July 15, 2025
Research Scientist Dr. Emily Begnel receives early career award to study antimicrobial resistance and its effects on gut health and HIV exposure in children
Congratulations to Dr. Emily Begnel, Research Scientist with Global WACh, for receiving a Thrasher Research Fund Early Career Award to fund “The prevalence of antimicrobial resistance and effects on gut health among children who are HIV-exposed but uninfected.” The award funds early career investigators and their development towards independent research in child health. Dr. Begnel will conduct her research under the mentorship of Drs. Jennifer Slyker and Patricia Pavlinac (UW Global Health and Epidemiology), and collaborate with Dr. Ana Weil (UW School of Medicine) and the Weil Lab.
Antimicrobial resistance (AMR) is rising globally and threatens public health by decreasing effectiveness of antibiotics in treating infections. Children who are HIV-exposed receive the antibiotic cotrimoxazole to prevent a range of bacterial infections; however, there is concern that it may contribute to the development of AMR in these children. There is urgency to better understand the dynamics of AMR development and spread, particularly among children in low- and middle-income countries where AMR is prevalent. Pathogens can transfer resistance genes to the bacteria in the gut microbiome, potentially contributing to long-term AMR.
With support from this award, Dr. Begnel’s study will investigate whether HIV-exposed, but uninfected children (CHEU) receiving cotrimoxazole prophylaxis may have a heightened susceptibility to AMR compared to children who are HIV-unexposed and uninfected (CHU) with similar sociodemographic and health characteristics. Specimens collected from the Linda Kizazi study (a research collaboration with the University of Washington, University of Nairobi, Kenyatta National Hospital, Fred Hutchinson Cancer Center, Emory University, and University of Montreal) will be tested and compared for AMR genes and pathogenic gut bacteria.
The findings will provide Dr. Begnel and collaborators opportunities to develop future studies to further explore the association of pathogenic gut bacteria, AMR, and child morbidity and mortality. It will also be crucial in informing ongoing policy discussions about the balance between the benefits and costs of cotrimoxazole prophylaxis, especially considering the current landscape of improved maternal ART and child HIV testing. Cotrimoxazole may not have a substantial benefit to reduce morbidity and mortality among CHEU and instead could contribute to rising AMR at a population level. Data from these analyses will provide a foundation for larger follow-up studies that more comprehensively assess the mechanisms by which cotrimoxazole-associated antimicrobial resistance genes could affect health outcomes.