ANTIMICROBIAL RESISTANCE: BACTERIA, HIV, FUNGI
Starting with studies by a single investigator in the 1980's at the Cleveland VAMC, the Center for
Antimicrobial Resistance and Epidemiology (CARE) program has evolved to include five faculty in the VA Research Service in approximately 5,000 sq. ft of lab space.
The focus of research at the VA centers on the problems of antimicrobial resistance, bacterial pathogenesis, and mycobacteriology.
Dr. Louis Rice studies genetic factors in the transmission and expression of Vancomycin resistance in enterococci.
Robert Bonomo, M.D., studies structure-function relationships in beta-lactamases to determine specific sites responsible for specificity of resistance.
Curtis Donskey, M.D., is studying interactions between intestinal flora and vancomycin resistant enterococci and is engaged in clinical studies on mechanisms of VRE transmission in hospital setting. 
Non-VA collaborators include Mahmoud Ghannoum, Ph.D. of the Department of Dermatology at CWRU; who is studying the role of biofilm formation and gene expression on resistance of Candida spp. to antifungals and Eric Arts, M.D. (CFAR/Infectious Diseases), who studies anti-retroviral resistance of HIV.
In the last few years, the CARE center has also established productive collaborations with the Departments of Biochemistry (Paul Carey, Ph.D.) and Biophysics (Frank Sönnichsen, Ph.D.) for guidance in the biophysical resolution of beta lactamase structure. Recently, Marion Helfand, M.D., Ph.D. (a current trainee of this grant) was awarded a VA Career Development Award and is now promoted to a faculty position in the CARE. Her studies will continue to address basic structural biology of beta lactamases, including studies on determinants of resistance to extended spectrum cephalosporins or resistance to beta-lactamase inhibitors. Recognizing that antimicrobial resistance is a world-wide problem, the CARE has developed international collaborations with researchers in Switzerland, Finland and Uganda.
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