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On 21 June 2017, the Cambodia Oxford Medical Research Unit (COMRU) and Angkor Hospital for Children (AHC) hosted the kick-off meeting for the multi-country Real-time Tracking of Neglected Bacterial Infectious Diseases Resistance Patterns Asia (TuNDRA) study.

Group photo in Siem Reap

Investigators discussed final details of this 5-year study, which will enrol children aged 0-59 months in Cambodia, Bangladesh and Viet Nam who have been hospitalised with suspected invasive bacterial infection. TuNDRA will identify the bacteria causing severe infections, the antibiotic resistance in those organisms and determine the proportion of children with suspected bacterial infection who are potentially unnecessarily treated with antibiotics.

“The study is important given current global concerns about antimicrobial resistance (AMR),” said study collaborator and COMRU Director Dr Paul Turner. “Very few sites in low- and middle-income Asian countries are doing systematic collection of blood cultures in children with suspected invasive bacterial infection.”

TuNDRA will recruit in Bangladesh (Dhaka, Child Health Research Foundation), Cambodia (Angkor Hospital for Children, COMRU), and Vietnam (Ho Chi Minh City, OUCRU). The study is funded by the German Federal Ministry of Health and co-ordinated by the Robert Koch Institute (RKI), Germany and the International Vaccine Institute (IVI), South Korea.

TuNDRA investigators will collect samples to determine the bacteria responsible for these infections and their antimicrobial resistance profiles. Bacterial isolates will be sent to Prof Stephen Baker at OUCRU for whole genome sequencing at regular intervals throughout the study. In addition to culture, blood will tested for detection of dengue infection and swabs will be collected for PCR detection of key respiratory viruses.

“Incorporating near real-time whole genome sequencing of key bacterial species will allow us to generate data on the prevalence and genetic mechanisms associated with anti-microbial resistance across the region,” noted Dr. Turner.

The kick-off meeting was followed by a one-day training on study procedures and data entry. Recruitment is expected to begin in early July.

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