Prevention Epicenter of Emory and Collaborating Healthcare Facilities (PEACH II)

我们建议的研究针对多重耐药引起的医疗保健相关感染 生物体(MDRO)横跨医疗保健领域，从院前舞台到急性短期 虽然有长期护理设施。我们有能力从事最大规模的研究活动 使用Emory的临床数据仓库在亚特兰大大都市区建立的医疗保健系统 研究与多个州的疗养院网络联系在一起，并与 其他预防中心，佐治亚州新发感染计划和佐治亚州卫生部 健康。桃子调查人员在MDRO中获得国家认可，并为预防 过去的震中任务。桃子II将推进跨学科研究，包括 人因工程学、微生物群与环境生态学、信息学转化 中断努力，在不同的环境中。我们建议推进预防 Eicenter的研究使命通过(1)与广泛的Emory和合作伙伴研究所进行接触 具有为震中工作做出贡献的专业知识的科学家，(2)合作观察和临床 试验包括研究进行、数据使用协议、伦理批准和实验室实践，由 利用医疗保健领域中不同的(包括服务不足的)患者群体 频谱，以及(3)扩大与其他预防中心和新出现的感染的合作 计划站点。为达致后一项目标，我们提出四项核心计划：核心计划1：参与处方 -住院提供者抗菌率基准，以减少不必要的预筛选；T1：在急性护理中 环境，管理的优先领域，减少AR感染；核心项目2：公平-临床试验 粪便微生物群移植治疗住院患者的抗生素耐药感染；T1-在急性护理环境中， 优先领域：减少AR感染、了解和减少传播(源头控制、 环境)、区域控制、医疗保健中的流行病学重要病原体、无症状 殖民与微生物群；核心项目3：预警--预测可能被殖民的入院人数 使用抗生素耐药细菌触发检测和分离；T-1：急性护理和急性后护理， AR区域控制的优先领域；创新的检测和响应；核心项目4：冠军- 急性后护理中预防感染的人因因素和微生物学协作性方法；T1： 在长期护理方面，优先领域：减少AR感染。了解和减少传播- 环境；区域控制和长期护理设施。其他可选协作项目 围绕手部卫生有效性的目标创新多种急性护理环境，遏制 长期急诊护理疗养院急诊抵抗力与改善脓毒症管理 多个院前环境。

Our proposed research addresses healthcare-associated infections caused by multidrug-resistant organisms (MDROs) across the healthcare spectrum from pre-hospital arena, into acute short-term though long-term care facilities. We have capacity to engage in research activities at the largest healthcare system in the Atlanta metropolitan area using Emory’s Clinical Data Warehouse, established research ties to a multi-state network of nursing homes, and long-standing research collaborations with other Prevention Epicenters, the Georgia Emerging Infections Program and Georgia Department of Health. PEACH investigators have national recognition in MDROs and have contributed to the Prevention Epicenters mission in the past. PEACH II will be advancing transdisciplinary research incorporating human factors engineering, microbiome and environmental ecology, and informatics into transmission interruption efforts, in a diverse spectrum of settings. We propose to advance the Prevention Epicenter’s research mission through (1) engagement with a broad range of Emory and partner institute scientists with expertise to contribute to Epicenter work, (2) collaborative observational and clinical trials including study conduct, data use agreements, ethics approvals, and laboratory practices by leveraging access to diverse (including underserved) patient populations across the healthcare spectrum, and (3) expand collaborations with other Prevention Epicenters and Emerging Infections Programs sites. Towards this latter aim, we are proposing four Core Projects: Core Project 1: InPART Rx - Inpatient Provider Antibiotic Rate Benchmarking to Reduce Unnecessary Prescribing; T1: in Acute Care settings, Priority Areas of Stewardship, decreasing AR infections; Core Project 2: FAIR – A clinical trial of Fecal Microbiota Transplant for Antibiotic-Resistant Infections in Inpatients; T1 – in Acute Care settings, Priority Areas: Decreasing AR infections, Understanding and decreasing transmission (source control, environment), Regional control, Epidemiologically important pathogens in healthcare, Asymptomatic colonization, and Microbiome; CORE PROJECT 3: PRE-ALERT - Predicting Admissions Likely Colonized with Antibiotic Resistant Bacteria to Trigger Detection and Isolation; T-1: Acute care and Post-acute care, Priority Areas of Regional control of AR; Innovative detect and response; Core Project 4: CHAMPIONS – Collaborative Human Factors and Microbiology Approaches to Prevent Infections in Post-acute Care; T1: in Long-Term Care, Priority Areas: Decreasing AR infections. Understanding and decreasing transmission- environment; Regional control and long-term care facilities. Additional optional collaborative projects target innovations around hand hygiene effectiveness multiple acute care settings, containment of emergence resistance in long term acute care and nursing homes and improving sepsis management in multiple pre-hospital settings.