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The MORU Microbiology aims to be a leader for prospective AMR surveillance system for low and middle-income countries, and a global leader for melioidosis and rickettsioses. We will engage policy makers, healthcare providers and public, and influence in policy changes for better surveillance, diagnosis, treatment and prevention for those diseases.

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www.antibioticfootprint.net and www.amrdictionary.net

The MORU Microbiology Department will focus its research efforts on these areas:

Antimicrobial resistance / drug resistant infections (AMR/DRI) | Melioidosis and Diabetic Melitus | Rickettsioses | Bioinformatics 

Antimicrobial resistance / drug resistant infections (AMR/DRI)

  • Be a leader for prospective AMR surveillance system for low and middle-income countries. Leading A Clinically Oriented Antimicrobial Resistance Network (ACORN), MORU aims to improve and evaluate a comprehensive data capture system in study sites in Cambodia, Lao PDR and Vietnam. ACORN will develop and refine tools for AMR data capture, verification and interactive visualization, and prepare for wider roll out of surveillance at sites across Wellcome Africa and Asia Programmes (AAP).
  • Be a leader to improve how to utilize readily available routine data for AMR surveillance. Using AutoMated tool for Antimicrobial resistance Surveillance System (AMASS), MORU aims to improve and evaluate utility of the application in Thailand.  AMASS is an offline, open-access and easy-to-use application that allows a hospital to perform data analysis and generate AMR surveillance reports stratified by infection origin quickly and independently. MORU also aims to enhance data sharing by using AMASS to share reports and anonymous summary data at sites across Wellcome AAP and with new partners.
  • Be a leader to improve how to analyse AMR data and improve culturing practice (utilization of blood culture) in LMICs. MORU aims to develop and improve methods to determine burden of AMR, conduct a series of epidemiological studies to understand how different culturing practice could bias parameters required for modelling and monitoring AMR burden, and develop methods to take account of and improve culturing practices while determining burden of AMR. (Key collaborators: Wellcome Trust Surveillance and Epidemiology of Drug-resistant Infections Consortium (SEDRIC))
  • Improve how to communicate and engage with policy makers and lay people about AMR. MORU will continue using AMR dictionary and antibiotic footprint concept to engage with policy makers and facilitate an improvement on how to communicate with lay people in each country in across Wellcome AAP. AMR dictionary currently contains about 40 words, and have been translated to English, Thai, Burmese, Khmer, Chinese and Lao. Malay, Tamil, Spanish and French versions are underway. All MORU Units, together with OUCRU, national AMR networks and Greenpeace collaborated in developing the AMR dictionary.

Melioidosis and Diabetic Mellitus

  • Continue global leadership in melioidosis research in epidemiology, diagnosis, treatment and prevention.
  • Continue to host and develop a hub for the research community for all information, maps, data, and to foster communication between researchers.
  • Improve our understanding on the genetic basis of melioidosis infection. A series of genetic epidemiology will be conduct to identify bacterial genetic factors that determine disease severity, identify host biomarkers associated with susceptibility to melioidosis and disease severity; and construct models scoring bacterial and host factors to predict disease outcome.
  • Improve our understanding on the association between melioidosis and diabetic mellitus, their immune regulation and dysfunction, and the impact of using metformin to reduce the incidence rate of bacterial infection and/or reduce the severity of the infection in the diabetic population.
  • Improve our understanding in in host responses during infection, by conducting a series on bacterial and host “-omics”. We will integrate clinical data with “-omics” data (regional and global partners) and hypothesis-driven experimental work to advance knowledge in this field.

Rickettsiosis

  • Become a global leader in tropical rickettsiosis research, studying epidemiology, diagnosis, treatment and prevention.
  • Host a rickettsiosis research hub containing all information, maps, and data that would be open to the research community and foster communication and collaboration between researchers.
  • Improve treatment for scrub typhus by conducting a multi-centre, multi-country clinical trial to determine the optimum treatment of severe scrub typhus, comparing intravenous doxycycline with intravenous azithromycin and a combination of the two (in collaboration with Christian Medical College, Vellore, India).
  • Develop the rationale for scrub typhus vaccination, and conduct non-human primate studies of vaccine candidates. Produce the evidence base for the development and safe conduct of a controlled human scrub typhus infection model including investigating the significance of persistence and dormancy.
  • Develop and improve technologies for studying the cell biology and host-pathogen interactions of fastidious and genetically-intractable bacterial organisms, especially the Rickettsiales. These methodologies include fluorescent labelling for microscopy, improved bacterial propagation techniques, high-throughput imaging assays and developing genetic tools.
  • Study fundamental aspects of the host-pathogen cell biology of Orientia tsutsugamushi with a particular focus on the peptidoglycan cell wall and its interaction with host cells, the intracellular infection cycle of the bacterium, and the mechanisms of virulence in hosts.
  • Initiate a comparative cell biology program on obligate intracellular Rickettsiales bacterium including R. typhi and Neorickettsia sennetsu.

Bioinformatics

  • Become a leader on integrating and analysing local, regional and global bioinformatics data with clinical data in neglected tropical infectious disease. Leveraging our large melioidosis, rickettsiosis and AMR/DRI networks.
  • Develop and evaluate how sequencing could be used on-site in LMICs. MORU will introduce Oxford Nanopore sequencing into our research projects to enable on-site sequencing in sites outside Bangkok, and investigate its utility in diagnostics and AMR investigation in real- time
  • Build local bioinformatics and genomics capacity through training lectures and workshops.
  • Study the highly complex and repetitive genome and the population genomics of Orientia  tsutsugamushi and Burkholderia pseudomallei, and their genome dynamics over time.
Areeya Faosap loads blood culture bottles at the MORU Microbiology BSL2 Melioid lab in Ubon Ratchathani© 2019 MORU. Photographer: Gerhard Jørén. Areeya Faosap loads blood culture bottles at the MORU Microbiology BSL2 Melioid lab in Ubon Ratchathani