Antimicrobial activity and the impact of drug resistance

Principal Investigator:           Associate Prof Matthew Chico (UK)

Co-Investigators                    Dr Julie Gutman (USA), Dr Ulla Ashorn (Finland), Prof Nigel Klein (UK)

Objective One

The prevalence of curable STIs/RTIs among pregnant women attending antenatal care in sub-Saharan Africa is high and, when considered collectively, curable STIs/RTIs may be more common than malaria infection.  Recent research suggests that SP has a protective effect against adverse pregnancy outcomes among women with curable STIs/RTIs, as well as malaria, and AZ is also expected to be protective against curable STIs/RTIs.  For these reasons, IMPROVE will estimate the effect of SP, DP, or DP plus AZ on curable STIs/RTIs measured at delivery.  

Objective Two

To understand how antimicrobial and antimalarial therapy alters the vaginal and intestinal microbiota of pregnant women, DNA sequencing wll be used.  Our analyses will determine whether exposure to the study drugs during pregnancy alters the composition of the microbiota or the relationship between maternal and infant microbiota structure. 

Objective Three:

To ensure that AZ use in pregnancy does not select for antibiotic resistance among medically important pathogens in the nasopharynx and the gut, samples will be tested for drug sensitivity.  Changes in resistance patterns associated with SP and AZ will also be assessed.