Chicago Prevention and Intervention Epicenter II (CPIE-II)

C-PIE II摘要 多药耐药菌(MDRO)是与医疗保健相关的越来越常见的原因 感染，使治疗复杂化，并导致发病率、死亡率和成本增加。这个 芝加哥预防和震中II(C-PIE II)已经开发了一系列研究项目来研究 从个人层面研究和预防关键HAI问题，即由MDRO引起的问题 重症监护病房到整个医疗机构(长期急性护理医院)到该地区(芝加哥， 美国第三大城市)和州(伊利诺伊州，人口1300万)。我们的建议范围包括 开展调查以改进我们开创的基本感染控制干预措施，例如 洗必泰(CHG)沐浴，研究采用最先进的分子诊断方法 技术，例如细菌全基因组测序和微生物组分析，以及尖端技术 信息学和分析方法，如自动警报和社交网络分析。我们将进行 我们的工作在复杂的现有基础设施内进行，该基础设施具有强大的公共卫生和学术合作 合伙企业。这些拟议的活动包括我们的核心项目和多中心协作项目 提案。 核心项目：我们将继续评估研究流行性感冒流行病学和控制的新方法 碳青霉烯类耐药肠杆菌科，通过以下途径优化抗菌药物管理干预 人种学评估，并评估替代的鼻部非殖民化战略对 耐甲氧西林金黄色葡萄球菌对抗生素和防腐剂的敏感性发生的可能性 我们计划在以下领域使用协调、协作的方法，从而提高调查的成功率 许多医疗机构类型、公共卫生机构和学术机构。 多中心项目：我们提出了一个大型协作项目(Marimba)，它将测试 假设特定宿主因素、临床护理暴露和肠道微生物区系改变相关 肠道多药耐药菌的定植风险增加。我们提出了一个中型合作伙伴 项目(DataMAP-AU)，以促进可在全国范围内扩展的基础设施，以促进和 对抗菌药物管理干预措施最具信息量的抗菌药物使用指标进行标准化。 我们提出了一个小型协作项目(CheckUp)，以更好地了解CHG皮肤的最佳使用 杀菌以减少MDRO对患者的侵袭。总体而言，我们希望我们的工作能够填补 与MDRO引起的禽流感的流行病学和预防有关的知识，并促进 感染预防科学。

C-PIE II ABSTRACT Multidrug-resistant organisms (MDROs) are increasingly common causes of healthcare-associated infections (HAIs), complicating treatment and leading to increased morbidity, mortality and cost. The Chicago Prevention and Epicenter II (C-PIE II) has developed a portfolio of research projects to study the epidemiology and prevention of key HAI problems, i.e. those caused by MDROs, from the level of individual intensive care units to entire healthcare facilities (long-term acute care hospitals) to the region (Chicago, the third largest city in the nation) and to the state (Illinois, population 13 million). Our proposals range from investigations to improve basic infection control interventions that we have pioneered, such as chlorhexidine gluconate (CHG) bathing, to research that employs the most advanced molecular diagnostic techniques, e.g. bacterial whole genome sequencing and microbiome analysis, and cutting-edge informatics and analytic methods, such as automated alerts and social network analysis. We will conduct our work within a sophisticated existing infrastructure of strong collaborative public health and academic partnerships. These proposed activities comprise our Core Project and Multicenter Collaborative Project proposals. Core Project: We will continue to evaluate novel methods to study the epidemiology and control of carbapenem-resistant Enterobacteriaceae, to optimize antimicrobial stewardship interventions through ethnographic evaluation, and to assess the effect of alternative nasal decolonization strategies on the susceptibility of methicillin-resistant Staphylococcus aureus to antibiotics and antiseptics. The likelihood of success of our investigations is increased by our plan to use a coordinated, collaborative approach across many healthcare facility types, public health agencies, and academic institutions. Multicenter Projects: We propose a Large-sized Collaborative Project (MAriMbA) that will test the hypothesis that specific host factors, clinical care exposures, and gut microbiota alterations are associated with an increased risk of colonization by enteric MDROs. We propose a Medium-sized Collaborative Project (DataMAP-AU) to promote an infrastructure that can be expanded nationally to facilitate and standardize antimicrobial use metrics that are most informative for antimicrobial stewardship interventions. We propose a Small Collaborative Project (CHECkuP) to better understand the optimal use of CHG skin antisepsis to reduce patient colonization by MDROs. In total, we expect our work to fill critical gaps in knowledge related to the epidemiology and prevention of HAIs caused by MDROs, and to advance the science of infection prevention.