Applied Research on Antimicrobial Ressitance

这项应用的总体目的是支持调查抗微生物耐药性成本的研究。长期目标：确定金黄色葡萄球菌引起的手术部位感染和血流感染的抗菌药耐药性的归属成本，以便研究人员能够评估预防这些耐药病原体引起的手术部位感染(SSI)和血流感染(BSI)的拟议方法的成本效益。 具体目标：i)确定甲氧西林耐药性对手术部位感染和金黄色葡萄球菌引起的血流感染的经济成本的可归因性影响。2)了解美国东南部几家医院耐甲氧西林金黄色葡萄球菌(MRSA)手术部位感染和医院血流感染的发生率和流行率。 方法：该项目将利用10家研究医院和一个感染控制基础设施，其中包括3名内科流行病学家和20多名感染控制从业者。由金黄色葡萄球菌和SSI引起的医院血流感染患者目前是通过前瞻性监测确定的，并且已经并将继续被前瞻性地输入研究医院的电子数据库。其他研究数据将从患者图表和医院数据库中获得。对于SSI的研究，SSI患者应该 对耐甲氧西林金黄色葡萄球菌的耐甲氧西林金黄色葡萄球菌将作为病例进行研究，并将其与甲氧西林敏感金黄色葡萄球菌(MSSA)引起的SSI患者和接受手术的未感染的对照组患者进行比较。对于血液感染患者的研究，将以MRSA引起的BSI患者为例进行研究，并将其与MSSA导致的BSI患者和未感染的对照组患者进行比较。

The overall purpose of this application is to support research investigating the costs of anti-microbial resistance. Long-term objective: To define the attributable cost of antimicrobial resistance for surgical site infections and bloodstream infections due to Staphylococcus aureus, so that investigators will be able to evaluate the cost effectiveness of proposed methods for the prevention of surgical site infections (SSI) and bloodstream infections (BSI) due to these resistant pathogens. Specific aims: i) To define the attributable impact of methicillin resistance upon economic costs of surgical site infections and bloodstream infections due to S. aureus. 2) To define the incidence and prevalence of surgical site infections and nosocomial bloodstream infections due to methicillin resistant S. aureus (MRSA) in a group of hospitals in the southeastern United States. Methods: The project will utilize 10 study hospitals and an infection control infrastructure that includes 3 physician epidemiologists and over 20 infection control practitioners. Patients with nosocomial bloodstream infections due to S. aureus and SSI are currently identified through prospective surveillance and have been and will continue to be prospectively entered into electronic databases at study hospitals. Additional study data will be obtained from patient charts and hospital databases. For the study of SSI, patients with SSI due to MRSA will be studied as cases and will be compared to patients with SSI due to methicillin susceptible S. aureus (MSSA) and to uninfected control patients who have undergone surgical procedures. For the study of patients with bloodstream infections, patients with BSI due to MRSA will be studied as cases and will be compared to patients with BSI due to MSSA and to uninfected control patients.