WASHINGTON UNIVERSITY AND BJC EPI-CENTER FOR PREVENTION OF HEALTHCARE ASSOCIATED

华盛顿大学和 BJC EPI-中心预防医疗保健协会

• 批准号: 8178885
• 负责人: Victoria J. Fraser
• 金额: $ 39.99万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-01 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8178885
• 关键词: WASHINGTON; UNIVERSITY; BJC; EPI; CENTER

DESCRIPTION (provided by applicant): The objective of the current Epicenter initiative is to establish a network of academic investigators to translate basic, epidemiologic and technologic discoveries into new strategies to prevent hospital-acquired infections (HAI) and antimicrobial resistance (AR). The WU /BJC Epicenter is internationally recognized for research productivity and leadership preventing HAI and AR. WU has outstanding research infrastructure and perennially ranks in the top 5 medical centers in the U.S. BJC is a 13 hospital integrated healthcare delivery system with long term care facilities, outpatient clinics, and physician practices connected with shared electronic medical records, clinical data repositories and billing systems. BJC includes two "top 10" hospitals, Barnes-Jewish Hospital and St. Louis Children's Hospital, which are both NHSN hospitals and 11 acute care hospitals including large and small, suburban and rural hospitals which are joining NHSN. The BJC Infection Prevention and Epidemiology Consortium uses standardized surveillance, data analysis, policies and procedures in all 13 hospitals. We have the necessary infrastructure to participate in the next Epicenter Program. We organized a team of basic, translational and clinical investigators with expertise in infectious disease, healthcare epidemiology, microbiology, critical care and basic science to work together to perform TO, T1 and T2 studies to discover and test new methods to prevent HAI and AR. We set broad goals focused on developing and evaluating novel strategies to reduce central line-associated blood stream infections (CLABSI), ventilator-associated pneumonia (VAP), Clostridium difficile infections (CDI) and catheter-associated urinary tract infections (CAUTI). To achieve these goals, we propose the following Specific Aims: 1. Develop, Implement and Evaluate a Central Line Care "Maintenance Bundle" to Reduce Central Line- Associated Blood Stream Infections (CLABSI) Outside ICU Settings. 2. Determine if Use of the Probiotic, Lactobacillus Rhamnosus GG Can Reduce Ventilator-Associated tracheobronchitis (VAT), Ventilator-Associated Pneumonia (VAP) and Colonization with Antimicrobial Resistant (AR) Bacteria in High Risk Patients. 3. Determine if Use of Primary Prophylaxis with Once Daily, Low Dose Oral Fidaxomicin Can Decrease C. difficile Acquisition and C. difficile Infection (CDI) Incidence in High Risk Patients. 4. Conduct First-in-Human Studies to Document the Natural History of Bacterial Biofilm Biomarkers in Patients with Urinary Catheters and Compare Biomarker Profiles in Catheterized Patients with Negative Urine Cultures, Asymptomatic Bacteriuria and Symptomatic Urinary Tract Infections. New knowledge, products and tools will result from the research proposed in these aims. This knowledge will be able to be translated into practice and used to prevent HAI in diverse healthcare settings across the U.S. Preventing HAI and AR will reduce morbidity and mortality and reduce costs for hospitalized patients.

描述（由申请人提供）：当前Epicenter计划的目标是建立 一个学术研究者网络，将基础、流行病学和技术发现转化为预防医院获得性感染（HAI）和抗菌素耐药性（AR）的新策略。WU /BJC Epicenter在预防HAI和AR的研究生产力和领导力方面得到国际认可。WU拥有出色的研究基础设施，长期位居美国前5名医疗中心BJC是一个包含13家医院的综合医疗保健提供系统，拥有长期护理设施、门诊诊所和与共享电子医疗记录、临床数据存储库相连的医生诊所和计费系统。BJC包括两个“前10名”医院，巴恩斯犹太医院和圣路易斯儿童医院，这两个医院都是NHSN医院和11个急性护理医院，包括大型和小型，郊区和农村医院加入NHSN。BJC感染预防和流行病学联盟在所有13家医院使用标准化的监测、数据分析、政策和程序。我们有必要的基础设施参与下一个Epicenter计划。我们组织了一个由基础、转化和临床研究人员组成的团队，他们具有传染病、医疗流行病学、微生物学、重症监护和基础科学方面的专业知识，共同开展TO、T1和T2研究，以发现和测试预防HAI和AR的新方法。我们设定了广泛的目标，重点是开发和评估新的策略，以减少中心静脉导管相关性血流感染（CLABSI），呼吸机相关性肺炎（VAP），艰难梭菌感染（CDI）和导管相关性尿路感染（CANTI）。为实现这些目标，我们提出以下具体目标： 1.制定、实施和评估中心静脉导管护理“维护包”，以减少ICU环境外的中心静脉导管相关血流感染（CLABSI）。 2.确定使用益生菌，鼠李糖乳杆菌GG是否可以减少高危患者的呼吸机相关性气管支气管炎（VAT），呼吸机相关性肺炎（VAP）和抗菌素耐药（AR）细菌的定植。 3.确定每日一次低剂量口服非达霉素的一级预防是否可以降低C。difficile Acquisition和C.高风险患者中艰难梭菌感染（CDI）的发生率。 4.进行首次人体研究，以记录导尿管患者中细菌生物膜生物标志物的自然史，并比较尿液培养阴性、无症状菌尿和症状性尿路感染的导尿管患者的生物标志物特征。 新的知识、产品和工具将产生于这些目标中提出的研究。这些知识将能够转化为实践，并用于在美国各地的不同医疗保健环境中预防HAI。预防HAI和AR将降低发病率和死亡率，并降低住院患者的费用。