By: Ada Chong
January 2023
Latania Logan, MD, MSPH is a new faculty member who joined the Emory Department of Pediatrics in August 2022 after moving from Chicago. Her research looks at understanding the mechanisms of resistance of gram-negative bacterial pathogens, the impact on the environment and effects of antimicrobial pressure, while combining these concepts with the clinical and molecular epidemiology to directly impact the care of children.
Dr. Logan researches why certain bacteria such as E. coli has become more drug resistant in children and young adults. She found that even though healthcare facilities are doing better with decreasing spread of these resistant bacteria in the hospital, the bacteria are still increasing in the community. Dr. Logan says the kids she studied had drug resistant bacteria even though they weren’t exposed to antibiotics and weren’t previously hospitalized, so she wanted to learn where in the community the kids were acquiring these bacteria.
During this research process, Dr. Logan and her team collected bacterial isolates from children and looked at it from a molecular perspective so they could see what makes bacteria resistant and what makes it spread. Children and young adults from ages 0 to 21-years-old and over 1,000 people were studied. They looked at the children’s risk factors for getting infections after looking at the characteristics of the bacteria. The team compared findings in children who had and didn’t have antibiotic resistant infections to understand the differences in the Chicago population. Dr. Logan looked at different geographic areas and found there were areas in Chicago that people were more likely to have antibiotic-resistant bacteria. She found a region in Chicago where children had a five times higher risk of having a drug-resistant infection compared to a reference region. There was another area that had an 80-90% decreased risk in the region that’s on the opposite side of town from the low-risk region. Dr. Logan and her team geocoded areas to see where these children with the antibiotic-resistant bacterial infections were living. She learned there were waterways near the areas where children were more likely to get antibiotic resistant infections. She sampled waterways where people could and couldn’t use the water for limited contact recreational activities, such as kayaking and canoeing and found that the antibiotic-resistant bacteria in the waterways people could and could not use were about 97% similar even though the waterways don’t connect. Dr. Logan says the bacteria could be brought to the waterway by different exposures such as animals, agriculture or wastewater. The next stage of her study is to focus on community reservoirs that could be contributing to the increased risk of drug-resistant bacteria in these healthy populations and to start looking at households in high-risk regions of Chicago and in other metropolitan areas to understand risk factors for having these bacteria in the household environment and among household members.
The top goals for this research is prevention of drug-resistant infections in healthy populations, understanding what are the characteristics of the bacteria that are affecting children and healthy populations, and understanding mechanisms that cause resistance and in which populations are the bacteria more likely to spread than others. Dr. Logan uses the One Health approach so she can get a holistic view of the issue and learn about the different reservoirs of germs and populations that are exposed. It’s not only about the issue affecting humans, but how animals are also becoming carriers of the bacteria and how the environment is getting contaminated with the bacteria. Dr. Logan says it’s important to think about the linkages within this transmission pathway.
In the future, Dr. Logan hopes to study antibiotic-resistant bacteria in the Atlanta population and other major metropolitan areas. These drug-resistant infections are also common in Atlanta. She says there’s opportunities to look at healthcare facilities that take care of a lot of patients with these infections and to look at other settings that might be contributing to transmission among healthy populations such as daycares and schools. Dr. Logan plans to start this research with pilot geocoding and epidemiological studies to see if what she finds in Atlanta is similar to Chicago.
Dr. Logan was inspired to do this research because she realized public health is so much more than just infectious diseases. She says there’s a lot of work on antibiotic-resistant bacteria done in hospitals, but not in the community. This inspired her because she enjoys community-based work so she can help all people and improve health outcomes. The area with high risk in Chicago has lower socioeconomic status neighborhoods compared to the areas of low risk in Chicago, and therefore they don’t have the same resources, so it drives Dr. Logan to have the chance to help these underserved populations. This is a way for her to satisfy her desire to serve from a personal, clinical and research perspective.