Federal Grant Award Summary

The University of North Carolina at Chapel Hill received a $741,051 Project Grant award from the National Institute of Allergy and Infectious Diseases (NIAID) under the Allergy and Infectious Diseases Research program (CFDA 93.855) effective July 1, 2026, through June 30, 2031. The research project, titled "From Tolerance to Resistance: Adaptive Pathways of Enterobacterales Persistence in the Gut Under Antibiotic Pressure," investigates how bacteria in the gastrointestinal tract of hematopoietic stem cell transplantation (HCT) patients develop antibiotic tolerance and subsequently acquire antimicrobial resistance (AMR), which contributes to bloodstream infection-related mortality in this patient population.

Under this award, UNC-Chapel Hill will conduct two primary research aims combining culture-based and genomic approaches across HCT patient cohorts. In Aim 1, researchers will selectively culture Escherichia coli and Klebsiella pneumoniae from patient stool samples and quantify tolerance levels using high-throughput screening and standardized time-kill assays across multiple antibiotics. In Aim 2, the team will identify genetic determinants of tolerance through stool metagenomic sequencing to map the molecular mechanisms driving bacterial persistence. The research addresses an urgent clinical gap by distinguishing antibiotic tolerance—a temporary survival mechanism distinct from genetic resistance—as a potential precursor to AMR, with implications for improving antimicrobial stewardship in immunocompromised populations.