The overall aim of GRACE is to combat antimicrobial resistance through integrating and strengthening centres of excellence for studying the application of genomics with primary care practitioners, to community-acquired lower respiratory tract infections (LRTI), which is the leading reason for seeking medical care and consuming antibiotics.
GRACE will develop into a “European Lower Respiratory Tract Infection Research Centre” to investigate and improve the bed-site management of community-acquired LRTI.
- To study major community-acquired Lower Respiratory Tract Infections (LRTI), which are the leading reasons for antibiotic prescribing.
- To study the role of “atypical” bacteria and viruses, including novel pathogens, in patients with community-acquired LRTI.
- To develop novel rapid genome based diagnostic tests for the detection of pathogens implicated in community-acquired LRTI.
- To establish a European repository of specimens and strains linked to a database including microbial and patient information.
- To assess risk factors for infection with resistant S. pneumoniae and H. influenzae in patients with community-acquired LRTI.
- To determine the relationship between the exposure to antibiotics at the individual and population level and resistance.
- To correlate antibiotic resistance, virulence characteristics and pneumococcal genotype to severity of community-acquired LRTI aiming to optimise future treatment and prevention strategies.
- To perform comparative pneumococcal genomics with micro-array technology with the aim of finding genes important for virulence and for antibiotic resistance development.
- To undertake a large scale genome wide screen for human susceptibility genes affecting severe community-acquired LRTI and thereby identify potential target pathways for new immunomodulatory approaches.
- To use human genomic data to devise the potential genetic risk profile for community-acquired LRTI and assess whether these polymorphisms identify individuals at risk of various presentations and outcomes of community-acquired LRTI in several European populations.
- To determine whether the human genetic risk factors identified in GRACE interact with each other or with key microbial genetic or other environmental risk factor for community-acquired LRTI.
- To describe current community-acquired LRTI management and analyse the determinants of antibiotic use in 10 to 15 primary care networks across the EU, using qualitative and quantitative approaches.
- To develop internationally agreed evidence-based definitions of the major community-acquired LRTI.
- To identify and develop appropriate clinical outcome measures for evaluating interventions.
- To develop clinical models to differentiate viral from bacterial infections and identify pneumonia.
- To develop clinical models to identify patients at risk for adverse outcomes including severe and prolonged illness.
- In a placebo controlled trial, to assess the effectiveness of antibiotics among patients with community-acquired LRTI in order to fill the current gap in evidence about which subgroups selectively benefit from antibiotic treatment, and which subgroups do not benefit.
- To develop and assess a practice based intervention using the novel data generated from the network in reducing inappropriate antibiotic use in patients with community-acquired LRTI and explore the effect on antibiotic resistance.
- To model the cost-effectiveness of the management strategies developed in the observational studies.
- To conduct economic evaluations in parallel with the intervention studies.
- To model the macroeconomic impact of antibiotic resistance and policies to contain resistance.
- To conduct economic evaluations of molecular diagnostics.
- To contribute information aimed at increasing awareness among the public and policy makers of the importance, economic impact and threat of antimicrobial resistance.
- To develop education and training support to disseminate awareness and knowledge relevant to antibiotic resistance and its control.
- To develop educational packages including web-based resources and workshops to inform postgraduate lifelong learning needs of prescribing professionals.