See PubMed or Google Scholar for recent publications.

Spillover of antibiotic resistance at the human-food animal interface

A major interest of the lab is the impact of antibiotic use in food animals on the selection and spread of resistant pathogens to humans. Previously, Dr. Nadimpalli has examined spill-over of pig-origin, multidrug-resistant Staph aureus to food production workers and their household members in North Carolina. More recently, the lab has been exploring the circular transmission of multidrug-resistant Enterobacteriaceae (and the mobile resistance elements they harbor) between humans and animals in middle-income countries, where intensive animal production that relies on routine antibiotic use is expanding:

  • Nadimpalli ML, Pickering AJ. A call for global monitoring of WASH in wet markets. Lancet Planet Health. 2020 Oct;4(10):e439-e440. [link]

  • Nadimpalli ML, Stegger M, Viau R, et al. Leakiness at the human-animal interface in Southeast Asia and implications for the spread of antibiotic resistance. bioRxiv. [link]

  • Nadimpalli M, Yith V, de Lauzanne A, et al. Meat and fish as sources of extended-spectrum B-lactamase-producing Escherichia coli, Cambodia. Emerg Infect Dis 2019; 25(1). [link]

  • Nadimpalli M, Delarocque-Astagneau E, Love DC, et al. Combating Global Antibiotic Resistance: Emerging One Health Concerns in Lower and Middle-Income Countries (Editor's Choice). Clin Infect Dis. 2018;66(6):963-969. doi:10.1093/cid/cix879. [link]

  • Nadimpalli ML, Stewart JR, Pierce E, et al. Face mask use and persistence of livestock-associated Staphylococcus aureus nasal carriage among industrial hog operation workers and household contacts, USA. Environ Health Perspect 2018;126(12). [link]

Role of the gut microbiome in conferring protection against multidrug-resistant pathogens

Currently, we are exploring how differences in the gut microbiome might underlie children's differential susceptibility to gut-colonization with multidrug-resistant pathogens that are otherwise widely present in low-resource settings, including in contaminated food, drinking water, and household soil. We are especially interested in the role that breastfeeding and human milk could play in preventing the establishment, proliferation, and/or selection of antimicrobial-resistant bacteria among young children via modifications to the gut environment, a relatively unexplored topic:

  • Nadimpalli M, Lanza VF, et al. Drinking water chlorination has minor effects on the intestinal flora and resistomes of Bangladeshi children. Nat Microbiol. 2022; 7, 620–629 . [link]

  • Nadimpalli M, Bourke CD, et al. Can breastfeeding protect against antimicrobial resistance? BMC Med 2020; 18: 392. [link]

Antibiotic resistance and inequality

The most vulnerable groups in our society - including racial and ethnic minorities and the economically disadvantaged - might also be most at risk of exposure to drug-resistant pathogens. Global changes in climate, urbanization, food production, and income inequality could worsen disparities unless we begin to identify and address them now. We are interested in working with clinicians, spatial scientists, and wastewater surveillance experts to explore the scale, scope, and underlying factors driving racial and ethnic disparities in community-acquired, drug-resistant infections in the United States and globally:

  • Nadimpalli M, Chan C, Doron S. Antibiotic resistance: A call to action to prevent the next epidemic of inequality. Nat Med. 2021 Feb;27(2):187-188. [link]

  • Nadimpalli ML, Marks S, Montealegre MC, et al. Urban informal settlements as hotspots of antimicrobial resistance and the need to curb environmental transmission. Nat Microbiol. 2020;5, 787–795. doi: [link]. Editorial titled "Antimicrobial resistance in the age of COVID-19" about this publication: [link]

The above infographics were designed by Dr. Nadimpalli and Madeline Verbica, curriculum illustrator for Great Diseases. You can find detailed summaries (including refs) here.