant recipients. The successful completion of this project will establish a potential rapid assay for the detection of fastidious and often multi-drug resistant organism that is highly relevant to the care of post-lung transplant patients in the cardiothoracic intensive care unit. Additional transformational results of using such sequencing diagnostics directly from respiratory specimens include differentiating colonizers versus pathogens, viral from bacterial pathogens, and phenotypic resistance.

Duke University Medical Center is a high-volume transplant center, particularly for heart and lung transplants. A collaboration is now being formed between physician-scientists in the cardiothoracic intensive care unit, infectious disease, and genomic and computational biologists at Duke University. The awarded funds will cover a portion of the cost of sequencing the genomes of the reference panel and developing a genotyping test panel. These services will be provided by the Genome Sequencing and Analysis Shared Resource.